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Brain drain, Lack of junior doctors (NCHD), Role of Irish immigration
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TC80.. Since you have in depth knowledge of IMO strategy, and it is evident that you have work experience with IMO as well, I would like to ask you few questions, IMO represent nearly 3000+ non EU doctors for n number of years, how many times Non EU doctors are selected in the IMO executive position in the past ????
To my knowledge the answer is none, you can correct me if I am wrong. We are aware that local hospital IMO representatives can be non-EU doctor, but I haven't heard someone who has represented IMO from non EU background.
No you are quite wrong - the president of the IMO was Asam Istiaq for around 5 years since 2003 or so. That is right through the boom times and through the creation of the HSE. Plenty of opportunity was there, and the IMO was being run by a non-EU doctor through this half decade.Once IMO has multicultural board of directors representing different nationalities then they will be able to understand the NON EU doctor's day to day problems.
I don't see what a working professional union (and I don't think much of that union anyway) has to do with the day to day problems of people simply because they come from outside the european union. We all get the same salary, same jobs and apply at the same interviews for the same opportunities in the same hospitals. Splitting up into us vs them camps is doing the HSE's work for them; everyone attacking each other for a smaller and smaller pot of influence.0 -
On the topic of the IMO. Why do we still change over on the 1st of July each year no matter what day of the week that may be? Consequences for patient care, stress of working one day and moving many miles that day etc etc.
Cancelled my membership. Useless shower.0 -
On the topic of the IMO. Why do we still change over on the 1st of July each year no matter what day of the week that may be? Consequences for patient care, stress of working one day and moving many miles that day etc etc.
Cancelled my membership. Useless shower.
thats changing as and from next january, changeover will be the 2nd monday of jan and july0 -
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The current nationwide mass migration of NCHD 's was only a matter of time. In fact that it didn't happen earlier is a miracle!!!
The majority of the NCHD body is made of non-EU doctors faced with multiple restrictions on top of the general problems faced by their colleagues. They require work permits - 500euros per contract (6/12 duration), have to do GNIB registration 150 euros (duration in line with your work permit 6/12 and each family member requires said registration) and a re-entry visa 100 euros (again in line with duration of your GNIB and required by all family members) to allo w for you to comeback into the state if you leave on say holidays.
Now add on other factors like pension and pension levy(which will never ne claimed), absence of career progression, long hours and all the other complaints outlined previously and it becomes clear that there is little incentive to hang around. It is also important to remind you that a lot of them have to gone to college in ireland paying tuition fees of up to 40,000 euros per year (x 6yrs).
That is not to say that EU/EEA doctors do not have worries of their own. It is must be hard for them as when all is said is done this is home and they will have to deal with the deficiencies and consequences in the long run. Many have been forced to emigrate (know of 15 in the 2 weeks alone), to better themselves from a proffesional point of view.
The fact is things are only going to get worse and i worry for the future of medical care in this country, the decisions of today will have great consequences tomorrow. Bickering and pointing the accusing finger will not help any.
The truth is there has been a total systemic failure and urgent and concerted action by everybody before the **** really hits the fan!!! (if it hasn't already).0 -
What really rubs me up the wrong way is the total lack of planning in reality (as opposed to what is being publicly stated). I don't even know what rota or even HOSPITAL I'm meant to be working in on Thursday morning! Heard through the grapevine (as usual) that Nenagh and Ennis are likely to close their A&Es and staff redeployed to Limerick!
Those of us hanging around in Ireland face unbelievable bullying in the workplace from Thursday - thinly disguised as "professionalism or duty-as-a-doctor" as hospitals struggle to stay open (if indeed they do!). Been told that I might have to forgo my holidays and study leave entitlements. This will only compound problems come January as more and more NCHDs jump this sinking ship.
I sure as hell will not be hanging around if my terms and conditions, as supposedly won by the IMO and protected by a High Court Order, will be tranced upon. Do you blame me?0 -
resus,
If anyone tells you you have to forgo your annual leave or study leave, you look them in the eye, and say "No". And you take them. I have the names of several good solicitors who specialise in employment law, and if it came to it, you would be awarded costs as they are breaking the law by telling you that you must do this. Get the IMO onto them first though so that you have gone through all the proper channels.
