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

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

Star Trek

Svalbard wrote: »

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.

They have a union actually, It's well known among consultants because it only prefers to look after consultants.


www.ihca.ie

The Irish Hospital Consultants Association

http://archives.tcm.ie/businesspost/2008/01/27/story29925.asp

Just to refresh memory quoting from above link:

Up to last Tuesday, when barrister Mark Connaughton brought the department, the HSE and the two unions (the IHCA and the IMO) together for a last-ditch effort to get agreement, things did not look optimistic.


Important:

As it struggled to get back in on Thursday afternoon, the deal had been effectively agreed with the IHCA. It underlined the fact that the IMO - which is a broad church union of public health doctors, GPs, junior doctors and consultants - is no longer recognised as the negotiating voice for hospital consultants.


The deal

Salaries will rise, and limited private practice rights are retained in the proposed new contract for hospital consultants. Heads of agreement are being finalised, and a detailed legal employment contract will be drawn up in the coming weeks.

* Consultants will work a 37hour week, including evenings and five hours on Saturdays and Sundays ‘‘in certain circumstances’’. Prior to this, consultants would have worked a 33-hour week from Monday to Friday, with some weekend on-call duties.

* Consultants will lead and be involved in clinical management. This will include the position of clinical director, similar to the existing post of master in a maternity hospital, a working doctor who is also in charge of budgets and clinical teams.

* There are three types of contract proposed: Type A is the ‘‘public only’’ contract, with a salary of up to €240,000 a year, plus allowances for evening and weekend work.

Type B, with a salary of up to €220,000, will allow the holder to do 80 per cent public work and 20 per cent private work in co-located hospitals, the latter to be monitored at hospital level.

Type C, with a salary of up to €175,000, will enable the holder to conduct private practice off site. This is being described as only being available in ‘‘exceptional’’ circumstances.

* A common waiting list for all diagnostic tests will be introduced.

* A new body to regulate the appointment of consultants, to replace Comhairle na nOspideal, will be introduced. Comhairle was abolished when the HSE was formed, and consultants’ input into new appointments was lost.

Private practice earnings not mentioned in the deal, Our dear consultants earn thousands every month.

Why don't government bound consultants to train NCHDs?

Looking at the deal, do you still think Ireland is going through economic recessions :eek: ????

drzhivago

kindajaded wrote: »

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.

Not clear why you would cancel your IMO membership because of this guy

This is exactly the time you need a union, and a union is only as strong as its members

I get upset when I see people say IMO is weak, by this what they are really saying is they themselves as doctors are weak because they dont know enough about their own contracts to know they have been shafted for years and couldnt bother to read their own paychecks half the time

tallaght01

The proposed cutbacks can be found on the IMO site here:

http://www.imo.ie/view_categories.php?cat_id=15&doc_id=4457

tallaght01

Star Trek wrote: »

They have a union actually, It's well known among consultants because it only prefers to look after consultants.


www.ihca.ie

The Irish Hospital Consultants Association

http://archives.tcm.ie/businesspost/2008/01/27/story29925.asp

Just to refresh memory quoting from above link:

Up to last Tuesday, when barrister Mark Connaughton brought the department, the HSE and the two unions (the IHCA and the IMO) together for a last-ditch effort to get agreement, things did not look optimistic.


Important:

As it struggled to get back in on Thursday afternoon, the deal had been effectively agreed with the IHCA. It underlined the fact that the IMO - which is a broad church union of public health doctors, GPs, junior doctors and consultants - is no longer recognised as the negotiating voice for hospital consultants.


The deal

Salaries will rise, and limited private practice rights are retained in the proposed new contract for hospital consultants. Heads of agreement are being finalised, and a detailed legal employment contract will be drawn up in the coming weeks.

* Consultants will work a 37hour week, including evenings and five hours on Saturdays and Sundays ‘‘in certain circumstances’’. Prior to this, consultants would have worked a 33-hour week from Monday to Friday, with some weekend on-call duties.

* Consultants will lead and be involved in clinical management. This will include the position of clinical director, similar to the existing post of master in a maternity hospital, a working doctor who is also in charge of budgets and clinical teams.

* There are three types of contract proposed: Type A is the ‘‘public only’’ contract, with a salary of up to €240,000 a year, plus allowances for evening and weekend work.

Type B, with a salary of up to €220,000, will allow the holder to do 80 per cent public work and 20 per cent private work in co-located hospitals, the latter to be monitored at hospital level.

Type C, with a salary of up to €175,000, will enable the holder to conduct private practice off site. This is being described as only being available in ‘‘exceptional’’ circumstances.

* A common waiting list for all diagnostic tests will be introduced.

* A new body to regulate the appointment of consultants, to replace Comhairle na nOspideal, will be introduced. Comhairle was abolished when the HSE was formed, and consultants’ input into new appointments was lost.

Private practice earnings not mentioned in the deal, Our dear consultants earn thousands every month.

Why don't government bound consultants to train NCHDs?

Looking at the deal, do you still think Ireland is going through economic recessions :eek: ????

Private practice is addressed by the different types of consultant contracts.

