HSE proposed pay cuts for junior doctors from February 18th...

ergo

OK, not sure if people are aware of this but am thinking you'll be hearing a bit more about it in the days and weeks to come.

and yes, I'm fully aware that a lot of people are losing their jobs around the country and any NCHD is lucky to have a job but these cuts seem to be off the scale (and unworkable in many cases)

and just to point out that for most trainees the training grant is fully used up paying for things like courses, exams and registration with the training body eg the Royal College of Physicians (€1,000 to register for example) or Surgeons so this money never directly went into NCHD's pockets but now will come out of their (reduced) wages


The IMO has been informed by the HSE that the following cutbacks will be enforced from February 18th: (cutbacks for NCHD's)

Training grant will be cancelled

Living out allowance cancelled

Higher degree allowance cancelled

Diploma allowance cancelled

Mandatory pre-call day off without any pay

Mandatory post-call day off without any pay

Mandatory one-hour unpaid lunchbreak each day

Interns to be restricted to 48hrs paid hours only from July 1st

Cutting in CORE BASIC pay (unspecified percentage)

Overtime to be cut from time-and-a-quarter for the first 15 hours to TIME ONLY

OT 1st 9 hours at Flat time 100% (not really OT at all)
Balance of hours at 125%


All this is on top of the income levy and the newly-announced pensions levy.....................



SUMMARY OF DIRECT COST PER NCHD
€3000 (living out allowance)
€1200-3,000 (diploma Degree allowance)
€450 PGMDB Money
€3,800 (Training Grant)

around €10,000 per person leaving aside the OT and all else
That is the money they directly plan to take from ALL NCHDS, for some NCHDS there will be another cost ie you will still be paying the various Royal colleges from your now after tax income

OT savings are individual but from what they have mentioned
5 Hours ( Lunch)
1-3 hours (training time not paid)
2.25 hours (change in OT from 125 down to 100%)

Thats minimum 8.25 hours per week per NCHD as well and a lot more if you do a lot of OT at 150%

Dr Galen

forgetting about any other sector of the employed, the one group of people that I'd want totally trained up are feckin doctors! This is pretty much madness. I don't think anyone realises just how badly this is going to hit things on the ground if its carried through on.

I'd talk to a lot of doctors day in and day out and the sense of impending despait among the lads and lasses is terrible. You know whats going to happen? They're all going to f**k off to somewhere we're they are actually appreciated and get a decent level of training etc.

RobFowl

All these benefits were fought for under very difficult conditions. The best option is to go to the UK,OZ ,USA or Canada where you'll get trained properly and be appreciated and not seen as an inconvenience.
Striking is not going to be popular but a work to rule should be considered seriously.

kelle

Do any cuts apply to Consultants, or is it just NCHD's?
It would appear the middle earners are targeted, and the higher earners untouched - typical of our government.
After witnessing a Registrar being verbally bullied by a Consultant last week (this I know is a regular occurence amongst NCHDs) along with these cuts, less and less LC students are going to consider Medicine as a career if they have any sense. I know for certain I will be steering my children away from it.

sportswear

im in final year in vincents.


The whole class is raging.

i cannot actually believe that they are going to expect us to work hours that we wont get paid for.

i hope there is industrial action

Vorsprung

Has anyone got a link to all this?

So if I'm working one in 6, I'm only gonna be working 4 days a week? What if a Reg and SHO are on call together - is the intern gonna run the show on his/her own for 2 days?

I'd love to know what percentage of the HSE's salary cuts are being taken up by NCHD's (who make up 5% of the HSE staff).

What are they going to say to all the mature students who they encouraged into 4 year spots? How are they gonna get their 48k investment in their future back?

How are doctors supposed to pay for expensive courses? Will teachers not be paid for in-service days now? Will nurses be forced to take annual leave for various courses? Like **** they will. (No disrepect to either group by the way) Watch the standard of healthcare in Ireland fall as less well trained medics climb the ladder a lot slower.

My plan was to go to Australia in July and come back for the BST interviews the following February. I may not bother coming back now.

Vorsprung

IMO to act over proposed pay cuts
Thursday, 5 February 2009 16:40

The Irish Medical Organisation says it will have no option but to call for industrial action by junior doctors if pay cuts being proposed by the HSE are implemented.