It is illegal to tell someone they have to do that. No ifs, ands or buts. Any consultants who tell you to do that would be wise to think twice, bullying of junior staff and intimidation of them to force them to do illegal things such as working without leave is a serious offence and can result in disciplinary action from the Medical Council as well as a lawsuit against the hospital.
Where are they going to get a replacement, by the way? Think of that. If they treat you like crap, they may wind up, best case scenario, paying a locum who can come and go as they please vast sums of money to cover one shift at a time.
At worst, there is no one at all to cover, The gap in staffing will force services to be pared down to the bone, if the consultants don't cover, they may be shut down altogether.
This goes for anyone else out there, if someone even MENTIONS that you might not get your legal leave entitlements, stand up say no, take them and call the IMO/solicitor/Medical Council.
Our contract has been torn up. Our health service is in chaos. It's time to fight back.0 -
IMO ineffectual, past experience of same.
I may well be asking you for those solicitors contacts. Watch this space. I guess it comes down to all of us having the courage to say, "NO".
In the past, standing up was risking your job/career etc. Thursday is a different ballgame all together. The options available to us now to locum are so great that it makes financial sense to give up full time employment as a doctor. Can earn more in 1 year from Thursday than I would in 3! Even enough to pay for a residency program in the states !! I even had to switch off the sms alerts from the agencies as I was being inundated with offers.
I'm going to say NO, you are spot on with you comment Jane5 . Made me feel a lot better, thanks0 -
IMO ineffectual, past experience of same.
I may well be asking you for those solicitors contacts. Watch this space. I guess it comes down to all of us having the courage to say, "NO".
In the past, standing up was risking your job/career etc. Thursday is a different ballgame all together. The options available to us now to locum are so great that it makes financial sense to give up full time employment as a doctor. Can earn more in 1 year from Thursday than I would in 3! Even enough to pay for a residency program in the states !! I even had to switch off the sms alerts from the agencies as I was being inundated with offers.
I'm going to say NO, you are spot on with you comment Jane5 . Made me feel a lot better, thanks
Take no moosh*t from any HR idiot. They haven't a clue how to manage. No actual qualifications suitable for their positions. Remember the hospital is responsible for patients, you are an employee. If your rights are impinged upon you have the full weight of contract law behind you. As it stands, with so many docs leaving these hallowed shores you, me, and anybody will be able to pick and chose jobs. I think if it come to the point that conditions get so bad, even the whisper of industrial action will cow these idiots into being a little nicer to us. They've all ready rowed back on teh proposed cutting of training positions. They will see sense before the end. this is going to be an interesting year. I'm looking forward to it!0 -
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One of my friends who is still an IMO member got this email from the IMO today and forwarded it to me:
"Dear Doctor
Further to previous advice and as per the new NCHD contract of employment, IMO wishes to remind NCHD members working under the new NCHD contract that the interim training fund of €1908.50 which was available to pay for courses, exams, clinical meetings etc from 1st January to 30th June 2010 will expire on Wednesday 30th June. Any money not claimed by the NCHD by Wednesday 30th June 2010 will no longer be available to the NCHD.
The IMO has sought details from the HSE as to the arrangements for training funding to apply from 1 July 2010 which will be forwarded to all NCHD members on receipt."
So, ummm, the IMO did not negotiate a concrete definite deal on NCHD training funding then? They're just waiting for the HSE to tell them what they'll give them, and how it will be given? And then they'll let us know?
Maybe this is not what this email meant. But that is what I understand from it, and it sure as hell is what my friend understood from it.
So the union that NCHDs pay handsomely to negotiate terms and conditions of work and training has not, in fact, bothered to negotiate any terms and conditions. They are just sitting there waiting for the HSE to tell them what they can or more likely, can't have.
