HSE settles case with IMO and 6 NCHDs

drzhivago

Amnesiac_ie wrote: »

This is great news but what's with the minimal media coverage? I must congratulate the IMO and the six brave NCHDs who took this action which has served us all so well.

I sincerely hope that BOTH sides; the HSE and our representatives in the IMO will engage in real negotiation over the new contracts in the coming months. The era of not showing up for meetings and stubbornly refusing to budge on certain issues has to end.

Come on where do you live airy fairy land.HSE negotiastors are paid 9-5, dont think about the task outside those hours, its not their money and the longer negotiations go on the more they justify their own job

IMO NCHDs have jobs too and do this in their own time. Put lots of outside work hours into this, have spoken to quite a few over the years

They get documenst at the end of a meeting, read them that night and come back in morning ready to negotiate

HSE take documenst away, come back in morning and then want time to read the documents

Makes a mockery of having a short negotiation period doesnt it

Amnesiac_ie wrote: »

Is it too much to think that by working together and having an open and frank dialogue both sides could contribute to new, more efficient contracts that could both save the health system money and protect training, working conditions and quality of life for NCHDs?

Great statement and probably what IMO are looking for

What HSE looking for more hours for less pay and cheapen everything else, can forget all about training, working conditions and quality of life stuff

They dont really care

Remember our colleague who died at work in Cavan
Do you remember the long investigation into that!!!

Amnesiac_ie wrote: »

Although, if Fine Gael can implement their new health proposals anytime soon it won't be long before the ridiculousness of "one central contract" for psychiatrists, A&E docs, GP trainees and surgeons working in hospitals as different as Beaumont and Bantry General has come to an end. www.faircare.ie

Not sure about that
didnt see anything about contracts in that

arguendo

How does this impact on Junior Doctors who qualified last week? My understanding is that the contract effective 1st July 2009 is for a 49 hour week, but additional unpaid hours will be worked, based on new rosters to be developed.

sportswear

but additional unpaid hours will be worked, based on new rosters to be developed

no thanks

Amnesiac_ie

Traumadoc wrote: »

What do you mean by "ridiculousness"?

I don't think there should be one contract for each NCHD position in the country. Different sized hospitals and different types of specialty make very different demands on individuals. I think different contracts should reflect this. A&E and the shifts they demand are quite different to the demands and workload of being a Psychiatry Reg in a large Psychiatric Hospital.

And as regards Fine Gael's health proposals; if the State does remove itself from the provision of health care and instead guarantees affordable health insurance for all than local hospital trusts and institutions will be free to negotiate individualised contracts with NCHDs.

The current contract we work under is a messy compromise that fails NCHDs in every specialty and fails the hospitals as well.

Amnesiac_ie

arguendo wrote: »

How does this impact on Junior Doctors who qualified last week? My understanding is that the contract effective 1st July 2009 is for a 49 hour week, but additional unpaid hours will be worked, based on new rosters to be developed.

I think the HSE might just finally have realised that no NCHD is going to work "unpaid hours" anymore.

drzhivago

arguendo wrote: »

How does this impact on Junior Doctors who qualified last week? My understanding is that the contract effective 1st July 2009 is for a 49 hour week, but additional unpaid hours will be worked, based on new rosters to be developed.

Guys
forget the hype
Forget what your friends who think they know are telling you

If you work you will be paid
Hours for EVERYONE will change because of the law
Interns will be no different to anyone else

New rosters will be developed as required by law but hours worked will be paid if not get on to IMO

As you have seen lately they are not afraid to use the forces of the dark side (law) against the even darker side (the HSE)

drzhivago

Amnesiac_ie wrote: »

I don't think there should be one contract for each NCHD position in the country. Different sized hospitals and different types of specialty make very different demands on individuals. I think different contracts should reflect this. A&E and the shifts they demand are quite different to the demands and workload of being a Psychiatry Reg in a large Psychiatric Hospital.