In a circular to junior doctors, seen by RTÉ News, the union says the HSE plans to introduce a 'devastating attack' on doctors' pay from 18 February.

This would include a mandatory one-hour unpaid meal break, cuts in overtime and a range of allowances.
Advertisement

Junior doctors who attend hospital courses or lectures will no longer be paid for this time, if the doctor is not available to the employer.

The IMO is to hold an emergency national meeting of its junior doctor members on 11 February in Dublin to discuss the issue.

It says that the cuts proposed are on top of the new pension levy, which itself will result in a deduction of between 6.4% and 8.5% from junior doctors' salaries.

In a letter to the IMO, the HSE says the measures are required in the challenging economic environment.

The HSE also says that the large increase in junior doctor numbers from 2,582 to over 4,600 since 1996, further supports the introduction of the cuts.

Link

Traumadoc

This is because they see NCHDs as the weakest link- they feel that you are so worried about your careers that you wont withdraw your labour.

redelephant

The training grant needed to go - it was a joke. Why should taxpayers pay for laptops, digital cameras and nights in 5 star hotels at conferences for NCHDs? I am ashamed to say I have 2 laptops + a PDA bought on the training grant, spent a night in the four seasons paid for with the grant and have boxes of unopened books bought to use up the training grant i was 'entitled' to.
If people have to pay themselves for course fees, exam fees etc it might improve the quality of these courses.

jonsnow

less and less LC students are going to consider Medicine as a career if they have any sense. I know for certain I will be steering my children away from it.[/quote]

yeah your right medicines points are going to crash through the floor :rolleyes:

Vorsprung

redelephant wrote: »

The training grant needed to go - it was a joke. Why should taxpayers pay for laptops, digital cameras and nights in 5 star hotels at conferences for NCHDs? I am ashamed to say I have 2 laptops + a PDA bought on the training grant, spent a night in the four seasons paid for with the grant and have boxes of unopened books bought to use up the training grant i was 'entitled' to.
If people have to pay themselves for course fees, exam fees etc it might improve the quality of these courses.

RCSI annual fees = about 3k
RCPI annual fees = about 2k

Factor in other courses, and that grant is being used up fairly quickly!

tallaght01

redelephant wrote: »

The training grant needed to go - it was a joke. Why should taxpayers pay for laptops, digital cameras and nights in 5 star hotels at conferences for NCHDs? I am ashamed to say I have 2 laptops + a PDA bought on the training grant, spent a night in the four seasons paid for with the grant and have boxes of unopened books bought to use up the training grant i was 'entitled' to.
If people have to pay themselves for course fees, exam fees etc it might improve the quality of these courses.

Well, frankly, you may well have misused your budget, then

I don't think that's a reason to take it away from other people.

The alternative is, I suppose, that the carious teams choose conferences etc that their juniors should go to during the year, or get the conference approved by the clinical director. Possibly also set a limit on overseas travel to attend conferences, and simply don't pay for some of the gatherings that are just ridiculously expensive. same goes for surgical skills courses etc. Get the hospitals to negotiate with providers. The cost of some of these things are just a pisstake.

DrIndy

This is a travesty. It will drive out many talented doctors.

What this is also is a paper exercise, the hours and the workload will not change one iota - however, we will simply not be paid for the post and pre call days we don't get off and the overtime we "should not be doing"

Don't forget ON TOP of this we are going to be facing an extra public service pension levy!

I have my plans well advanced for going to Australia with a Registrar job in ED waiting for me. I had a feeling since september the HSE was going to the dogs and as such prepared for this happening, but i am still flabbergasted at the extent of this.

The only people who will suffer are the irish population - all the doctors who are mobile without close family links will be very, very tempted to go and who will fill the ranks?

We should all refuse to pay the RCSI and RCPI levies - do they have plans to cut costs and staff like every other organisation is?

tallaght01

This happened to us in the UK for years.

When I was a paeds SHO over there, we didn't get jack all for education. Despite being on the paeds rotation, and doing ICU and A+E/acute care jobs I never got one penny in time off or a grant, even though I was entitled.

Most people did the courses on their time off, and paid for them.

I wasn't willing to do either, so I didn't even do APLS!!!