Stop paying them to represent you. They aren't. And you will need that 700-800 euro a year for books , conferences and courses now that they have lost your grant for you.0 -
which is EXACTLY why I don't pay them anymore ;>0
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I'm not a Dr, and therefore not a member of the IMO. However, I'm active in the Irish Pharmacy Union, and as you know we have our troubles too. I'd just like to point out that losing members is only going to make your Union weaker. A Union doesn't just represent its members, it is its members. It can only be as strong as its members are. The greater the need you have for your Union, the more important it is for you to stick together and strengthen your Union by joining it, persuading your friends to join it, and most importantly by ensuring that your representatives are the most capable and dynamic people you can find.
Just my €0.02 worth.One of my friends who is still an IMO member got this email from the IMO today and forwarded it to me:
"Dear Doctor
Further to previous advice and as per the new NCHD contract of employment, IMO wishes to remind NCHD members working under the new NCHD contract that the interim training fund of €1908.50 which was available to pay for courses, exams, clinical meetings etc from 1st January to 30th June 2010 will expire on Wednesday 30th June. Any money not claimed by the NCHD by Wednesday 30th June 2010 will no longer be available to the NCHD.
The IMO has sought details from the HSE as to the arrangements for training funding to apply from 1 July 2010 which will be forwarded to all NCHD members on receipt."
So, ummm, the IMO did not negotiate a concrete definite deal on NCHD training funding then? They're just waiting for the HSE to tell them what they'll give them, and how it will be given? And then they'll let us know?
Maybe this is not what this email meant. But that is what I understand from it, and it sure as hell is what my friend understood from it.
So the union that NCHDs pay handsomely to negotiate terms and conditions of work and training has not, in fact, bothered to negotiate any terms and conditions. They are just sitting there waiting for the HSE to tell them what they can or more likely, can't have.
Stop paying them to represent you. They aren't. And you will need that 700-800 euro a year for books , conferences and courses now that they have lost your grant for you.0 -
A few points Resus. All leave has to be approved by your line manager (Thats HSE for consultant ). If you read your contract you will find that annual leave entitlements are over 6 months. This means in any given 3 month rotation your consultant can refuse you leave outright. You can say no indeed but if you take the time off you can be held in breech of contract. Similarly with study leave, there are so many loopholes in that part of the contract that its amazing anyone gets any study leave at all.
As for sorting it out with solicitors... I recently tried to take a case against my hospital for the ten grand or so they owe me. But because the IMO is in mediation with the HSE on the subject it appears judges will just refer to the mediation process rather than allow you to pursue the case. This means while the IMO talk there is nothing we can do independently. Talking to the IMO reveals they are waiting for a precedent to be set on the Castlebar case (the legal expression of the IMO's impotence ) which has been going on forever now. Best case scenario it would be several years before I got my money,if at all.
Running to the IMO when you are denied leave, all you will get is an expensive there,there. Regarding locums, my latest SHO had to quit for mental health issues, locums weren't even considered. The shortage in jobs is mostly confined to god awful posts where you dont want to work anyway.
Losing members does make the IMO weaker, if thats possible. They are like one of these African puppets regimes, totally ineffectual while claiming that at least they are better than nothing. This is not true. If the IMO ceased to exist then it could either be replaced by a better union or its members could join a better union. By crawling along as a zombie union it makes us all worse off.
Training fund is gone. The HSE will probably pay your royal college fee (dont know about the new reg scheme) and not a lot else. Exams maybe covered but possibly only one attempt. So forget about conferences, exam preparation courses, books , online training etc.
Im off to the US soon. Training complete, another exile. I hope to see you all there.Will the last doc out kindly tell the HSE - "We told you so"0 -
I heard more or less the same.
