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

drzhivago

cxcully wrote: »

These specific cuts in OT/S Leave/Lunch outside of the Training Grant were known about before Xmas?!

Dr. Z, I'm sorry if I gave the impression I was going to sit back and let the IMO do all the work. Most NCHDs are fully aware of what the Union is for and the extent to which they advocate on our behalf. We discussed it as a group and will support whatever is decided. Will certainly attend the Galway meeting.

a lot more than the grant was discussed, specifically unrostered hours, allowance etc

No one really expected the lunch break and not getting paid for grand rounds/tutorials received or given is new

Its just when all is aded together it comes to a massive sum, seems unrealistic, when you divide down to each man and woman on the ground its massive

The way the medical card income limits are any junior doctor with a mortgage after this may qualify for mortgage support and a medical card and thats not being hysterical thats fact

I didnt mean to be rude about the UNION but you are the UNIOn you are still talking as if it is a disembodied person, the difficulty will come when people dont keep up with whats happening and turn up to a meeting to find out they may be taking industrial action in a matter of weeks without really knowing what industrial action is

tallaght01

Dr Z, you seem to be involved with the IMO, or at least know what's going on with it.

Are they going to ballot for industrial action? because I don't see the HSE backing down very easily on these cuts.

For the rest of you, would you be willing to undertake industrial action?

drzhivago

tallaght01 wrote: »

Dr Z, you seem to be involved with the IMO, or at least know what's going on with it.

Are they going to ballot for industrial action? because I don't see the HSE backing down very easily on these cuts.

For the rest of you, would you be willing to undertake industrial action?

I went to the meeting before christmas, I read what they have been postingout and emailing
I have discussed the issue with barrister friends and am confident what hse is doing will not stand up to legl challenge

I for one hope they dont ballot at this stage as I really dont think NCHDs know what strike is, and dont know what they are balloting about yet

drzhivago

also interesting to read HSE response to IMO letter last week
http://hse.ie/eng/News/National_Tab/HSE_response_to_IMO_statement.shortcut.html

"maintaining levels of care" - though cutting numbers of dotors in clinics, on wards adnf on call

"reducing hours to comply with EWTD" -- but what thy are doing wont actually comply with EWTD, fewer doctors working in hospitals at night, still working illegally more than 13 hours per day ( still 24hour shifts and above)

"HSE disappointed the IMO should feel it necessary to consider embarking upon industrial action" --- what did they think was going to happen if they slash pay with no negotiation, they had a meeting where they put the list of cuts on the table and said there was no negotiation around these and would not wait for the normal industrial relations mechanisms such as the LAbour Court or LRC to kick in as that did not fit their timetable

"The HSE and employers would hope that the IMO would follow agreed procedures to ensure that arrangements would be put in place so that patient safety is not compromised in any way in the event of industrial action taking place"-- in other words we dont follow normal procedures but we expect you to do so, you can have a strike but not one that will have any effecy, any one remember the recent nurses strike, not successful because they did exactly what the hse said, provided loads of cover and hence no real action felt

The above quotes are from a HSE press release

The guy has even put his mobile number on it

Most of us nowadays get free webtexts from mobile providers, do you think we should regularly text this guy to remind him of our depth of feeling on the issue

ZYX

drzhivago wrote: »

The way the medical card income limits are any junior doctor with a mortgage after this may qualify for mortgage support and a medical card and thats not being hysterical thats fact

No it is total rubbish. To qualify for a medical card a couple must earn less than €266.50 a week.

RobFowl

ZYX wrote: »

No it is total rubbish. To qualify for a medical card a couple must earn less than €266.50 a week.

Not quite true there ZYX the single person limit for a DVC medical card is €276 (where do you get your information from ?)
And also
Additional guideline allowances will be given for:
o Reasonable expenses incurred in respect of rent/mortgage payments
o Reasonable expenses incurred in respect of childcare costs
o Reasonable expenses incurred in travel to work
- The assessment of eligibility for Medical Cards and GP Visit Cards will be based income of the applicant (if any) after tax and PRSI have been deducted
There are also discretionary limits re loan expenses, significant illness etc so and intern or SHO could qualify under the right conditions

http://www.hse.ie/eng/Find_a_Service/entitlements/Medical_Cards/MCGPVCincomeguidelines.pdf

ZYX

RobFowl wrote: »

Not quite true there ZYX the single person limit for a DVC medical card is €276 (where do you get your information from ?)
And also
Additional guideline allowances will be given for:
o Reasonable expenses incurred in respect of rent/mortgage payments
o Reasonable expenses incurred in respect of childcare costs
o Reasonable expenses incurred in travel to work
- The assessment of eligibility for Medical Cards and GP Visit Cards will be based income of the applicant (if any) after tax and PRSI have been deducted
There are also discretionary limits re loan expenses, significant illness etc so and intern or SHO could qualify under the right conditions

http://www.hse.ie/eng/Find_a_Service/entitlements/Medical_Cards/MCGPVCincomeguidelines.pdf

Do you know the difference between a medical card and a GP visit card?