And as regards Fine Gael's health proposals; if the State does remove itself from the provision of health care and instead guarantees affordable health insurance for all than local hospital trusts and institutions will be free to negotiate individualised contracts with NCHDs.

The current contract we work under is a messy compromise that fails NCHDs in every specialty and fails the hospitals as well.

Amnesiac I am sorry to disagree with you but in all my years working as an NCHD everyone feesl the stress of their own job is the worst and looks at other jobs as easy by comparison probably because they dont understand them

yes A&E is physically tasking and mentally very demanding, have done my fai share of them shifts and was doing shiftwork there when it wasnt paid as shifts and when overtime was paid at less than the basic hour but I still believed in a national contract and still do

If we move towards a banding system like in the UK there is an argument for work intensity payments but otherwise making a decision on whther someone is a physical danger to themselves or society is a significant one and occasiionally one where the wrong call is made. Just because the pace of the work appears slow it doesnt mean it is less serious or deserves less pay

Payment by results does not work for NCHDs because we dont have accountable units of work unlike consultanst, the buck does not stop with us

I would be grateful for your thoughts on how you feel people should get aid so taht i can feedback to my buddies in IMO and help them with their upcoming negotiations but I dont think different pay ates because you work ina big or small hospital will be on the cards from either side in this

But you never know

drzhivago

Amnesiac_ie wrote: »

I think the HSE might just finally have realised that no NCHD is going to work "unpaid hours" anymore.

Interesting comment
have been getting calls from NCDHs today who have been claled into various hospitals regarding their hours submissions over the last few months and their paychecks

Tehy have been informed that on occasion due to technical or other oversights not all the monies they were due were paid, this is to be rectified in upcoming pay paths

It looks like the rats are leaving the sinking McGrath on this one

drzhivago

arguendo wrote: »

How does this impact on Junior Doctors who qualified last week? My understanding is that the contract effective 1st July 2009 is for a 49 hour week, but additional unpaid hours will be worked, based on new rosters to be developed.

While it is still free for you as technically you are still students when you dont have a job you should join the imo

Amnesiac_ie

drzhivago wrote: »

Amnesiac I am sorry to disagree with you but in all my years working as an NCHD everyone feesl the stress of their own job is the worst and looks at other jobs as easy by comparison probably because they dont understand them

yes A&E is physically tasking and mentally very demanding, have done my fai share of them shifts and was doing shiftwork there when it wasnt paid as shifts and when overtime was paid at less than the basic hour but I still believed in a national contract and still do

If we move towards a banding system like in the UK there is an argument for work intensity payments but otherwise making a decision on whther someone is a physical danger to themselves or society is a significant one and occasiionally one where the wrong call is made. Just because the pace of the work appears slow it doesnt mean it is less serious or deserves less pay

Payment by results does not work for NCHDs because we dont have accountable units of work unlike consultanst, the buck does not stop with us

I would be grateful for your thoughts on how you feel people should get aid so taht i can feedback to my buddies in IMO and help them with their upcoming negotiations but I dont think different pay ates because you work ina big or small hospital will be on the cards from either side in this

But you never know

It's not the pay-rate that I think is the problem with the common contract; it's the fact that different hosptials and different specialities require very different working hours and practices. Acute medicine will never be a 9am-5pm (or even 8am-8pm!) number whereas specialities such as Microbiology and Pathology can continue to be. I think a common contract is a very blunt tool given the hugely different work practices in different specialites and different sized hospitals.

I also think the HSe should be able to offer felxible or half time to NCHDs who want to work reduced hours. I know a lot of people, particularly parents of young children who would relish a couple of years of flexitime; allowing them to spend time with their kids yet continue active training.

The contract we have at the moment bears no resemblane to real life work practices in any specialty; 9am-5pm and 4pm on Fridays? I think whatever is negotiated should reflect the realities of the workplace and those realities differ greatly for different jobs.

