HSE breaking contractual agreements with NCHDs. AGAIN!

j.mcdrmd

Hi,

Sam34 suggested that I read this and closed my thread, my very first one. Feels like I have been thrown to the lions.

I have read this before and did not want to get involved as it appeared to be a lot of very angry people disagreeing. I don't mean to offend anyone by that, I realise that I know very little about the issues.

I have no connection to medicine in any capacity other than an intern is a family member.

The work conditions are coming as a bit of a shock to us (not the intern) and I just wanted to check out if it is at all true without any of the stuff Sam34 is complaining about.

I still kind of think that it couldn't be true, sure doctors would not put up with conditions that adversely affect their own health and thus the health of the patients in their care, would they?

I am actually really concerned about the patients health as well as the doctors health and I think it would have been better to discuss this in a calm way about facts on the ground for both patients and staff so that ordinary members of the public could understand. I don't think we have a clue and when you get to hospital and are sick it is a bit late to find out.

Just one question, does an intern HAVE to get insurance or does the hospital get it on their behalf? I would like this to be sorted before the inevitable happens.

J McDrmd

dissed doc

j.mcdrmd wrote: »

.....

I still kind of think that it couldn't be true, sure doctors would not put up with conditions that adversely affect their own health and thus the health of the patients in their care, would they?

I am actually really concerned about the patients health as well as the doctors health and I think it would have been better to discuss this in a calm way about facts on the ground for both patients and staff so that ordinary members of the public could understand. I don't think we have a clue and when you get to hospital and are sick it is a bit late to find out.

Just one question, does an intern HAVE to get insurance or does the hospital get it on their behalf? I would like this to be sorted before the inevitable happens.

J McDrmd

The state hospitals will cover insurance if you are working there as an NCHD or consultant. BUT, the standard insurance doesn't exactly give you the necessary advice such as legal advice on matters that arise. This happens regularly as an intern, e.g., being left run cases with no proper supervision, excessive workload and patient deaths and so on. This is where having you own insurance is important as you then have a more neutral party instead of "ah just get on with it" from the hospital staff.

I don't know if the MDU are still in Ireland, in which case the MPS (which is not an insurance company by definition) is the only option. Worth having IMO, as they also run medicolegal courses on the type of things that lead to bigger issues, etc., .

sam34

j.mcdrmd wrote: »

Hi,

Sam34 suggested that I read this and closed my thread, my very first one. Feels like I have been thrown to the lions.

ah now, to be fair, you've hardly been thrown to the lions.:)

there's no point in multiple threads being open on the same issue, as people will have to post similar/identical posts in both threads, and it gets messy and confusing.

drkpower

dissed doc wrote: »

I don't know if the MDU are still in Ireland, in which case the MPS (which is not an insurance company by definition) is the only option. Worth having IMO, as they also run medicolegal courses on the type of things that lead to bigger issues, etc., .

The most important reason to have seperate insurance is in case you are unfortunate enough to be called before a Medical Council Fitness to Practice Investigation, which isnt covered by the Clinical Indemnity Scheme (in most cases). CIS also dont cover you for Good Samaritan acts, but the chances of being sued for GS acts are extremely low/virtuallly unheard of in Ireland.

RobFowl

resus wrote: »

a. There is a shortage of NCHD's in Irish hospitals with Intern and SHO jobs not filled and nobody to replace them.
The are between 5-10% of post vacant mostly in AE/obstetrics and anaesthetics. The system is hanging on though

b. Patients are confused and upset by the change of teams.
They can be but a proper handover by teams should reduce the risk of errors.

c. Hours worked by Interns and SHO's are dangerously long (for the patients and doctors health) with shifts upto 26 hours and weeks up to 60+ hours.
Yes and are suposed to be coming down but this is being done in a controversial (to be mild) way
d. Interns are left as the only doctor "on the wards" overnight from their first week. They don't even know their way around.
Interns are first line on the wards but are backed up with SHO's and Registrars and ultimately consultants (usually off site)
e. During up to 26 hour shifts no time is guaranteed for a meal break, often they just do not get fed.
Eating on the go is far too common and no protected mealtimes are the norm in the Irish system
f. "On call" is a euphemism for even harder work with less backup.
It can be
g. If two patients get very ill at the same time "on call" 1 of them might die.
Ill patients in hospitals cab get sick at the same time. Nurses , doctors and other staff can to a degree can do some resusitation. Sick patients are assesed and the sickest and most urgent treated first. It's rare for 2 "arrests" to happen at the same time but crises do occur as can natural disaters etc. There are at least rudimentary plansd in place in most hospitals.
h. Threats are made not to pay overtime.
This has been reported anecdotally
i. The majority of the Interns who finished here in June have left the country because of their treatment by the HSE.
The majority have stayed but a significant number of interns and more senior doctors are emigrating
j. Points are up for medicine, I know this one is true I just wonder why?
Seem to be due to HPAT repeats and grinds/coaching which does seem to influence results despite the system being introduced to avoid this
Ok, so this may be exaggeration, the intern has no clue I am posting this, but they are forgiven if it is because of the long hard slog they put in to get here.