Not my problem,as far as I'm concerned.

panda100

bigjimthefirst wrote: »

What are they going to say to all the mature students who they encouraged into 4 year spots? How are they gonna get their 48k investment in their future back?
.

Very true, bad news for the mature students especially those with kids and familys.

Also havent the HSE cut the number of Intern positions since last June? With the increase in medical students through the graduate courses theres definatly not going to be enough intern places to go round.
F*ck maybe going back to med aint such a good idea!!

galway_girl

redelephant wrote: »

The training grant needed to go - it was a joke. Why should taxpayers pay for laptops, digital cameras and nights in 5 star hotels at conferences for NCHDs? I am ashamed to say I have 2 laptops + a PDA bought on the training grant, spent a night in the four seasons paid for with the grant and have boxes of unopened books bought to use up the training grant i was 'entitled' to.
If people have to pay themselves for course fees, exam fees etc it might improve the quality of these courses.

REDELEPHANT - what a stupid and irresponsible comment to make on a public forum that anyone with access to a computer can read. Be assured that your comment will be used against us a group as we are in the run-up to industrial action. I, like the majority of NCHDs, did not abuse my grant and found it extremely difficult to even get it paid to me - I am still owed money which I am sure now I will not receive. However, it is the minority of cases like yourself that are used as examples by the media as part of anti-doctor propaganda. You're a disgrace and an embarassment to the profession and it will not be to defend people like yourself that we will pursue industrial action, it is to defend entitlements that ensure a high standard of post-grduate training in this country. Two further points - one, you are not required to use your training grant just because it is available and two, to falsely claim for courses/laptops/PDAs etc on the training grant is fraud.

mulletamoeba

Three things for NCHDs.
1. Join the IMO - you cannot participate in any industrial action unless you're in a union. fees are tax deductable.
2. Don't sign recently altered contract that some hospitals circulated if you have one (it does not guarantee training grant etc)
3. Prepare for industrial action. The fact is the NCHD is the workhorse of the health service. If we unite against the HSE ****s and defend our working conditions it will work. Think of skeleton weekend-style cover, no clinics, no elective surgery. The system cannot run as currently configured except on the backs of illegally overworked NCHDs. Industrial action would bvery quickly bring it to a head.

PS I have no problem contributing to national deficit problems providing it is proportionate to what everyone else is doing (ie. the pension levy etc.) NCHDs are being cynically targeted as they think we won't do anything about it. They could be right, a lot of doctors are total pussies about their conditions as they don't want to rock the boat. They will be proved wrong I think.

PPS Where is the consultant support now? They have their recently inflated salary scale. My guess is the IHCA stays silent, complicit with the HSE.

Dr Galen

galway_girl wrote: »

REDELEPHANT - what a stupid and irresponsible comment to make on a public forum that anyone with access to a computer can read. Be assured that your comment will be used against us a group as we are in the run-up to industrial action. I, like the majority of NCHDs, did not abuse my grant and found it extremely difficult to even get it paid to me - I am still owed money which I am sure now I will not receive. However, it is the minority of cases like yourself that are used as examples by the media as part of anti-doctor propaganda. You're a disgrace and an embarassment to the profession and it will not be to defend people like yourself that we will pursue industrial action, it is to defend entitlements that ensure a high standard of post-grduate training in this country. Two further points - one, you are not required to use your training grant just because it is available and two, to falsely claim for courses/laptops/PDAs etc on the training grant is fraud.

one would wonder about the truth behind this comment to be honest. Unless someone was already coming from a pretty monied background, i find it hard to compute how the grant could pay for all of that along with say RCSI fee's etc

Traumadoc

mulletamoeba wrote: »

PPS Where is the consultant support now? They have their recently inflated salary scale. My guess is the IHCA stays silent, complicit with the HSE.

Dont worry we are in the firing line too.:mad:

DrIndy

unless you are an intern, every SHO and Reg has RCPI or RCSI exam fees to pay or memebership charges.

The training grant is well used and appropriately in almost every way.

norrie rugger

bigjimthefirst wrote: »

Will nurses be forced to take annual leave for various courses? Like **** they will.