I think the HSE find the "Health Service" part too difficult and are trying to concentrate more on the "Executive" side of business.
http://www.irishtimes.com/newspaper/ireland/2010/0701/1224273706917.html0 -
Nice article from a consultant in today's Irish Times about how to solve the staffing crisis:
http://www.irishtimes.com/newspaper/opinion/2010/0702/1224273803383.html
In summary:
1- indentured serfdom, which has managed to keep all the home-trained doctors at home in places like South Africa
2-Increased numbers of nurse practitioners- they're better than those sh*tty NCHDs anyway
3-"Interns" is the 3rd part of the Triple Therapy, but he doesn't really develop this point.
Nice little dig about people looking for work-life balance as well...0 -
Is the suggestion here that the way to solve the staffing crisis is to make the place even more miserable and intolerable?
If places like Australia are sucking in all the graduates, would it not be a good idea to look at the practices in places like, ah I don't know, maybe Australia, and not to be moving further in the opposite direction?0 -
I believe this will only last a few years-graduate entry means a lot of doctors less willing or able to travel- similar to what happened with physiotherapy, we may have medical unemployment.0
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Join Date:Posts: 11109
I believe this will only last a few years-graduate entry means a lot of doctors less willing or able to travel- similar to what happened with physiotherapy, we may have medical unemployment.
I tend to agree. The forward planning has been little short of incompetent. Increasing consultant numbers is a good plan but the reduction of one NCHD post for every consultant post created will leave a huge gap in jobs for new graduates and doctors in training.
Add in the increased number of graduates coming out and something has to give.
Less training posts for more graduates will leave us reliant on doctors getting their training abroad then coming back. However the Australian window of job opportunities seems to be closing in 2-3 years time and the UK is prioritising UK graduates and again is reducing the number of training posts.
The new medical council rules re registration means we'll either have unemployed docs on the training register or partially trained docs doing casual and poor quality jobs if any at all.
All this has happened on Mary Harneys watch as was the creation and development of the HSE.
The future generations of doctors in Ireland will pay heavily for her disastrous tenure as health minister.0 -
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Join Date:Posts: 11109
locum-motion wrote: »It's 2 NCHD's per Consultant, not 1, isn't it?
Makes it even worse doesn't it :eek:0 -
MrCreosote wrote: »Nice article from a consultant in today's Irish Times about how to solve the staffing crisis:
http://www.irishtimes.com/newspaper/opinion/2010/0702/1224273803383.html
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wow, Chris Luke not gonna win many friends (here) with those opinions...and I don't really see a long term solution in his proposal...why would people stay here for no jobs at the end of the day (at the end of many years of training)?
Very few people want to emigrate...Australia is a long way away and not the easy option he's making out0 -
ergo, I agree with you. In particular I think the following statement from the article is quite insulting.In truth, it requires a bold and necessary development of the Fottrell prescription, employing the growing number of medical graduates at the frontline, as was the norm until Bondi Beach proved irresistible and “work-life-balance” made the stability of our health service somewhat, er, subsidiary for many of our young doctors.0
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wow, Chris Luke not gonna win many friends (here) with those opinions...and I don't really see a long term solution in his proposal...why would people stay here for no jobs at the end of the day (at the end of many years of training)?
Very few people want to emigrate...Australia is a long way away and not the easy option he's making out
I agree, many are leaving because the training is so good and organised,
no "maybe, if you hang around long enough, you can get onto higher training then after providing a service for a number of years maybe you can be a consultant overseas or do a few fellowships and then maybe you can get a job as a consultant back home" crap.0 -
Join Date:Posts: 11109
I'm afraid Chris Like seems to have fallen for that "i did it so you should too".
It's an extension of the attitude that delayed the proper implementation of the EWHD to the point where the HSE got away with introducing it on their terms to furhter their agenda of closing smaller hospitals.
I agree the comments on "work life balance" are not just insulting and poorly informed they are simply stupid.....0 -
wow, Chris Luke not gonna win many friends (here) with those opinions...and I don't really see a long term solution in his proposal...why would people stay here for no jobs at the end of the day (at the end of many years of training)?
Very few people want to emigrate...Australia is a long way away and not the easy option he's making out
I've reread the article and that comment rankles with me even more today! Ergo is dead right- if you're going to emigrate 10,000 miles away it would have to be pretty bloody fantastic at one end, or pretty bloody crap in Ireland to make you do it. And it's not *that* fantastic downunder.