The intern is not complaining, say they are competent in fact.

I am worried about the patients of course. I am also worried about the intern as I already see a "pinched look" about what was a very fit, bright eyed and bushy tailed young doctor.

Anyone who knows the inside track from the teaching hospitals care to comment?

Also do they need to get insurance or does the hospital cover that?
The hospital indemnity covers them but additional cover through the MPS is advisory.
Thanks if you read to the end.

J McDrmd"


All of the above is NO exaggeration and yes, Many interns are simply leaving the country. THIS WORRIES ME TOO. How can we influence our "powers that be" that treating their employees like modern day slaves, resulting in them LEAVING IRELAND, ( regardless of whether or not you agree with their reasons for leaving) is endangering patient care?

Hope that helps to some extent. I've forced myself not to be too negative :rolleyes:

maninasia

dissed doc wrote: »

What sort of insanity is this?

A training job with training money and courses? Access to online resources? Prioritising medical care over managerial security?

You could pay NCHDs a salary of zero and it would save 315 million of the health budget. That is it. That is all the NCHDs cost (~4500 x €70,000). Throw in taxes that take back around 40% of that net of levies and taxes, the entire cost of NCHDs to the state every year is €189 million.

Taking a 25% paycut? That will save the state the grand total of just over €47 million a year. Thank god! We are saved!! The recession is over and it WAS ALL THE DOCTORS FAULT. All the country needed was that €47 million.


.....bailing out the banks......€50,000 million

.....paying social welfare costs.....€20,000 million

.....net saving of a 25% paycut for all junior doctors.....€47 million

.....diverting attention to the doctors to avoid scrutiny of the state finances......priceless

The HSE does not want a large group of doctors to ever form as it would lead to difficulties for the HSE. Throw a smaller group enough overtime cash to keep them sweetish and they won't complain.

It's up to doctors to do if for themselves, you need to go on strike about working conditions. Why do you put it up with? What are you going to do? Are you little more than a highly trained monkey?

As for the country going broke, that's clear as day. Your employer going broke is a problem, take it from me I have had the experience before..

I was laughing at the comment about how private sector employers would pay for training, give you grants etc. Those days are gone and didn't exist in most companies anyway. Things are tough out there, anybody with a decent job and education should be thankful.

Everybody in Ireland needs to lower their income expectations to get back on track, Ireland is not Kuwait. Ireland also has a very poor health service, in it's structure, it's efficiency, it's ability to deliver healthcare to the general population..really not good. Ireland is falling behind other countries and a large part of that is everybody paying themselves out of a small pot too much for poor services- this goes for health, govt admin, gardai, education..you name it. I always laugh to see these people driving around in nice cars but many working in run-down 19th century facilities and giving lipchange to changing their working attitudes but actually just pocketing the money (benchmarking). There's always an excuse..I work hard, I have a big mortgage, Ireland is expensive blah blah. Like nobody else has these problems around the world. Culture of greed has taken root, it should be a culture of public service, or doing a job and doing it well. These issues come out from the core moral compass, the moral compass has to change to embrace the idea of more than 'ME'.

There was a doctor that posted from the US. The US health system fails large parts of it's population, it is not a good one to emulate, it is also extremely expensive (although I appreciate this was not the point he was making). It's also illustrative to note that he took a big pay cut to work there but admits his pay is more than adequate even in New York, a notoriously expensive city.

opinion guy

maninasia what have we been doing all this time without you ? You've got all the answer!!!
Maninasia for Taoiseach!!!!!

maninasia

It wouldn't be hard to be better than the last few anyway.

opinion guy

maninasia wrote: »

It wouldn't be hard to be better than the last few anyway.

You know what ? I actually can't argue with you there!:D