They already do in some cases

Svalbard

ergo wrote: »

The IMO has been informed by the HSE that the following cutbacks will be enforced from February 18th: (cutbacks for NCHD's)

Training grant will be cancelled

Living out allowance cancelled

Higher degree allowance cancelled

Diploma allowance cancelled

Mandatory pre-call day off without any pay

Mandatory post-call day off without any pay

Mandatory one-hour unpaid lunchbreak each day

Interns to be restricted to 48hrs paid hours only from July 1st

Cutting in CORE BASIC pay (unspecified percentage)

Overtime to be cut from time-and-a-quarter for the first 15 hours to TIME ONLY

OT 1st 9 hours at Flat time 100% (not really OT at all)
Balance of hours at 125%


All this is on top of the income levy and the newly-announced pensions levy.....................

This is only part of the memo sent to the IMO. the rest is as follows:

Rosters formulated 8am to 8pm
Hospitals to examine and eliminate unnecessary layers of on-call
Maximisation of on call off site where feasible
Cross cover across different specialities to be maximised
Full roll out of successfully concluded NIG pilots
Interns employed on 48 hour week from 1 July 2009

Ok, NCHDs are being attacked on 3 fronts - finances, training and working conditions.

1. Finances - The lesser of the 3 evils. The rest of the public sector (rightly or wrongly) are quite upset about the pension levy. If that was all NCHDs had to worry about I'd be popping open the champagne about now. Our pay is going to be savaged. The HSE, by doing this, obviously value the hospital cleaners more than the doctors.
What also gets my goat is, despite RTE getting to see the above document, thier reports continue to harp on about 'unpaid luchbreaks' - as if that was the most pressing issue!!!!

2. Training - No training grant + not being paid for hours spent at in house training + much less senior supervision + horrendous working conditions = the worst quality medical training in the western world. Training courses (ACLS,ATLS,PCLS) are ridiculously expensive as are exam and college fees. This on top of a massively reduced take-home pay.

3. Working Conditions - Personally, this is the worst consequence of what the HSE is proposing. We already work in appaling conditions which are just about bearable. We will now be chronically understaffed if the HSE's proposals are implemented. Pre and post-call day off (unpaid)!!!!! Take a service with 4 SHOs (I will be working in such a post this July). 1 person on call, 1 person post-call is at home, 1 person pre-call is at home the other 1 is on site. 2 SHOs working at any one time when there was once 4.
"Eliminate unnecessary layers of on-call" - this means what exactly? For example does it mean where once a Paeds SHO and Reg were on call, now its just the SHO?
"Maximisation of on call off site where feasible" - This is already happening to Psychiatry SHOs in Galway, where they are being paid off-site rates despite repeatedly telling management that the volume of work requires them to be on-site virtually all of the time.
All this means is that if someone attends an Irish hospital out of hours, or is an inpatient that requires medical/surgical review out of hours, they will either be seen by a junior with no senior back-up or will have to wait for the doctor to come from home or not be seen at all.
This coupled with poor standards of training impact even further on aptient care.
Its a highly stessful and untenable sitaution for Irish doctors with potentially fatal consequences for Irish citizens.

It really isn't an issue of being out of pocket for me, it is the proportion compared to other HSE workers, to the rest of the public service. We may not get much sympathy from those who have lost their jobs (understandably) but those same people had better hope they or their loved ones do not require hospitalisation after these changes are brought in. It is the erosoion of services and the awful conditions we will be expected to shoulder - understaffing, huge workloads and reduced access to senior supervision- that is really galling.

I'm the kind of person who likes to devise personal contingency plans in crises such as these (of course the plans dont always work out, but making them helps me control the rage I am currently feeling.)

This is how I will be proceeding:

If the cuts and dangerous changes to work practices are implemented I will support any ballot for industrial action.
The HSE may or may not decide to engage with the IMO.
Depending on this industrial action may ensue.
It may work, it may not.
If it doesn't I will resign from my training scheme and seek employment abroad. I never planned to emigrate, I don't like the idea of living far from my family, but if it comes to it I will.

Traumadoc

I think they are making such savage cuts in your pay so that when it inevitibly goes to negotiation they will roll back on a few cuts and make you guys look mean.
I really dont think it is even feasible: say you are running a surgical service with 4 SHOs doing a 1 in 4 now they want you to take a day off pre and post call so every 4 days you have 2 off.:rolleyes:

Watch the media spin on this. HSE pays for a lot of newspaper ads.