RobFowl

ZYX wrote: »

Do you know the difference between a medical card and a GP visit card?

Boths are forms of medical card paid under the GMS system. My GMS number used is the same, the cards issued to patients are the same the only difference is that one entitles you to free prescriptions as well. The HSE count them as medical cards when measuring panel sizes.

The added allowances you omitted to mention are immeasurable as they vary from person to person and very often bring people into the threshold.

Anyway getting off thread here so let's agree to differ.

drzhivago

RobFowl wrote: »

Boths are forms of medical card paid under the GMS system. My GMS number used is the same, the cards issued to patients are the same the only difference is that one entitles you to free prescriptions as well. The HSE count them as medical cards when measuring panel sizes.

The added allowances you omitted to mention are immeasurable as they vary from person to person and very often bring people into the threshold.

Anyway getting off thread here so let's agree to differ.

Thanks for that Fowl, have you seen the Indo today, great big headlines junior doc earns 100K in overtime.

`They mention a number of other high earners, what they neglect to mention is the number of weekly hours they have to work to earn that

Ironically they mention rates of 150% when doctors work past 54 hours and yet dont mention the fact that it is illegal to work more than 56 hours, and form August that will be 48 hours

NCHDs can only earn such high sums because of the mandatory OT, The HSE say they wnat to reduce hours to EWTD levels but they still want to make people work 24 hour shifts

They wnat to force people to continue working relatively long OT but cut the rates- you have no choice backed into a wall

where too next?

PaddyofNine

drzhivago wrote: »

where too next?

I know.

jimmycrackcorm

Is the system just badly organized? 100000 in single overtime would cover more than an extra NCHD job.

PaddyofNine

jimmycrackcorm wrote: »

Is the system just badly organized?

I think that's a given. I wonder how many NCHD jobs would be covered by (A) halving the salaries of the HSE head honchos, or (B) spending the money they use for spin-doctoring on actual front-line healthcare, i.e. doctors and nurses.

Piste

GAH, these HSE cutbacks are so infuriating! Please please please, everyone in the IMO, stand up to the HSE! Healthcare is not a luxury and should never be compromised even in a recession. In these times peope will be looknig to get money by any means necessary and so litigation and compensation cases will probably rise, so we cannot afford to have doctors who aren't expertly trained.

I'm applying for medicine this year and while I'm happy that the intern's working week is complying with the EWTD I can't help full feel quite skeptical- will interns really be working just 48 hours or will that just be the time they work "on paper"?

I feel powerless to do anything, but if the IMO organised a march or protest I would be there and support them all the way. While savings do have to be made, these are NOT the ways to be making them. I urge everyone who is a member of the IMO and who can have their voice heard to do something about this. Garner public sympathy, get the media on your side, you cannot accept this!

drzhivago

jimmycrackcorm wrote: »

Is the system just badly organized? 100000 in single overtime would cover more than an extra NCHD job.

Yes and no

Up until 2000 overtime was actually undertime ie for extra hours they paid less than basic, 50% in most hospitals, some hospitals stopped paying even that after 65 hours because the agreement was that we should not work more than 65 hours on average (perverse logic there)

So if you keep one guy for 100 hours you paid a basic 39, another 13 hours total pay to get to 65 and in many cases nothing after that
Outgoings to hospital 52 hours pay
Hours worked 100

In 2000 that changed to actual overtime
Hours worked 100
Outgoings (basic 39 + 15*1.25 + 46*1.5) = 126.75 hours pay

On that basis we thought they would reorganise hours or else hire people

They have done neither so in interim people working the long hours to keep hospitals open have been paid for it and also castigated for it s being greedy doctors.

quite demoralising to actually face public criticism for agreeing to work illegal hours to keep all these hospitals open

If the doctors refused to work those long hours the HSE would be on the news to say Cashel/Clonmel/nenagh/ennis/Mallow/Bantry/Mullingar/Portlaois/Tullamore/Cavan/monaghan/Navan/Dundalk/wexford/ St Johns/St Micghaels hospitals had to close today because we dont have enough doctors to staff them and the doctors who are there wont work the long hours to keep them open for us

No win situation for the docs isnt it

drzhivago

Piste wrote: »

I'm applying for medicine this year and while I'm happy that the intern's working week is complying with the EWTD I can't help full feel quite skeptical- will interns really be working just 48 hours or will that just be the time they work "on paper"?

