Ireland on the brink...how can health professionals help???

Vorsprung

opinion guy wrote: »

Emigrating is one option.
Only taking jobs that ensure EWTD compliance is another.
Locuming and enforcing your own dictate of not working more than X hours in one go is another.

There are many ways to take action.

What if I don't want to be a psychiatrist when I grow up?!

There are very few EWTD compliant jobs out there as far as I know, and within the large teaching hospitals, I would imagine there are not many at all.

kelle

Fado Fado wrote: »

Yes they do, actually. As the DOHC salary scale shows, a radiographer in his or her first year out of college earns €36,186 for a week's work, while an intern - with far greater responsibility, it can surely be argued - will earn €33,619.

Now, I'm not bashing on radiographers - although I do think the on call fees they are payed for CT and MRI scans is ludicrous. For doing, for example, a non-contrast CT brain, which takes about 2 minutes (certainly no more than 5) between 12pm on a Saturday and 9am on a Sunday, the CT Radiographer gets paid €119.23 - per scan. The doctor who reports the scan certainly doesn't get paid that fee. And you could easily do ten such scans during the Saturday/Sunday on call.

It would be far far cheaper to pay a CT radiographer a sessional rate to stay in house and do the scans. But this won't happen in the forseeable future, of course, because the radiographers are represented by that roadblock in the way of an efficient health service - SIPTU. This is the same union that organised an electrician strike in St. James's Hospital because management had the audacity to suggest that a job ensuring some other such exorbitant callout fee could be managed by a lesser paid worker.

http://www.irishtimes.com/newspaper/health/2010/1019/1224281437401.html

SleepDoc

kelle wrote: »

http://www.irishtimes.com/newspaper/health/2010/1019/1224281437401.html

And this proves what?

That doctors have to work dangerous hours? And horror of horrors, get paid for it?

opinion guy

Vorsprung wrote: »

What if I don't want to be a psychiatrist when I grow up?!

There are very few EWTD compliant jobs out there as far as I know, and within the large teaching hospitals, I would imagine there are not many at all.

Cork and Galway I'm told are EWTD compliant. All emergency departments. Anaesthetic and paeds.
Also when you locum you can dictate your own hours. If you don't believe me phone the locum agency and ask them

sam34

Vorsprung wrote: »

What if I don't want to be a psychiatrist when I grow up?!

psychiatrists dont just work 9 to 5 you know!

seriously speaking, most psych units that i know of are non-compliant and doing an ostrich on the EWTD

Nchd2010

Cork and Galway I'm told are EWTD compliant. All emergency departments. Anaesthetic and paeds.

I have no idea about Galway. CUH spending the most of any hospital on locums. And not compliant anyway. Anecdotally, standards are dropping alarmingly in a fine institution (according to 2 consultants).

I know of several emergency departments that are not EWTD compliant. Anaesthetics in small hospitals not compliant, similar for paeds. Sorry mate, you're mistaken. Again.

Also, can we maybe get back on topic at some stage?

opinion guy

Nchd2010 wrote: »

I have no idea about Galway. CUH spending the most of any hospital on locums. And not compliant anyway. Anecdotally, standards are dropping alarmingly in a fine institution (according to 2 consultants).

I know of several emergency departments that are not EWTD compliant. Anaesthetics in small hospitals not compliant, similar for paeds. Sorry mate, you're mistaken. Again.

Also, can we maybe get back on topic at some stage?

So I'm wrong in "several emergency departments" and in "small hospitals". i.e the minority of cases. So actually I'm more right than I am wrong. And the point is -don't take the jobs in the non-compliant hospitals. I'm talking about using the market forces to drive change - don't you get that ?

Nchd2010

Medicine is not a market place. It's scary just how severe cuts in the budget are going to be. As a country we cannot afford to hire locums, nor can we afford to take on more doctors, close small hospitals and upgrade larger hospitals in order to ensure EWTD compliance. If that wasn't the case, and we were truly a wealthy nation, I would be all for threatening the HSE, but this just isn't possible at the moment. Simple as.

Also you're wrong in four out of five of your statements. At least.