RobFowl

Traumadoc wrote: »

Watch the media spin on this. HSE pays for a lot of newspaper ads.

I think you've hit the nail there. Nothing in todays times, indo or examiner at all.
Waiting for the "fatcat docs want to be paid to eat lunch" headlines

mulletamoeba

who would work under such conditions? The standard of training will be a joke. The majority of decent NCHDs will leave. Those who are stuck for family reasons etc. will remain though even those may leave as they'll be unable to earn a decent living and be incapable of supportig a family etc. the standard of care, and of doctor providing it, will plummet.

DrIndy

I will also support industrial action - but we need to be careful. Doctors are regularily assaulted by the media and the spin will only be beginning.

In truth, there are only a small number of HSE staff who are regularily paid overtime. Lab Scientists, Physiotherapists, Radiographers and Doctors. The former 3 have a large retinue of specialised staff working across specialised disciplines and then condense into a small emergency service only on call and thus their on call rota is better (in major hospitals anyway). Doctors are nearly expected to provide a full diagnostic service on call as off call (bar most elective surgery - chemo is given as normal as is cardiology management as examples) This means due to tight service requirements, we have a tight on call rota and would regularily clock 80-100 hours per week (some dipping to a minimum of 60 and others hitting 120).

Most public servants do no overtime, but receive TOIL (Time off In Lieu) for hours worked - ie you do 6 hours overtime, you get a half day off instead. This applies to most staff in the allied health disciplines.

So the burden to cut "unneccesary" overtime falls the hardest on doctors. This is very reasonable to someone who has no idea of the work we do which includes most members of the HSE.

There is a gross misunderstanding of our work environment within the managerial structures of the HSE, instead they just see overtime sheets going in and payslips going out. Their only true interaction with us would be in A&E where they get a bad service like everyone else (due to understaffing) as most would opt for private insurance and private consultations. There is animosity within the senior ranks as although the managerial element controls the purse-strings of the hospital, they have no actual say in the dispensation of the majority of the funds as this is controlled by the clinical directors who are consultants and have a higher salary than CEO's.

I was chatting to a non-clinical staff member from my old medical school (i popped in to get some documentation sorted) and she commented on a case of a students who left her intern year half way through because she could not cope with on call. The comment on the doctor was "she should have known what she got herself into" "everyone else manages on call". This is the pervasive attitude in the HSE - that when we are on call, we spend most of our night in bed and review the occasional patient - the truth is anything but. When i did medical call last year for the entire year - I slept 30-60 minutes per shift. I was on a 1 in 9 rota. My reg would relieve me for that time - I always arranged that myself so that the senior was more alert on the post call round.

With the increase in service requirements due to more specialised treatments, on call is busier and busier, admission rates are higher and case complexity much greater. People are living longer due to a cocktail of drugs and complicated surgery. No longer are people coming in with pneumonia, they arrive with that, heart failure, kidney failure and the antibiotics you start them on interact with all their other tablets and throw everything out of whack. Finally they get MRSA or C. Diff and stay for another 2 weeks in hospital. Then there is no convalesence, nursing homes or any other form of home care package to support the relatives who truly love the patient and want them home, but totally cannot cope.

Here we actually need an increase in service provision so that TRAINING can occur and junior and middle ranking staff become better at their jobs at look after people much better.

The opposite will be the case.

I always had a bad feeling that things were going to go hell in Irish Medicine right from July - but this is spectacular.

I am emigrating and departing in May - off to Oz where the weather is warmer and i have time to care for people rather than firefight the chaos back.

Join me.

Traumadoc

It would be interesting to see what would happen if the NCHDs agreed to this work plan - and have a "work to rule" refuse to work any hours in excess.


They will need a lot of locums to fill the service gaps ( obstetrics for example).

NCHD

Thanks Ergo for the post

please check

http://sites.google.com/site/hsecutbacks/

You will find the HSE/IMO letters decribing the cuts.

NCHD

Vorsprung

mulletamoeba wrote: »

PS I have no problem contributing to national deficit problems providing it is proportionate to what everyone else is doing (ie. the pension levy etc.) NCHDs are being cynically targeted as they think we won't do anything about it. They could be right, a lot of doctors are total pussies about their conditions as they don't want to rock the boat. They will be proved wrong I think.