I hope I haven't given the impression that I think some specialties are "worth" more or deserve higher pay; I simply think the contract we have at the moment is silly and by trying to suit all specialities and hospitals ended up being rather artificial and irrelevant to all.

drzhivago

Amnesiac_ie wrote: »

It's not the pay-rate that I think is the problem with the common contract; it's the fact that different hosptials and different specialities require very different working hours and practices. Acute medicine will never be a 9am-5pm (or even 8am-8pm!) number whereas specialities such as Microbiology and Pathology can continue to be. I think a common contract is a very blunt tool given the hugely different work practices in different specialites and different sized hospitals.

I think you are mixing two concepts here
common contract ie terms and conditions related to employment AND premium pay for hours worked in unusual patterns

The blunt tool as you describe it refers to

• training grant
• diploma allowances
• living out allowance
• hepatitis vaccination
• travel expenses
• technology
• rostering arrangments
• pay rates for overtime

What we dont currently have is an appropriate structure to reward
Unsocial hours
night work
shift premia
night overtime

These are just payments and are only one part of the blunt tool, thus writing in proscribed terms regarding these payments into ALL contracts will still result in One contract

Amnesiac_ie wrote: »

I also think the HSe should be able to offer felxible or half time to NCHDs who want to work reduced hours. I know a lot of people, particularly parents of young children who would relish a couple of years of flexitime; allowing them to spend time with their kids yet continue active training.

There is a flexitime scheme at present only open to SPR/SR because there were only 20 ringfenced funded posts, competitive application for them. was run by PGMDB who are no longer in existence so dont know if scheme still running

There is a general HSE flexi scheme but NCHDS dont apply because they believe schemes will look on it badly so chicken and egg

Amnesiac_ie wrote: »

The contract we have at the moment bears no resemblane to real life work practices in any specialty; 9am-5pm and 4pm on Fridays? I think whatever is negotiated should reflect the realities of the workplace and those realities differ greatly for different jobs.

Be careful for what you ask for as it may come true might be a better PM topic

Amnesiac_ie wrote: »

I hope I haven't given the impression that I think some specialties are "worth" more or deserve higher pay; I simply think the contract we have at the moment is silly and by trying to suit all specialities and hospitals ended up being rather artificial and irrelevant to all.

I dont think it is silly, I think NCHDs dont understand it and dont know how to ask for the terms of their contract to be applied to them for maximum benefit to them

drzhivago

drzhivago wrote: »

Just heard from a buddy
HSE has settled case with IMO and 6 NCHDs today, not sure if it was settled in court or out of court

Costs awarded to IMO and NCHDs

No changes to NCHD contracts until after December 2009

Period of intense negotiation on working hours problems and separate negotiations on all other contract issues

Total costs of court case around €1 million apparently as a result of Mr Sean McGraths whim. what chance he will still keep his job despite the costs and despite the fact that 2 months later they are still to go back to the same place to negotiate with the same people only now they have lost 8 weeks negotiating time

I cant believe there is so little discussion/debate/comment from the medics here about this case

This was the biggest threat that we have faced ever and it has ended like a damp squib

I wonder has Sean McGrath now got what he wanted a demoralised group who will be easy to push over

drzhivago

Upcoming IMO meetings to discuss settlement terms and way ahead


HSE AREA LOCATION VENUE TIME
Tuesday 5th May Southern, Cork, Jury’s Hotel, Western Road, Cork, 7pm,
Tuesday 5th May,Western, Galway, Meyrick Hotel, Eyre Square, Galway, 7pm,
Wednesday 6th May, Eastern, Dublin, Hilton Hotel, Charlemont Place, Dublin 2, 7pm,
Tuesday 12th May, Mid Western, ,Limerick, Marriot Hotel, Henry Street, Limerick, 8pm,
Tuesday 12th May, South East, , Waterford, Tower Hotel, The Mall, Waterford, 8pm,
Wednesday 13th May, North Eastern, Monaghan, Nuremore Hotel, Carrickmacross, Monoghan,8pm,
Wednesday 13th May, Midlands, Tullamore, Tullamore Court Hotel, Tullamore, Co Offaly, 8pm,
Tuesday 19th May, North Western, Sligo, Clarion Hotel, Clarion Road, Sligo, 8pm