RobFowl

I think one thing we need to do is stop pretending that we can provide 24/7 services in all the hospitals (someone mentioned 51 earlier).

To give a lead in terms of safe centralisation of services and stop pandering to local politics and misguided loyalty to institutions.

Also when safe services cannot be provided we need to be vocal but also proactive in offering solutions.

Lastly we need to downsize what we expect to earn.......

Traumadoc

Down sizing will happen, but it will make the service even worse. We just do not have the capacity, and bigger hospitals are not cheaper to run.

Smaller hospitals are more efficient, thats why private hospitals dont have 600 beds.

If you close smaller hospitals at the moment expect things to get a lot worse, Ask whats happening in the North East- if a surgical patient turns up in Navan they are brought to whatever hospital is on take for Navan , it could be Beaumont . If you return with a post op complication you may be taken to another hospital such as Cavan.

Nchd2010

Also, quite amazingly, according to a health journalist I know, Navan, despite now seeing less patients, have not downsized the NCHD contingent, and brilliantly have actually taken on more NCHD locum staff to work in ED. I'm not sure if this is true, but my source is pretty good.

opinion guy

Nchd2010 wrote: »

Also, quite amazingly, according to a health journalist I know, Navan, despite now seeing less patients, have not downsized the NCHD contingent, and brilliantly have actually taken on more NCHD locum staff to work in ED. I'm not sure if this is true, but my source is pretty good.

Navan lost its interns about 3 or 4 years back when they lost training recogition

Traumadoc

Vorsprung wrote: »

Invest in Foxtel!



I had a read of that article, and I have to say I'm less than convinced. Are these 2 year schemes aimed at non-EU medics? There's a mention of 80 odd new ED SpR training posts. There's currently about 8 SpR jobs up for grabs per year (I'm sure Traumadoc will correct me on that if I' wrong) and there are less than 40 ED consultants in the country. So it's about an extra 16 odd SpR jobs per year (assuming a 5 year scheme).

That's great. 15 people applied for the SpR last year. Where are these applicants going to come from? Have plans been put in place to hire extra consultants in the large hospitals (no is the answer I think unless things have changed since I was last home). If the jobs aren't there at the end, where is the carrot? It seems to me that people without the necessary time will get on the scheme, and you'll get less and less qualified 1st year SpRs floating around.

Am I understand that correctly as has my long day taken its toll?

Not sure on the A&E Spr numbers, A lot get trained in Australia and the UK anyway.

Nchd2010

I'm pretty sure the IMT article refers to specialist training posts, not specialist registrar posts ( the link won't work for me at the moment). I suspect that the posts that were designated non-training last year will magically become training posts again. More bull**** really. 2 year contracts are also a load of nonsense really, they're dead end jobs with no real hope of any proper training or progression. Hence they're specifically aimed at non-Irish, as they're just not that attractive.

kelle

SleepDoc wrote: »

And this proves what?

That doctors have to work dangerous hours? And horror of horrors, get paid for it?

It proves radiographers do not get paid more than doctors, which the OP quoted.

SleepDoc

kelle wrote: »

It proves radiographers do not get paid more than doctors, which the OP quoted.

It does nothing of the sort.

Radiographers get paid more than many grades of doctor for a basic working week.

Traumadoc

kelle wrote: »

It proves radiographers do not get paid more than doctors, which the OP quoted.

No it does not, it shows that one NCHD gets a large amount of money for doing a large amount of overtime.

Radiographers do get paid more than some NCHDs but radiographer pay does not increase like doctors pay as they are rewarded for increased responsibility or experience.

This is to reward career progression.

RobFowl

SleepDoc wrote: »

It does nothing of the sort.

Radiographers get paid more than many grades of doctor for a basic working week.

An intern is technically not allowed practice independently without close supervision. Newly qualified radiographers are. It makes perfect sense that their starting pay is higher.
I get quite annoyed at this attitude that all doctors at every stage of their career should be paid more that other linked professionals. Training for doctors is long and the financial rewards are very good. Looking back as an Intern I certainly did not deserve to get paid more than experienced Staff nurses, Radiographers, Physio's, OT's and many other essential professionals.