Amen to that

NUIG Girl

Does anyone know if we are still going to get annual leave or are they going to tell us when we have to take our leave??

I am living for my 2 weeks off in May !! Ill have a beakdown if I dont get it:P

Svalbard

The content of Sean McGrath's letter will clearly drastically reduce our wages far out of proportion to other public sector workers (including consultants) as well as cause a deterioration in already pretty bad working conditions.

On a personal note, I find the tone of the letter insulting. It is carefully worded to make it seem as if all proposed cuts are reasonable and we would be greedy to want to hold on to what we have. The great HSE propaganda machine once again rears its ugly head.

The part about discontinuing the training grant but still maintaining a high level of training, which will be figured out at some point in the future, is laughable.

Like most doctors I would welcome a reduction in the hours worked but we all know there are insufficient staff and too much in-built inefficiency in the health service to make this possible now or in the near future. What will happen is quality of service will drop and the people on the ground will be expected to take enormous strain on a daily basis due to increased workload.

The HSE is counting on the public being against the doctors if it comes to industrial action and they may well be right. We must be prepared for this by at all times being honest and transparent and not sinking to HSE-style propagandising. At the end of the day, we must fight this attack on our profession regardless of how the HSE uses the media to make us look.

tallaght01

So, are you going to go for industrial action. You'll get balls-all support for loosing the living out allowance, say, but the core rate reduction will help, aswell as the flat rate for overtime.

But I think the public would be more angry if they knew the training grant was going.

"Dr Thunder" from the boards blog received an email from the irish mail on sunday a few months ago, asking to keep them in the loop if there were any health stories that the public should be aware of.

Dr Thunder has never been inclined to take up the offer, except for today when he emailed them back asking for some media coverage of this issue

But i think the NCHDs need to grow a pair and work to rule. Total disaster for the govt if you guys hit the pickets.

ZYX

I think you have to remember that most of these allowances were brought in during the last 15 years. As were the very large increases in take home pay for NCHDs. NCHDs are now high earners compared to the national average. Public sympathy will be very thin on the ground if you strike.

Vorsprung

tallaght01 wrote: »

But i think the NCHDs need to grow a pair and work to rule. Total disaster for the govt if you guys hit the pickets.

But what is work to rule for a doctor?

Svalbard

Do we need public sympathy?

Vorsprung

Svalbard wrote: »

Do we need public sympathy?

If the HSE actually knew what doctors do that would be a start.

Kristopherus

Wow!!! One would think that ye were all earning just over the dole rate. Back in the late seventies, the IMO got the DOH to capitulate to a claim for overtime by NCHDs. This has built up over the years to include the addition of a raft of allowances. Most NCHDs earn 60k to 100k pa. And didnt a group of NCHDs bring a case against the HSE to prevent them implementing the EWTD:D A case against reducing working hours ! And you expect us to take you seriously Get a life ffs.

Dr Galen

Kristopherus wrote: »

And you expect us to take you seriously Get a life ffs.

ditto......

Svalbard

Kristopherus wrote: »

And you expect us to take you seriously.

I have been pondering this too. Do we need 'you' (the public) to support us? If we do we may as well not bother protesting these cuts as we will not get much sympathy. We are seen as privileged professionals with a good earning potential (despite what we're earning now- I don't earn 60-100k per annum or anywhere near that amount) and job security. Can we reasonably expect the public to understand the devastating effect these cuts will have on medical training and the provision of services in this country?
Machiavellian as it might seem we may need to forge ahead with industrial action regardless of public support.

Traumadoc

Is it better to be loved (nurses) or feared ( esb workers) when it comes to industrial action?

Dr Galen

people really don't love us anymore Traumadoc. those days are gone, but does it bother most of us........no....not really. we still go in, do what we have to do with our patients, same as we mostly always have and don't expect or get any special praise for it.

as for the Doc's situation, i can only speak for myself, but if they decided to take a form of industrial action, and it was organised in a manner so as not to affect overall patient care I'd be wholly supportive of them

Star Trek

kelle wrote: »

Do any cuts apply to Consultants, or is it just NCHD's?
It would appear the middle earners are targeted, and the higher earners untouched - typical of our government.