DrIndy

drzhivago wrote: »

I cant believe there is so little discussion/debate/comment from the medics here about this case

This was the biggest threat that we have faced ever and it has ended like a damp squib

I wonder has Sean McGrath now got what he wanted a demoralised group who will be easy to push over

I think its mostly a sense of relief that is going around!

good work all the same for the IMO.

Prime Mover

drzhivago wrote: »

I cant believe there is so little discussion/debate/comment from the medics here about this case

This was the biggest threat that we have faced ever and it has ended like a damp squib

I wonder has Sean McGrath now got what he wanted a demoralised group who will be easy to push over

I think thats a bit harsh. It is great and fair play to those who brought the case. However it does just bring the situation back to square one again. There are still a lot of things that need to be sorted out and perhaps people are waiting to see how things progress?

For example, how are they going to get to EWTD hours if they are supposed to be cutting back on NCHDs in this "2 NCHD for 1 consultant post" plan. Whats going to happen to all the extra medical grads now in training? Will there be jobs and training posts for them?

I would like to see a better career path for NCHDs emerge out of the negotiations. Why is it in other countries doctors can become Attendings in 5/6 years on a dedicated training scheme whereas in Ireland it can take 15 years of transferring all around the country to become a Consultant?

Traumadoc

drzhivago wrote: »

I cant believe there is so little discussion/debate/comment from the medics here about this case

This was the biggest threat that we have faced ever and it has ended like a damp squib

I wonder has Sean McGrath now got what he wanted a demoralised group who will be easy to push over

I think everyone is demoralised at the moment, The HSE has introduced a whole new set of pay scales to consultants based on their previous pay rates ( geographic location) never agreed to in negotiations and very little is being said. Also agreed call out payments also not to be honoured , our training grant (1200 euro) also will not be increased as agreed.

drzhivago

Prime Mover wrote: »

For example, how are they going to get to EWTD hours if they are supposed to be cutting back on NCHDs in this "2 NCHD for 1 consultant post" plan. Whats going to happen to all the extra medical grads now in training? Will there be jobs and training posts for them?

I would like to see a better career path for NCHDs emerge out of the negotiations. Why is it in other countries doctors can become Attendings in 5/6 years on a dedicated training scheme whereas in Ireland it can take 15 years of transferring all around the country to become a Consultant?

I dont get the 2 for 1 deal when considering the hours as this will only result in longer hours

It makes sense when you look at Hanly Report as they need to reduce junior doc numbers

BUT there seems to be no link to medical student numbers so looks like they will be on their won in a few years

I doubt in these negotiations anything will happen regarding career path, the HSE dont care about that and dont have any control over it

drzhivago

Traumadoc wrote: »

I think everyone is demoralised at the moment, The HSE has introduced a whole new set of pay scales to consultants based on their previous pay rates ( geographic location) never agreed to in negotiations and very little is being said. Also agreed call out payments also not to be honoured , our training grant (1200 euro) also will not be increased as agreed.

dont think that is the case traumadoc
got an email from IMO where it shows rates are being paid

Traumadoc

There are different rates for type A for the 3 different regions in the spread sheet from the IMO I got.

drzhivago

Traumadoc wrote: »

There are different rates for type A for the 3 different regions in the spread sheet from the IMO I got.

Yes
just checked back to that
I was looking at the letter
Now I am really confused
Teh pay rates just dont add up to be honest

If someone stayed on Buckley (33hrs) they would earn more than someone going to B* and doing 37 hours

I thought the incentive was to change and become flexible

This looks like a mess to be honest and is now hyperconfused with the A/B/B*/C added in to the geographic and specialty mix

I think there is a mistake there as I read all the stuff as it came out of the contract negotiations and it looked as if the geographic stuff was gone

PoleStar

While there has been some mention of how terrible it is that the IMO have kept this victory in the courts quiet, what I want to know is how come the IMO have apparently pulled the wool over the eyes of every NCHD in the country!