Nchd2010

I certain did not deserve to get paid mote than experienced Staff nurses, Radiographers, Physio's, OT's

But what about inexperienced professionals? I also don't buy this crap about doctors having more opportunity to earn more in the future...sure anyone could say that if a radiographer is an independent practitioner they could just start their own private radiography business, which doctors cannot do straight out of college.

The FACT is that most, if not all, qualified doctors have three honours degrees, which is about 3 times what most of the other professionals mentioned would have.

bleg

So not having a go at each other is out the window then yea?

SomeDose

Nchd2010 wrote: »

But what about inexperienced professionals? I also don't buy this crap about doctors having more opportunity to earn more in the future...sure anyone could say that if a radiographer is an independent practitioner they could just start their own private radiography business, which doctors cannot do straight out of college.

The FACT is that most, if not all, qualified doctors have three honours degrees, which is about 3 times what most of the other professionals mentioned would have.

And...who cares? What moral law dictates that your earnings should be indexed to the number of qualifications you have? There's plenty of people out there who will out-earn you despite their supposed lack of degrees and qualifications, that's just a fact of life. If you can't reconcile that, well then you have a confidence problem.

RobFowl

Nchd2010 wrote: »

The FACT is that most, if not all, qualified doctors have three honours degrees, which is about 3 times what most of the other professionals mentioned would have.

If you noticed the Medical council value these so highly they do not even acknowledge one !!
And in UCD the vast majority of these are not honours degrees.
In truth these are simply the basic qualifications all doctors have. It's a bit like the leaving cert. Once the most important exam of your life then as soon as its finished it's last weeks news.
The most important qualification Doctors is their CCST. I think you have to recognise that medical school produces very raw graduates who have a minimum of another 4 years of post grad training before they are properly qualified for individual practice.
Other professions allied to medicine require shorter training periods and produce fully trained professionals in a shorter time frame. That is why they have higher starting salaries not just in Ireland but throughout the world.
If you feel hard done by salary wise here then take a look at resident salaries in the States....

bleg

It's 8 years to become a fully qualified pharmacist in Ireland now as well with the new professional structures put in place. I can guarantee you that the majority aren't as well paid as physicians. The ones that are have to be somewhat of an entrepreneur also.

ThatDrGuy

bleg wrote: »

It's 8 years to become a fully qualified pharmacist in Ireland now as well with the new professional structures put in place. I can guarantee you that the majority aren't as well paid as physicians. The ones that are have to be somewhat of an entrepreneur also.

How long does it take to train a professional nurse ? I know some who are 20 years working, have had ten of thousands of euro spent training them yet are not "qualified" to give iv paracetemol. When you pay an intern you are paying for flexibility. Radiographers wont treat a patient. Nurses wont treat a patient. As an intern I did practically every job in the hospital including portering and repairing the computers because the IT people hadnt a notion of what they were doing. Even took a portable xray on xmas day once (no radiographer then - surprise,surprise). If the hospital flooded tomorrow the doctors would end up manning the sandbags. Everyone else would say its not their job.That flexibility - to do what needs to be done in the interests of the patient is essential to the health service. Its why allied health professionals shouldnt be paid as much as they are, a 65,000 Euro Dietican provides nowhere near the value of two interns.

SomeDose

bleg wrote: »

It's 8 years to become a fully qualified pharmacist in Ireland now as well with the new professional structures put in place...

8 years...how?

It takes 5 years to become fully qualified. Unless you're referring to the extra 3 years required to be eligible to supervise a retail pharmacy, which has no relevance to your professional qualification status.

Nchd2010

When you pay an intern you are paying for flexibility.

This is true tbf. Although it's generalisable to most doctors. In an emergency situation, you simply won't get a radiographer to do a FAST scan. FACT. Or even a fast scan. FACT. I'm more than willing to do focussed ultrasonography for abdominal or thoracic trauma at any time. In fairness most (but not all) radiographers will demand a written request for a scan, which will be performed when they have time. Less than a week ago, I rang a radiographer on call at home for an urgent CT brain at about 8am. I was told that it wouldn't be worth her while coming in as "the scanner will be turned on at 9 anyway, sure it won't make any difference." Apparently "time is tissue" doesn't apply in certain circumstances.