I feel powerless to do anything, but if the IMO organised a march or protest I would be there and support them all the way. While savings do have to be made, these are NOT the ways to be making them. I urge everyone who is a member of the IMO and who can have their voice heard to do something about this. Garner public sympathy, get the media on your side, you cannot accept this!

Are you going back as mature student, wouldnt fancy taht option with such high fees now and low earning potential to pay back, one thig I have asked for ver the years is for an army style system where you get fees subsidised or free on the basis that you agree to work in the pubic system for a set number of years after you graduate.

I feel that would be a win win, student get to afford to go to college, systems hs guaranted supply of doctors and doesnt ahve to depend on recruitment from around the world which will only work when we are paying more than other countries

regarding 48 tht will be what you work, you may well have another 10-12 of formal educational activities but that is what you will be working for

I dont think media would be very helpful right now at all and would be detrimental to us, an inexperienced doc put in front of a camera or mike would get led up the garden path about overtime and earnings making things worse

RANIA

i am married to an sho, we are seriously concerned ,working out calulations and it looks like there is a real possiblity of not being able to pay our mortage.hubbie is considering quitting the hospital route to train as a gp., that or emigration.
ye all really need to get yer fingers out, get writing letters, the media really is not on yer side.that hse cutbcak letter was very well written and just makes ye sound like miserable misers.the public opinion is that ye should suck it up because on e day ye will be consultants. they really did nchds no favours bickering about their contracts, thats whats in the public memeory, the greedy consultants and 200k not being eniugh for them.,,,
write letters, talk about the human cost, do a spin on it,how ireland will be left with the mediocre doctors , how there will be no advances here blah blah , ye don't have long to get some public sympathy on yer side..this country is a joke, a bit communist really to espect highly educated professionals to work for the same as a shop assistant..whcih is pretty much what they are doing.no reward for bettering yourself, ireland of the mediocre doctors soon.

drzhivago

RANIA wrote: »

i am married to an sho, we are seriously concerned ,working out calulations and it looks like there is a real possiblity of not being able to pay our mortage.hubbie is considering quitting the hospital route to train as a gp., that or emigration.
ye all really need to get yer fingers out, get writing letters, the media really is not on yer side.that hse cutbcak letter was very well written and just makes ye sound like miserable misers.the public opinion is that ye should suck it up because on e day ye will be consultants. they really did nchds no favours bickering about their contracts, thats whats in the public memeory, the greedy consultants and 200k not being eniugh for them.,,,
write letters, talk about the human cost, do a spin on it,how ireland will be left with the mediocre doctors , how there will be no advances here blah blah , ye don't have long to get some public sympathy on yer side..this country is a joke, a bit communist really to espect highly educated professionals to work for the same as a shop assistant..whcih is pretty much what they are doing.no reward for bettering yourself, ireland of the mediocre doctors soon.

with all respect I think it would sound better coming from you,a few well chosen letters would have potential to do good,

RANIA

thats no problem, was thinking of doing so but was not sure how nchds would feel about it.anything in particular i should say or mention drzhivago?

Piste

drzhivago wrote: »

Are you going back as mature student, wouldnt fancy taht option with such high fees now and low earning potential to pay back, one thig I have asked for ver the years is for an army style system where you get fees subsidised or free on the basis that you agree to work in the pubic system for a set number of years after you graduate.

Nah just doing my Leaving Cert this year so I wouldn't have to pay fees (in theor, though that may well change soon )

drzhivago

RANIA wrote: »

thats no problem, was thinking of doing so but was not sure how nchds would feel about it.anything in particular i should say or mention drzhivago?

I think coming from a family member, worried about mortgage, explaining long absences to children, all the moves with the jobs would actually hit a nerve

The public expect the greedy docs to complain but it would mean something different for a family member to speak from the heart

Joe duffy, gerry ryan, ryan tubridy would all be options for you too

panda100

This hasnt been put up here yet so thought it important to do so:
(from the IMO website)

Full NCHD support is essential to the IMO in our fight against these cuts. An Emergency Meeting has been scheduled for 8pm,Wednesday 11th February 2008 in the Concert Hall, RDS, Dublin 4.