The circulated victory email from the IMO says the case was settled. That settlement included an agreement to work towards implementing the EWTD from July 2009, ie 6 weeks from now!

Forgive me if I am wrong, but having attended all the recent IMO meetings, the overall sentiment from the NCHD population was for no changes to our work practices to take place. Now it seems the IMO has done exactly what we didnt want, caved in, and sold us all out in the end, and given the HSE exactly what they wanted!

Look at what happened in the UK when the EWTD was introduced: many surveys of NCHDs have shown things going back to the old days of working long hours but not getting paid. And for those who think this wont happen here, prey do tell what are you going to say to your consultant when he says "would you mind sticking around later to give me a hand with that case in theatre, and oh by the way, I must do that reference for your upcoming SPR interview".

In the UK, trainees are asking in certain specialties for a derogation from the EWTD to 65 hours, in Australia limits are 72 hours, in the US its 80 hours. While certain specialties can train with shifts and low hours eg dermatology, emergency medicine, some such as surgery require long hours to be put in to get trained. If EWTD comes in, higher training in certain specialties will suffer greatly. Look what happened in the UK post Calman when the reductions all started: the suspension rate for newly qualified consultant surgeons is 20% or more in the first 2 years of consultant practice (and that is inside information from someone who assess UK hospitals), and it is thought that this is due to the reduced operative experience in those coming off training schemes in recent years.

I told the IMO what I wanted as did the thousand NCHDs that showed up in the RDS a couple of months ago. And I know it was not what the IMO gave us.

It is our duty if a ballot is put to the NCHD population to vote no for EWTD. No to EWTD will protect the high quality of medical and surgical training in Ireland. The HSE aint interested in your training, it aint interested in European law, it is only interested in the opportunity that the EWTD has provided to drastically cut costs for junior doctors. Sean McGrath must be rubbing his hands with glee. He started out with a list of things he wanted. And the tactic worked. Ask for a lot and there is a chance you will receive something. He got much more, and the IMO seem proud of it.

And none of the above considers any of the effects on such cuts to patient care. Thats another days rant.

DrIndy

In fairness, a press release was issued to all media sources, however - only the Irish times chose to actually run a story on it.

In my experience - The Indo has tended for anti-medic bias through most of their stories. I am surprised RTE didn't run it though because they gave good press to the initiation of the legal action.

drzhivago

PoleStar wrote: »

While there has been some mention of how terrible it is that the IMO have kept this victory in the courts quiet, what I want to know is how come the IMO have apparently pulled the wool over the eyes of every NCHD in the country!

Dont think the IMO kept this quiet, I got a number fo emails about the result and also the press releases theys ent out

It got balanaced coverage in irish Times but not much else

I dont think there has been any wool pulling either read on

PoleStar wrote: »

The circulated victory email from the IMO says the case was settled. That settlement included an agreement to work towards implementing the EWTD from July 2009, ie 6 weeks from now!

yes that is the law and read on an agreement to work towards implementing-- we have been working towards implementing for a long time, all of us in these pilot projects changed rotas, no more 1/2 or 1/3 rotas in a lot of places

PoleStar wrote: »

Forgive me if I am wrong, but having attended all the recent IMO meetings, the overall sentiment from the NCHD population was for no changes to our work practices to take place. Now it seems the IMO has done exactly what we didnt want, caved in, and sold us all out in the end, and given the HSE exactly what they wanted!

I forgive you, the sentiment was for no changes to pay practice, no introduction of unpaid breaks, no introduction of half day pre and post call without proper look at how services were going to run

PoleStar wrote: »

Look at what happened in the UK when the EWTD was introduced: many surveys of NCHDs have shown things going back to the old days of working long hours but not getting paid. And for those who think this wont happen here, prey do tell what are you going to say to your consultant when he says "would you mind sticking around later to give me a hand with that case in theatre, and oh by the way, I must do that reference for your upcoming SPR interview".