After witnessing a registrar being verbally bullied by a Consultant last week (this I know is a regular occurrence amongst NCHDs) along with these cuts, less and less LC students are going to consider Medicine as a career if they have any sense. I know for certain I will be steering my children away from it.

The government won't dare target consultants because they have permanent jobs and their union is very strong. The same goes for nurses and midwives.The most vulnerable of the medical professionals are NCHDs. They are non permanent,a lot of them are foreigners and their extension of visas depend on their job status.The predatory government is looking for someone vulnerable to attack, which in this case is NCHDs.

Svalbard

Traumadoc wrote: »

Is it better to be loved (nurses) or feared ( esb workers) when it comes to industrial action?

I don't think nurses are loved by everyone. When they went on industrial action in early 2007 I think a lot of people were just fed up with them.
As for fear - I expect you mean the public might fear the effect industrial action by NCHDs would have. The last time NCHDs went on strike (was it 1997?) they were surprised that their absence had little effect on patient care. Certainly OPDs and elective theatre lists were cancelled, but there wasn't the huge crisis they envisioned. At the time the consultants did the work of the NCHDs.
I suppose if the action/strike goes on for long enough the knock-on effect to joe-public will become apparent.

mulletamoeba

if NCHDs cannot stand up for themselves on this issue, when everything from their income, to their training to their work quality to the level of care they are allowed to provide for their patients is being destroyed, they have no balls whatsoever. Taking to some medics in the nw hospital where i work they seem incredibly laissez-faire, like lemmings before they fall walk blithely off the cliff. These are family men, many with families to support, mortgages to pay and training needed. If these changes are introduced and last a while they will be next to impossible to reverse. They must be stopped at source with unified industrial action. Public support is irrelevant, the cause is a just one, both for the doctors and the patients they care for. If you can't stand up for yourself faced with this cataclysm, you are pathetic and deserve what you get.

Medicine as a profession in ireland is finished if this happens.

I won't be hanging around to see the mess that ensues if it does.

Svalbard

Star Trek wrote: »

The government won't dare target consultants because they have permanent jobs and their union is very strong. The same goes for nurses and midwives.The most vulnerable of the medical professionals are NCHDs. They are non permanent,a lot of them are foreigners and their extension of visas depend on their job status.The predatory government is looking for someone vulnerable to attack, which in this case is NCHDs.

I agree with most of what you said, except to say that consultants and NCHDs have the same union, the IMO. This could be a problem if the HSE try a tactic of "its them (the NCHDs) or you" with the consultants. Certainly there could be a conflict of interests within the IMO. What we really need is a separate union, but with the changes due to come in on the 18th, its not the best time to be splitting away from the IMO.

Thoie

Svalbard wrote: »

I have been pondering this too. Do we need 'you' (the public) to support us? If we do we may as well not bother protesting these cuts as we will not get much sympathy.

...


Can we reasonably expect the public to understand the devastating effect these cuts will have on medical training and the provision of services in this country?

As a non medical person, who has sympathy for NCHDs, there are a few things that will help garner sympathy from the public.


A few "week in the life of" posts/letters/journals. Nothing gets sympathy from lay people like "cleaned the vomit off myself at 2:30am, went to bed, got a bleep from ward X at 2:50am to go attend a woman who was blah blah blah". "Tried to examine a patient with history of heart problems, to discover there was no paper in the machine - spent 20 minutes frantically looking for paper."

When talking to the public, drop the "1 in 4", post-call, pre-call jargon. People not in the profession don't know what they are, and don't know if they're doctor speak for "playing Playstation" or "saving lives".

Don't discuss being paid or not paid for lunch time. Focus on the fact that you didn't get time for lunch/dinner today, and have survived solely on vending machine coffee for 12 hours.

Highlight cases where you recommended that a patient needed a certain amount of attention/care but they didn't get it because of lack of staff/cutbacks.

Highlight cases where patients got the care they needed, when they needed it, then point out that if there were only 50% of the doctors available, what might have happened.