The HSE would be delighted if we started bickering amongst each other, though. It's exactly what they'd like to happen.

drzhivago

Star Trek wrote: »

They have a union actually, It's well known among consultants because it only prefers to look after consultants.


www.ihca.ie

The Irish Hospital Consultants Association

http://archives.tcm.ie/businesspost/2008/01/27/story29925.asp

Just to refresh memory quoting from above link:

Up to last Tuesday, when barrister Mark Connaughton brought the department, the HSE and the two unions (the IHCA and the IMO) together for a last-ditch effort to get agreement, things did not look optimistic.


Important:

As it struggled to get back in on Thursday afternoon, the deal had been effectively agreed with the IHCA. It underlined the fact that the IMO - which is a broad church union of public health doctors, GPs, junior doctors and consultants - is no longer recognised as the negotiating voice for hospital consultants.


The deal

Salaries will rise, and limited private practice rights are retained in the proposed new contract for hospital consultants. Heads of agreement are being finalised, and a detailed legal employment contract will be drawn up in the coming weeks.

* Consultants will work a 37hour week, including evenings and five hours on Saturdays and Sundays ‘‘in certain circumstances’’. Prior to this, consultants would have worked a 33-hour week from Monday to Friday, with some weekend on-call duties.

* Consultants will lead and be involved in clinical management. This will include the position of clinical director, similar to the existing post of master in a maternity hospital, a working doctor who is also in charge of budgets and clinical teams.

* There are three types of contract proposed: Type A is the ‘‘public only’’ contract, with a salary of up to €240,000 a year, plus allowances for evening and weekend work.

Type B, with a salary of up to €220,000, will allow the holder to do 80 per cent public work and 20 per cent private work in co-located hospitals, the latter to be monitored at hospital level.

Type C, with a salary of up to €175,000, will enable the holder to conduct private practice off site. This is being described as only being available in ‘‘exceptional’’ circumstances.

* A common waiting list for all diagnostic tests will be introduced.

* A new body to regulate the appointment of consultants, to replace Comhairle na nOspideal, will be introduced. Comhairle was abolished when the HSE was formed, and consultants’ input into new appointments was lost.

Private practice earnings not mentioned in the deal, Our dear consultants earn thousands every month.

Why don't government bound consultants to train NCHDs?

Looking at the deal, do you still think Ireland is going through economic recessions :eek: ????

Some very selective quoting here

There is only one medical UNION and that is the IMO, a registered trade union with a negotiating licence and covered under the Industrial relations Acts

the IHCA has a negotiating licence, quite a different thing

The figures you quote and also the terms related to them were only negotiated after the IMO rejoined the procedures but you seem to miss that bit out here

drzhivago

Svalbard wrote: »

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.

I dont think this would be a problem at all as the HSE have signed contracts with both with agreed terms and conditions, legally they couldnt say to either side NCHD or consultants its them or you

There would not be a conflict of interest in the IMO either as each of their craft groups operates independently and negotiates independently but never have to negotiate with each other so no conflict there.

drzhivago

tallaght01 wrote: »

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.

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.

There is no core rate reduction

THE OT changes would seem very strange to almost any industry where OT is worked to get flat rate for 9 hours although this compares very favourably with the rates my colleagues got as I terns 50% (not 150%) for OT hours and capped at 65

I agree people ned to grow a pair as most junior NCHDS do not even know how bad it was prior to 2000. i am sick and tired of hearing the past is past but this is what the HSE are trying to do now, bring you back to the past where you will not get paid for all your working hours

If there were no recession we could expect some sympathy from other workers, they dont realise we do not have job security and married men and women in their 30's and 40's are moving around on 6 month contracts from place to place

The main problem NCHDs have is they are too middle class, few understand their contracts, few understand what unions are for, few are willing to help their union fight for their causes and few will be willing to take action if needs be and I dont necessarily mean industrial action here either.

tallaght01

drzhivago wrote: »

There is no core rate reduction

.

I have to say that I thought that was going to be hard to implement alright!

drzhivago

ZYX wrote: »

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.

The allowances did not come in the last 15 years, Diploma and degree allowances have been paid for around 30 years to NCHDs and possibly even longer

Living out allowance has been paid for over 30 years also, at least, I cant find evidence going back further but have heard it discussed by consultant colleagues who were NCHDS once

Take home pay only increasd because we actually got paid OT, I remember this being negotiated, the feeling at the time was that if they actually had to start paying OT they would look at how the hours were structured and do away with 1/3 or 1/4 rotas. This never happened not because of the docs but because the HSE and DOH never got their acts in gear

Regarding NCHDS being high earners compared to average what comparison are you using, if you take any job and make them work comparable hours their own take homes will be massive.

If you compare the basic salaries you will have many docs working alongside nurses who will be far better paid than them, with all the hours reductions, unpaid hours etc that will happen very soon

drzhivago

bigjimthefirst wrote: »

But what is work to rule for a doctor?

I think it woudl have to be going back to the doctoring

Just because there is no phlebotomist for routine work at the weekends NCHDS should not be expected to do it

Just because there is no ECG technician at weekends NCHDS should not be expected to do it

Same goes for portering, filing, cleaning, fixing leaky taps, fuses or changing plugs

Many of which I have been asked to do because I was " the only man around"