It is essential that all NCHDs, members and non-members, attend this meeting or one of the other regional and/or Hospital meetings that have been scheduled in the coming weeks, details of which can be found below. Please also encourage your colleagues to attend one of these very important meetings.

Regional meetings:
Wednesday 11th February, Dublin, Concert Hall, RDS 8pm
Thursday 12th February, Cork, Imperial Hotel 8pm
Wednesday 18th February, Midlands, Tullamore Court Hotel 8pm
Thursday 26th February ,Galway, Meyrick Hotel 8pm

HOSPITAL VISITS

DATE HOSPITAL VENUE TIME
Thursday 12th February Waterford Regional NCHD RES 1pm
Wednesday 18th February Naas General Large Conference Room 1pm
Tuesday 17th February Wexford General NCHD RES 1pm
Thursday 19th February Mayo General NCHD RES 1pm
Friday 20th February Limerick Regional NCHD RES 1pm
Tuesday 24th February Kerry General NCHD RES 1pm
Tuesday 24th February St Lukes, Kilkenny NCHD RES 1pm
Wednesday 25th February Cavan General NCHD RES 1pm
Thursday 26th February Letterkenny Regional NCHD RES 1pm
Tuesday 3rd March Sligo General NCHD RES 1pm


Med Students get free membership to the IMO so il be mobilising as many final year medics as I can for tommorows meeting in the RDS.

RANIA

why is the galway meeting on feb 26th if they are propsing all the cutbacks from the 18th,it can't be that hard to meet in advance?

Traumadoc

http://www.independent.ie/health/latest-news/junior-doctor-pockets-more-than-8364100000-in-overtime-1634065.html

More spinning.
I would like to see oReillys quote in full.

drzhivago

RANIA wrote: »

why is the galway meeting on feb 26th if they are propsing all the cutbacks from the 18th,it can't be that hard to meet in advance?

People wont attend on Fridays (been tried too many times)
Galway only had a meeting 7 weeks ago about these very issues in the same hotel, there are also only a small number of people who go and do these talks around the country, these are your NCHD colleagues who are travelling around to meet you guys so there hopefully will be a good turn out.

Can be very difficult to schedule these at short notice, there is still the other work to do, the LRC cases continue, Labour court and disciplinary hearings.

Having been involved before it would surprise you how many days per week there are hearings involving NCHDs at which there is IMO representation in various parts of the country over training stuff, work permits, Visas, assaults, harassment, bullying.

I know some Galway people are driving to Dublin Tomorrow as that will be the biggest meeting, I have been speaking to quite a few who are planning this, if you can do that it would be your best option as you will get a flavour of what a large group of people are feeling about this and not just the people you already work closely with in your own hospital or town.

Yes it is a long way, yes it is inconvenient, but think also about the small number who are going to have to go to all these meetings around the country and this is supporting them too

drzhivago

Traumadoc wrote: »

http://www.independent.ie/health/latest-news/junior-doctor-pockets-more-than-8364100000-in-overtime-1634065.html

More spinning.
I would like to see oReillys quote in full.

yes very strange for a Past IMO President!!!!

drzhivago

panda100 wrote: »

This hasnt been put up here yet so thought it important to do so:
(from the IMO website)

Med Students get free membership to the IMO so il be mobilising as many final year medics as I can for tommorows meeting in the RDS.

Do you have the IMO student membership forms, if you need them PM, we got them last week for our own student and they passed them round the classes by email pretty quickly

Its so easy in a technological age. I met a man who was involved in the 1971 NCHD strike, who incidentally came up with the name NCHD at the time. when they were organising a strike they had to post letters in advance to people to warn them to be near the only phone box in their hospital at a particular time for instructions-took them ages to organise things but they did it

Now we have facebook, email, mobile phones,iPhones, texts, should be relatively easy to mobilise the troops one would think

Prime Mover

Here you go....

Dr James Reilly, said yesterday it was "nonsensical" to run a health system where there was such a dependence on overtime. "It is outrageous what is being paid out and it can't be safe both for the doctors concerned and their patients if they are working between 60 and 80 hours a week,"

http://www.irishtimes.com/newspaper/health/2009/0106/1230936695161.html

Now what is interesting about that quote from "yesterday" is that yesterday was actually Monday January 5th according to the Irish Times.