Left myself 8 years ago, when it was a case of give up Ireland or give up medicine. If avoiding 100hour weeks and 56-hour on-calls to work in a functioning healthcare system is a selfish pursuit of work-life balance, well too bad.0 -
Ha! I was out with a friend who trained in Cork last night, and have it on good authority that Mr. "Indentured Servant" Luke did a SIGNIFICANT amount of his training in AUSTRALIA!
What a massive hypocrite! And what an irresponsible thing to say in public!
As a senior medical figure he has a responsibility to not make things worse for both the profession and patients, and he has failed that responsibility by publicly advocating dangerous work conditions, such as "indenture". I think any NCHD could hazard a guess as to how that would be implemented here. Wouldn't be abused at all. Oh no. I absolutely can't see ANY way that EITHER the HSE OR the consultants would be able to abuse that system. Not at ALL.
How many patients are affected by medical mishaps caused by fatigue, overwork, and stress every year? How many die from these errors?
How many NCHDs are involved in road traffic accidents as a result of fatigue? How many die? I have known several.
How many NCHDs suffer such severe health issues from constant sleep deprivation and overwork that they are rendered unable to work at all? How many commit suicide? Once again, I have known several.
How many pregnant NCHDs miscarry or suffer health problems and pregnancy complications due to sleep deprivation, illegally long shifts with no rest periods, and stress? I have known several.
How many patients DIE waiting to see a doctor in the ED, because the "indentured servants" are all so busy, because there are so few of them because the conditions here are so bad that they leave, or quit, or the HSE just plain WON'T staff they hospitals with adequate numbers of doctors?
This man is openly advocating policies that lead to the above situations. It is extremely irresponsible of a senior medical figure to do that, and I condemn it. Any muppet can see that well rested, happy doctors who see their families and have hobbies (in short, have "work-life balance") are more productive, and less likely to make errors. We have brought in the HPAT under the guise of attempting to have more well rounded doctors (although we all know it's just to get rid of the doctors who might get pregnant). So it would be a bit contrary to stated policy to recruit these well rounded, balanced young med students, and then force them to do nothing but work, and see nothing but work, for years and years on end.
We need more doctors. FACT.
In order for us to obtain them, increasing the number of medical students is not the answer. There are no jobs for them.
We need to increase the number of funded NCHD positions in hospitals all across the board. FACT.
We need to comply with health and safety LAWS and EU working time directive, and implement a shift system. FACT. No more 56 hour shifts. No more 110 hour weeks.
We need to dramatically decrease the amount of overtime NCHDs do. Having more of them around means everyone can work normal hours. This is cheaper and will result in savings, which can be used to hire more doctors. Because, and this is something the HSE can't seem to really get a handle on, PAYING SOMEONE SINGLE TIME FOR 12 HOURS IS CHEAPER THAN PAYING SOMEONE TIME AND A HALF FOR 24 HOURS
We also need to make jobs decent to work in. Every NCHD should be able to reasonably expect a parking space when on call, for example. I have seen NCHDs run out of the hospital to move their cars, etc, while carrying the cardiac arrest bleep. This is unacceptable. Rotations should stagger their changeover dates so NCHDs have more than one night to move their belongings and families from Cork to Galway, which results in a tired doctor the next day, which, you guessed it, is DANGEROUS. As is having a completely new complement of staff all starting on the same day, none knowing where anything is.
This article has infuriated me almost beyond reason. If this is the way the seniors really think, then Irish healthcare is up the creek without a paddle.0 -
Seem like excellent arguments to me, Jane.
Why not put them in a Letter to Madam?
L-M.Ha! I was out with a friend who trained in Cork last night, and have it on good authority that Mr. "Indentured Servant" Luke did a SIGNIFICANT amount of his training in AUSTRALIA!
What a massive hypocrite! And what an irresponsible thing to say in public!