Highlight the difficulties of examining A&E patients in hallways. The press seem to love stories about A&E patients in hallways.

tallaght01

mulletamoeba wrote: »

if NCHDs cannot stand up for themselves on this issue, when everything from their income, to their training to their work quality to the level of care they are allowed to provide for their patients is being destroyed, they have no balls whatsoever. Taking to some medics in the nw hospital where i work they seem incredibly laissez-faire, like lemmings before they fall walk blithely off the cliff. These are family men, many with families to support, mortgages to pay and training needed. If these changes are introduced and last a while they will be next to impossible to reverse. They must be stopped at source with unified industrial action. Public support is irrelevant, the cause is a just one, both for the doctors and the patients they care for. If you can't stand up for yourself faced with this cataclysm, you are pathetic and deserve what you get.

Medicine as a profession in ireland is finished if this happens.

I won't be hanging around to see the mess that ensues if it does.

Now THAT'S a pair of balls :P

Traumadoc

Svalbard wrote: »

The last time NCHDs went on strike (was it 1997?) they were surprised that their absence had little effect on patient care. Certainly OPDs and elective theatre lists were cancelled, but there wasn't the huge crisis they envisioned. At the time the consultants did the work of the NCHDs.
I suppose if the action/strike goes on for long enough the knock-on effect to joe-public will become apparent.

The last strike did not happen as the government agreed to nearly all the IMOs demands the night before the strike.

kindajaded

redelephant wrote: »

The training grant needed to go - it was a joke. Why should taxpayers pay for laptops, digital cameras and nights in 5 star hotels at conferences for NCHDs? I am ashamed to say I have 2 laptops + a PDA bought on the training grant, spent a night in the four seasons paid for with the grant and have boxes of unopened books bought to use up the training grant i was 'entitled' to.
If people have to pay themselves for course fees, exam fees etc it might improve the quality of these courses.

you are joking? this is fraud. i would hate to believe that many of my younger colleagues have been this dishonest. i graduated 10 years ago, before the days of large ovetime payments and, i think like most honest people, have only used the training grant when i needed it. last year i left a potential 6,000 euros unclaimed.
i wonder are you also one of those who has never bothered to pay union fees? let me tell you i am ready to cancel my imo fees, now 10 years of them running into thousands i have paid for the likes of you to take the p- out of what took so long to achieve. all i will lose out of the current hse plans is my last bit of md fees, why pay another few hundred for this? what the hse should have done long ago was root this kind of stuff out instead of seething over what we all know has been happening until the country was in such a state that they knew no one will have any sympathy for nchds and they could take the axe and punish everyone for the few who have been grossly dishonest.

drzhivago

ergo wrote: »

Training grant will be cancelled
Living out allowance cancelled
Higher degree allowance cancelled
Diploma allowance cancelled
Mandatory pre-call day off without any pay
Mandatory post-call day off without any pay
Mandatory one-hour unpaid lunchbreak each day
Interns to be restricted to 48hrs paid hours only from July 1st
Cutting in CORE BASIC pay (unspecified percentage)
Overtime to be cut from time-and-a-quarter for the first 15 hours to TIME ONLY
OT 1st 9 hours at Flat time 100% (not really OT at all)
Balance of hours at 125%
All this is on top of the income levy and the newly-announced pensions levy.....................
SUMMARY OF DIRECT COST PER NCHD
€3000 (living out allowance)
€1200-3,000 (diploma Degree allowance)
€450 PGMDB Money
€3,800 (Training Grant)

Some of this is incorrect
My understanding is a half day pre OR post call unpaid not full day pre and POST

The OT quote above is incorrect as well

Overall the financial effect will be devastating as will the effect on training

Not sure how I will survive to be honest, dont do lots of overtime but do rely on the allowances and training grant

Training grant no way near enough as is to cope with exam fees, recertifying life support, college courses, conferences, books etc

Dont think public will undertsand that though

The image they have of doctors is of a rich group

The term junior doctor to them means someone 1st year out of college, they dont get that it goes on for 16-17 years like that

drzhivago

Traumadoc wrote: »

The last strike did not happen as the government agreed to nearly all the IMOs demands the night before the strike.

Yes and no

Last strike was in Waterford in 2004 Actually just a local one

Last National strike was in 1987, I was a med student then, interesting times

in 1992 or 3 there was a threatened strike over MPS fees at the time and that was sorted

There was a threatened strike in 2000 and as traumadoc says the DOH offered docs most of what they were looking for, OT for 1st time ever, training grant for 1st time.

They have been annoyed b that ever since and have been trying to row back on it