The working long hours and not getting paid must not return here but that is up to the NCHDS, the hospital is legally obliged to record all hours of their presence, and the NCHD must point out where they are regularly going over their times and why. This is where the NCHDs need the cohonas again. I dont doubt there are some NCHDs will feel under pressure to work beyond their hours but if they are going to be bullied into doing this they need to stand up for themsleves, what exactly do you propose wuld stop such a practice even if you got exactly what you wanted in any contract negotiation. The situation you outline above could still happen if you were happy with your contract and then what would you do

From the example this seems to be a surgical bias could the same happen in medicine

PoleStar wrote: »

In the UK, trainees are asking in certain specialties for a derogation from the EWTD to 65 hours,

Good for them, wish them luck and if you are interested maybe it would be a good idea to check careers out there, not trying to be deliberately inflammatory but it is a different jurisdiction

PoleStar wrote: »

in Australia limits are 72 hours,

dont think so unless this is a special deal for a single specialty, have worked over there myself

PoleStar wrote: »

in the US its 80 hours.

Yes for 4 years only in most specialties, up to 6 or 7 if you do a fellowship and you get ¢35-40k per year there for that with no overtime, i would not like to propose that as a solution here would you particularly if you are going to have to do it for 10-12 years

PoleStar wrote: »

While certain specialties can train with shifts and low hours eg dermatology, emergency medicine, some such as surgery require long hours to be put in to get trained.

Thats a very surgical bias, why do you think they can do it and surgeons cant, in addition the question should be can they actually train have you asked the emergency SPRS if they are happy training this way. They rarely get to work with their trainers, why shoudl they be put up here as a group this works for when we dont have information from the people doing it themselves

as regards dermatology I dont know of any of them who do shifts nor is there a requirement to so that is a spurious example

PoleStar wrote: »

If EWTD comes in, higher training in certain specialties will suffer greatly. Look what happened in the UK post Calman when the reductions all started: the suspension rate for newly qualified consultant surgeons is 20% or more in the first 2 years of consultant practice (and that is inside information from someone who assess UK hospitals), and it is thought that this is due to the reduced operative experience in those coming off training schemes in recent years.

I think you need to face reality EWTD implies directive, the fact is there is a law in Ireland OWTA (Organisation of Working Time Act) that is what applies now not EWTD, references to EWTD in this settlement agreement are confusing implying that it is something in the future but it is here now

regarding UK you are again looking at a surgical bias and now that the UK have made mistakes we should be able to plan to avoid some of these, if operating theatres were open longer in the day the more surgery would take place, we still have waiting lists, if surgery was done ona 6 day week as they are proposing for consultanst then would SPRS not get more experience

Instead of looking for the fault with what the hospitals provide you should be looking for your own job to be changed to ensure that you get the same or even better experience, only you can do that

PoleStar wrote: »

I told the IMO what I wanted as did the thousand NCHDs that showed up in the RDS a couple of months ago. And I know it was not what the IMO gave us.

Tell us what you told them

PoleStar wrote: »

It is our duty if a ballot is put to the NCHD population to vote no for EWTD.

I think your duty is to read what the proposals are and vote according to how you feel when you have considered them. Asking people to vote No without knwoing what they are voting on is ludicrous and in any case you are not voting no to EWTD that time has come and gone

The HSE are interested in the law in so much as they will be fined on a massive scale if people are working hours longer than allowed because the issue has been realised at EU level quite recently. as you say they are really not interested in quality of medical training that is clear

PoleStar wrote: »

No to EWTD will protect the high quality of medical and surgical training in Ireland. The HSE aint interested in your training, it aint interested in European law, it is only interested in the opportunity that the EWTD has provided to drastically cut costs for junior doctors. Sean McGrath must be rubbing his hands with glee. He started out with a list of things he wanted. And the tactic worked. Ask for a lot and there is a chance you will receive something. He got much more, and the IMO seem proud of it.