I know this is anecdotal, but I really don't believe any doctor working in an Irish hospital would deny that emergency treatment and diagnosis is frequently delayed in such circumstances.

Also I really don't believe it's "having a go" at fellow professionals by suggesting that they are overpaid. Let's face it, radiographers went on strike around this time last year, when they, nurses, paramedics etc were hit with a pay cut. Doctors, taking exactly the same cut, did not strike.

Any chance of getting back on topic folks? The mods will probably close the thread soon as there is genuine debate happening.

RobFowl

Vorsprung wrote: »

I had a read of that article, and I have to say I'm less than convinced. Are these 2 year schemes aimed at non-EU medics? There's a mention of 80 odd new ED SpR training posts. There's currently about 8 SpR jobs up for grabs per year (I'm sure Traumadoc will correct me on that if I' wrong) and there are less than 40 ED consultants in the country. So it's about an extra 16 odd SpR jobs per year (assuming a 5 year scheme).

That's great. 15 people applied for the SpR last year. Where are these applicants going to come from? Have plans been put in place to hire extra consultants in the large hospitals (no is the answer I think unless things have changed since I was last home). If the jobs aren't there at the end, where is the carrot? It seems to me that people without the necessary time will get on the scheme, and you'll get less and less qualified 1st year SpRs floating around.

Am I understand that correctly as has my long day taken its toll?

From the IMT here http://www.imt.ie/news/2010/10/structured-rotations-for-all-medical-posts.html it seems they are actually structuring training posts together in 2 years blocks. Seems to be an attempt to improve training by giving a guaranteed range of experience.

SleepDoc

RobFowl wrote: »

An intern is technically not allowed practice independently without close supervision. Newly qualified radiographers are. It makes perfect sense that their starting pay is higher.
I get quite annoyed at this attitude that all doctors at every stage of their career should be paid more that other linked professionals. Training for doctors is long and the financial rewards are very good. Looking back as an Intern I certainly did not deserve to get paid more than experienced Staff nurses, Radiographers, Physio's, OT's and many other essential professionals.

I am not saying that other professionals should necessarily be paid less than all doctors. I am of the opinion however that doctors take virtually all the responsibility for patient care with far less of the support that enjoyed by other health care professionals.

The IT article is authority for precisely nothing. If a radiographer worked a 120 hour week, their take home pay would surpass 6 figures at the expense of their social life, their sanity and their ability to do their job safely.

lonestargirl

Such a vast proportion of the HSE's budget goes on pay that the only way to make substantial savings is a wholesale re-organisation of work practices within the organisation.

• The 'standard' week: people don't get sick 9-5, if you go into a health profession you should be prepared to work outside these hours. I would designate 6am - 10pm Mon-Sat as 'standard' hours, i.e. no extra pay for being rostered during these times.
• Performance related pay. At the age of 24 I earned €40k a year, I was very good at my job and I think the HSE got value for money from me. I worked with someone, with the same job title and less responsiblility, who earned €55k simply because she had been there longer than me. Pay increments need to be based on the achievement of specified targets if you want to recruit and keep highly-skilled motivated staff.
• Flexibility from health service staff, some areas are understaffed others are overstaffed. People need to be prepared to move role if the staffing need of the hospital requires it. The same person I mentioned above was against my group voluntarily agreeing to flexi-schedules because if it was imposed on us later we 'would be able to get compensation for a change in work practices'. These kinds of attitudes have no place in a professional service.
• No overtime, this means hiring more staff (which wold be good for the live register), but instances of people earning €100+k in overtime only happen when people are working stupid amounts of hours. Ideally you want people working for their base hourly rate at all times.
• Maternity leave payments are vey generous in the public and health services. Should we really be topping up to full salary for people earning €70k a year? I'm not looking to put families in poverty, but a graduated reduction in the % of salary paid out above €40k would I feel be appropriate.

lonestargirl

Nchd2010 wrote: »

The FACT is that most, if not all, qualified doctors have three honours degrees, which is about 3 times what most of the other professionals mentioned would have.

Going by your logic I should earn more than you since I have a level 9 degree (will be level 10 in a few years) and yours are 'only' at level 8.