As a senior medical figure he has a responsibility to not make things worse for both the profession and patients, and he has failed that responsibility by publicly advocating dangerous work conditions, such as "indenture". I think any NCHD could hazard a guess as to how that would be implemented here. Wouldn't be abused at all. Oh no. I absolutely can't see ANY way that EITHER the HSE OR the consultants would be able to abuse that system. Not at ALL.
How many patients are affected by medical mishaps caused by fatigue, overwork, and stress every year? How many die from these errors?
How many NCHDs are involved in road traffic accidents as a result of fatigue? How many die? I have known several.
How many NCHDs suffer such severe health issues from constant sleep deprivation and overwork that they are rendered unable to work at all? How many commit suicide? Once again, I have known several.
How many pregnant NCHDs miscarry or suffer health problems and pregnancy complications due to sleep deprivation, illegally long shifts with no rest periods, and stress? I have known several.
How many patients DIE waiting to see a doctor in the ED, because the "indentured servants" are all so busy, because there are so few of them because the conditions here are so bad that they leave, or quit, or the HSE just plain WON'T staff they hospitals with adequate numbers of doctors?
This man is openly advocating policies that lead to the above situations. It is extremely irresponsible of a senior medical figure to do that, and I condemn it. Any muppet can see that well rested, happy doctors who see their families and have hobbies (in short, have "work-life balance") are more productive, and less likely to make errors. We have brought in the HPAT under the guise of attempting to have more well rounded doctors (although we all know it's just to get rid of the doctors who might get pregnant). So it would be a bit contrary to stated policy to recruit these well rounded, balanced young med students, and then force them to do nothing but work, and see nothing but work, for years and years on end.
We need more doctors. FACT.
In order for us to obtain them, increasing the number of medical students is not the answer. There are no jobs for them.
We need to increase the number of funded NCHD positions in hospitals all across the board. FACT.
We need to comply with health and safety LAWS and EU working time directive, and implement a shift system. FACT. No more 56 hour shifts. No more 110 hour weeks.
We need to dramatically decrease the amount of overtime NCHDs do. Having more of them around means everyone can work normal hours. This is cheaper and will result in savings, which can be used to hire more doctors. Because, and this is something the HSE can't seem to really get a handle on, PAYING SOMEONE SINGLE TIME FOR 12 HOURS IS CHEAPER THAN PAYING SOMEONE TIME AND A HALF FOR 24 HOURS
We also need to make jobs decent to work in. Every NCHD should be able to reasonably expect a parking space when on call, for example. I have seen NCHDs run out of the hospital to move their cars, etc, while carrying the cardiac arrest bleep. This is unacceptable. Rotations should stagger their changeover dates so NCHDs have more than one night to move their belongings and families from Cork to Galway, which results in a tired doctor the next day, which, you guessed it, is DANGEROUS. As is having a completely new complement of staff all starting on the same day, none knowing where anything is.
This article has infuriated me almost beyond reason. If this is the way the seniors really think, then Irish healthcare is up the creek without a paddle.0 -
We need to dramatically decrease the amount of overtime NCHDs do. Having more of them around means everyone can work normal hours. This is cheaper and will result in savings, which can be used to hire more doctors. Because, and this is something the HSE can't seem to really get a handle on, PAYING SOMEONE SINGLE TIME FOR 12 HOURS IS CHEAPER THAN PAYING SOMEONE TIME AND A HALF FOR 24 HOURS
95% of what you say is right. But that bit isnt. While it looks correct at first glance, issues such as Employers PRSI, pension entitlements etc and other costs actually make it a litttle bit more complicated.0 -
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95% of what you say is right. But that bit isnt. While it looks correct at first glance, issues such as Employers PRSI, pension entitlements etc and other costs actually make it a litttle bit more complicated.
Which would be totally offset by not having to pay a fortune in locum fees as there would actually be enough staff to cover. It would also be offset in massive reducion in clinical indemnity payouts as half dead doctors arn't sticking canulas through radial nerves and giving gentamycin stat.0
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