I think your NO to EWTD has gotten through to me but i think you are 10 years too late on this one, were you a doctor 10 year ago, if you were you would understand why so many of them wanted this in the first place it was because they were not paid for the long hours they were doing and felt it was a way of reducing hours to give themselves back a life

I am not sure he is rubbing his hands with glee, contracts cannot be touched, the law is there relating to hours worked, employers can move schedules around that is their right, in general it is done with consultation and negotiation and this is what is happening now unlike McGraths original proposal

I think you need to look at your job with your rota colleagues and say can this be legally compliant with working time, if not then it is unimplementable in my hospital and then your hospital will have to decide do we go ahead with this and risk fines or do we cut services, presuming you cant get into a cross cover scenario

PoleStar wrote: »

And none of the above considers any of the effects on such cuts to patient care. Thats another days rant.

That is another argument but some pointers to consider as well in this debate

• Law exists in Ireland on workin time, NCHDs are menat to be fully brought into the respective provisions by AUGUST, THERE IS NO OPT OUT OR DEROGATION POSSIBLE
• Working time can only be average 48 hours per week
• maximum working day can only be 13 hours
• training time can be additional to this (may be particularly relevant for surgeons)
• On call from home is not working time within the 48 hours
• call in time when on call from home is within 48 hours

Take all that on board look at your job and see can it be done, if it cannot hospital management will need to come up with alternatives or else pay the fines.

As far as I read this
The IMO can force hospital management to pay you for hours worked
The Hospital can roster you for long hours and if you dont individually complain you will continue to get paid for those hours and work those hours until someone else complains or they are investigated
THe IMO has to fight for ALL NCHDs and there are many who want shorter hours, hence the law is there to protect them

There seems to be a way for most to get what they want out of this just McGrath will actually have to pay for the hours and in the meantime the training grant which you must admit is a good thing

drzhivago

DrIndy wrote: »

In fairness, a press release was issued to all media sources, however - only the Irish times chose to actually run a story on it.

In my experience - The Indo has tended for anti-medic bias through most of their stories. I am surprised RTE didn't run it though because they gave good press to the initiation of the legal action.

I think the swine flu was big news at that time and this was probably a damp squib to RTE by comparison

PoleStar

Drzhivago, everything you said, I know already.

Yes I am taking a surgical slant as that is my specialty. To provide a service and maintain surgical training to the same degree just cannot be done.

One alternative is to employ more doctors to ensure service provision. This will dilute surgical experience. This is what happened in the UK: surgical logbook reporting of operations has gone down by 33% since EWTD.

Other alternative is to extend training. Im not sure if many people would want a higher training program of 9 years duration.

Thankfully I just found out in Ireland that RCSI has recommended surgeons be given an opt out of 65 to 7o hours.

drzhivago

PoleStar wrote: »

Drzhivago, everything you said, I know already.
Yes I am taking a surgical slant as that is my specialty. To provide a service and maintain surgical training to the same degree just cannot be done.

Dont agree they do it in rest of europe

PoleStar wrote: »

One alternative is to employ more doctors to ensure service provision. This will dilute surgical experience. This is what happened in the UK: surgical logbook reporting of operations has gone down by 33% since EWTD.

Cant appoint more doctors as there is a moratorium, in fact you are likely to see less NCHDs because of the shift to new consultants only being provided when replacing 2 suppressed NCHDS

PoleStar wrote: »

Other alternative is to extend training. Im not sure if many people would want a higher training program of 9 years duration.