Isn't it very convenient the way this story was resurrected?

nesf

Of all the groups of civil servants there are two I have genuine sympathy/respect for in terms of working conditions, junior doctors and prison guards. I don't think industrial action will help ye though because all anyone will see is that you guys could bring in 6 figures last year and most of them won't grasp how problematic removing a training grant is. If you just look at junior doctor take-home wages after overtime and including grants etc they look extremely generous which makes them easy to attack.

Prime Mover wrote: »

Dr James Reilly, said yesterday it was "nonsensical" to run a health system where there was such a dependence on overtime. "It is outrageous what is being paid out and it can't be safe both for the doctors concerned and their patients if they are working between 60 and 80 hours a week,"

What I find interesting is that the quote reads both ways and could be spun either in the direction of overtime payouts being excessive or overtime worked being excessive in terms of safety, sanity of doctors etc. Whether this is intentional or not is the question.



That said, if they actually did reduce overtime and hire enough extra people to cover it would the doctors on here be happy with the reduced pay/overtime? If you would be, then that's the message to come out with imho.

drzhivago

nesf wrote: »

Of all the groups of civil servants there are two I have genuine sympathy/respect for in terms of working conditions, junior doctors and prison guards. I don't think industrial action will help ye though because all anyone will see is that you guys could bring in 6 figures last year and most of them won't grasp how problematic removing a training grant is. If you just look at junior doctor take-home wages after overtime and including grants etc they look extremely generous which makes them easy to attack.

Have quite a deal of sympathy for prison officers having visited the jails for medical emergencies the conditions are terrible

I dont think industrial action as most consider it would help but what about a perverse industrial action such as agreeing to most of their demands and working only a 48 hour week as the law demands, they would then have to close 20 hospitals

I am so annoyed about the way they leak these figures for maximum effect at times like this, they would never earn such massive amounts if they didnt do dangerously long hours, shorten the hours and there wont be that.

for the last few years I have not done any OT in jobs I was in, the grant helps pay some of the costs of the education side of being a doctor (3 day course, mandatory for your field €1000 plus accommodation), thats only one example, public would get bored if you trotted out all such examples

nesf wrote: »

That said, if they actually did reduce overtime and hire enough extra people to cover it would the doctors on here be happy with the reduced pay/overtime? If you would be, then that's the message to come out with imho.

I think most know that if hours come down then overall earnings come down, no argument there
BUT Government policy is to reduce junior doctor numbers, which they are doing, and not to increase the number so they wont hire more

The numbers dont work here, reduce hours and reduce numbers

we will end up going back to the system I started working in where many of the hours you worked you were just not paid for, and i dont mean 1 or 2 per week but 30+

When this came up big in 2000 one girl was featured on TV crying saying all she wanted to do was get some sleep, the hours havent changed since then they just get paid for the hours they work now

The cycnical HSE say this is to comply with the law, the measures wont even do that, they still want people doing 24 hour shifts mid week and up to 70 hour shifts at weekends, that wont change, what they will do is the day before the 24 hour shift you wil get a half day and before and after the weekend you will get a half day

where else would it happen

Prime Mover

drzhivago wrote: »

I dont think industrial action as most consider it would help but what about a perverse industrial action such as agreeing to most of their demands and working only a 48 hour week as the law demands, they would then have to close 20 hospitals

I hear what you are saying but that won't work. Instead of just pushing back on the HSE proposals, the IMO needs to lead into the negotiations with it's own vision of how the NCHD system should be organised. What you need to have in the public domain is how you would run the system at a fair level of remuneration, how you would roster hours that allow training, rested doctors and safe delivery of care to the public etc.

If you keep moaning about benefits getting cut, no one will care because everyone's benefits are getting cut at the moment.

You need to get out of the victim mindset for the negotiations. The HSE are under their own pressures to achieve a deal. The NCHDs are vulnerable to negative public perception when newspaper articles show individual doctors earning large sums albeit after working crazy hours, but the HSE have zero goodwill and credibility as being competent to run an efficient health service.

Your stance should be unless XXX is implemented that will make the hospitals safer for the public and doctors, XXX cuts are not acceptable. The general public can't argue with that.

So in summary, if these IMO meetings just descend into people throwing their toys around and venting, then it will be a wasted opportunity. You need to come up with a consensus on what are acceptable hours, training, salary and your message to the public should be about how your way will improve patient safety.

These negotiations are an opportunity to fix a lot of what is wrong with NCHD working life.