What is the need to increase length of training, what are the competencies and how are they achieved

It is not as clear in some of surgical disciplines what the gamut of competencies are to be achieved and how one is certified as achieving themwhat is teh metric

The College of Anaesthetists has very helpful guides for SHOs and registrars what are the competencies to be achieved at various stages through the training

If it is clear in your particular surgical discipline then why will they not be achieved in a reduced hour week, what needs to be done to change that situation

Would there not be nough theatre attendance and procedures
Would there not be enough scoping
would there not be enough clinic attendance
would there not be enough management of on call patients
What would the particular issues be
would there ot be enough mentor/mentee teaching

All of these could be addressed ina reworked hospital model if you could outline what the issue is

I dont think it is a simple as you believe ie a cost saving exercise, they are genuinely fearful for the effect of non-implementation ie local fines and National fines (money wasted in my opinion)

Most surgical trainees I have met do not even understand the directive let alone Irish law, let alone what the implication is for their specialty or post

For some I am not sure that there ill be any change to their working patterns at all

PoleStar wrote: »

Thankfully I just found out in Ireland that RCSI has recommended surgeons be given an opt out of 65 to 7o hours.

I am impressed with your confidence in the RCSI but depressed by the fcat that 8 weeks before the deadline for the final implementation of this law in ireland that the RCSI is asking for an opt out when there is no capacity for such an opt out

In writing the legislation in ireland our legislators did not leave that in from the directive

we also have a clause that says you can have only one job, that was way some countries in Europe had to get around this as junior doctors would work for the hospital for a period of hours and for the university running the training program for a number of hours

If I am not mistaken did the RCSI not get involved in some of the pilot EWTD projects around the country

were the RCSI not involved in submitting sample rotas to the Hanly report as well

drzhivago

PoleStar wrote: »

Drzhivago, everything you said, I know already.

Yes I am taking a surgical slant as that is my specialty. To provide a service and maintain surgical training to the same degree just cannot be done.

One alternative is to employ more doctors to ensure service provision. .

There will be different solutions at SHO, Registrar and SPR level

This is a law that applies across the board so negotiating a solution to make everyone happy will be challenging no doubt for IMO

For example
some doctors want shorter hours
some doctors want more pay for same hours
Some doctors want more pay for less hours
Some Doctors want more training for same pay
Some doctors want more training for more pay
Some doctors want more training, less hours for less pay

You can please some of the people.......

It would probably be a lot easier to solve if those in the various camps actually got up and wrote down in their respective camps exactly what is required to solve the problem for their respective camps bearing in mind there is a law and there are no opt outs or derogations but as this is Ireland there is always wriggle room

Traumadoc

In Australia Surgeons work shorter hours and training is quicker.
I dont buy the idea that training is better here because we work longer hours.

It is not training, it is providing a cheap service to the public patients.

In the training hospital in Australia in I worked in there 16 consultants and 4 registrars on the orthopaedic service.

drzhivago

Traumadoc wrote: »

In Australia Surgeons work shorter hours and training is quicker.
I dont buy the idea that training is better here because we work longer hours.

It is not training, it is providing a cheap service to the public patients.

In the training hospital in Australia in I worked in there 16 consultants and 4 registrars on the orthopaedic service.

agree completely traumadoc, long hours does not equate to great training may actually be no training and just long hours
so to look at your Oz scenario we have here more like 4 ortho consultants, possibly 6 registrars, 2 SHOs trying to run a similar service

where do you think the public get the better deal

I bet they dont have clinics that have 200 people in them in OZ and probably have a lot more consultant run clinics because there are more consultants

Pete4779

drzhivago wrote: »

agree completely traumadoc, long hours does not equate to great training may actually be no training and just long hours
so to look at your Oz scenario we have here more like 4 ortho consultants, possibly 6 registrars, 2 SHOs trying to run a similar service

where do you think the public get the better deal

I bet they dont have clinics that have 200 people in them in OZ and probably have a lot more consultant run clinics because there are more consultants

It's cheaper to employee NCHDs than consultants, so you get what you pay for, regardless of the health outcome. Consultant salaries in Australia are around Aus$200k - comparable to Ireland.