Typical attitude from the Medical elite

Tim Robbins

Here's a typical attitude from the Medical elite in this country. They give out about HSE cutbacks but then conveniently forget these cut backs have to be made because it is impossible to make significant changes on their highly paid salaries...

Madam, – Your Editorial (“Eventful year in healthcare”, December 29th), identified many pertinent issues. However, your mention of a positive note, highlighting the relative protection of mental health funding for 2011, sadly does not ring true.
After many years of service developments at a painstakingly slow pace and despite year-on-year reduction in percentage funding allocated for mental health, the past two years have seen an erosion of many such developments. These cuts have been facilitated and excused by the HSE recruitment moratorium which has impacted on mental health services particularly.
In the Laois/Offaly mental health services 25 per cent of acute inpatient beds were decommissioned on December 27th, 2010. This followed other cuts both on inpatient bed numbers and community care provision. These cuts are and will impact directly on patient care. Correspondence from the local consultant group to those responsible for the latest bed closures highlighted the direct negative impact on patient care and the risks involved, but these concerns were not addressed and the bed closures proceeded.
Similar service cuts are occurring throughout the country impacting on those members of the community who have acute mental health needs as well as those coping with disabling and enduring mental illness.
Is anyone listening? Does anyone care? – Yours, etc,
DR KATHERINE BROWN,
Consultant Psychiatrist,
St Fintan’s Hospital,
Portlaoise, Co Laois.

She thinks she is part of the solution when she is actually part of the problem.

Incredibly smug.

Anyone else care to comment?

drkpower

Tim Robbins wrote: »

Here's a typical attitude from the Medical elite in this country. They give out about HSE cutbacks but then conveniently forget these cut backs have to be made because it is impossible to make significant changes on their highly paid salaries...

Clearly all - or even most - health service cutbacks are not required because of the salaries of consultants; that is just nonsense, as i am sure you know.

Looking at the issue seriously, there is little doubt that salaries paid to consultants are on the high side and should be reduced, but the implication of your argument is that, until salaries are reduced (presumably to the levels you see fit), those best placed to comment on the failings of the heatlh services, consultants, should not speak out as regards any issues in the health services, should not advicate on behalf of their patients.

That is simply short-sighted.

Tim Robbins

drkpower wrote: »

Clearly all - or even most - health service cutbacks are not required because of the salaries of consultants; that is just nonsense, as i am sure you know.

Looking at the issue seriously, there is little doubt that salaries paid to consultants are on the high side and should be reduced, but the implication of your argument is that, until salaries are reduced (presumably to the levels you see fit), those best placed to comment on the failings of the heatlh services, consultants, should not speak out as regards any issues in the health services, should not advicate on behalf of their patients.

That is simply short-sighted.

They are entitled to their opinions but there's something extremly smug about them deliberately avoiding their very high salaries in any analysis regarding cost of providing health services.

This consultant didn't even offer any constructive suggestion. All she is saying is: my area is very important, don't cut mine and I am not even bothered in making a suggestion where you should cut.

It gets very smug where she implies there is something wrong with us for not protesting about the cuts in her particular area.

drkpower

Tim Robbins wrote: »

They are entitled to their opinions but there's something extremly smug about them deliberately avoiding their very high salaries in any analysis regarding cost of providing health services..

So when any employee, in any field of employment, complains about the effects of resourse allocation, should they, as a pre-requisite to raising the issue, put their salary on the table? In a country where most people's salary could be said to be excessive (ie. versus EU norms), surely by your logic, anyone complaining should have to address their salary as part of the process?

Tim Robbins wrote: »

This consultant didn't even offer any constructive suggestion. All she is saying is: my area is very important, don't cut mine and I am not even bothered in making a suggestion where you should cut.

Is it for a consultant providing one service to decide specifically what other services should be cut? Should the A/E consultant who wants less over-crowding have to suggest that the cardiac surgery list is lengthened to pay for it? Should the cardiac surgeon who wants shorter waiting lists have to suggest that the paediatric hospital loses its MRI machine?

Or should the frontline service providers highlight where their particular service is failing and allow the policy makers decide on priorities? Im not sure you have thought this through.

Tim Robbins wrote: »

It gets very smug where she implies there is something wrong with us for not protesting about the cuts in her particular area.

When she asks 'is anyone listenting?'; that is simply a cry for attention - it is not a stinging rebuke of the laziness of the populus. You seem to be reading that article with a pre-determined outcome; the consultant is wrong and everything she says is wrong.

Tim Robbins

drkpower wrote: »

So when any employee, in any field of employment, complains about the effects of resourse allocation, should they, as a pre-requisite to raising the issue, put their salary on the table? In a country where most people's salary could be said to be excessive (ie. versus EU norms), surely by your logic, anyone complaining should have to address their salary as part of the process?

Is it for a consultant providing one service to decide specifically what other services should be cut? Should the A/E consultant who wants less over-crowding have to suggest that the cardiac surgery list is lengthened to pay for it? Should the cardiac surgeon who wants shorter waiting lists have to suggest that the paediatric hospital loses its MRI machine?

Or should the frontline service providers highlight where their particular service is failing and allow the policy makers decide on priorities? Im not sure you have thought this through.

I just find her one - eyed attitude lazy and sickening. She is deliberately avoiding the elephant in the room, and not making any constructive suggestion towards a better or even alternative solution.

Yes I believe she or any consultant should be prepared to take cuts in their salary before they start giving out about cuts to their areas. Why should anyone be expected to listen to her and not raise what are valid questions about cost?

RobbieTheRobber

Tim, Im assuming this is a letter sent to the letter section of some newspaper?

You accuse the person who wrote of having views which you describe as being

one - eyed attitude lazy and sickening.

Yet, what you have taken here is one persons views and assummed that an entire sector shares these values. This is a letter where the person discussed one particular gripe yet you feel you know this person enough from this paragraph about a specific topic to make other major assumptions about her and her profession.
Would you not also describe that as a one - eyed attitude, lazy and sickening?

drkpower

Tim Robbins wrote: »

I just find her one - eyed attitude lazy and sickening. She is deliberately avoiding the elephant in the room, and not making any constructive suggestion towards a better or even alternative solution.

So you do believe that consultants & service providers in one area of the health service should be suggesting cutbacks in others; ot tax increases to fund it; or social welfare cuts to fund it.......? Do you really think that is appropriate or helpful?

Tim Robbins wrote: »

Yes I believe she or any consultant should be prepared to take cuts in their salary before they start giving out about cuts to their areas. Why should anyone be expected to listen to her and not raise what are valid questions about cost?

Do you think any employee, in any area, who is on an 'excessive' salary, should have to take cuts in their salary (over and above what has already been taken) before they are in a position to speak out about what they believe to be problems in the services they deliver?

Do you really think that would be a positive development?

dan_d

I agree with the spirit of what the OP was saying...although I don't find the letter particularly offensive, and as I haven't read the article it was referring to, I won't comment on it.

But I do always see a huge amount of irony (and not the funny sort), in letters and soundbites from consultants on the subjects of the various problems in the HSE, when they themselves (willingly or unwillingly) are a huge part of the problem. Of course they can comment, but.....I for one, find their comments a bit difficult to take, given the background against which they are made.

irishh_bob

Tim Robbins wrote: »

They are entitled to their opinions but there's something extremly smug about them deliberately avoiding their very high salaries in any analysis regarding cost of providing health services.

This consultant didn't even offer any constructive suggestion. All she is saying is: my area is very important, don't cut mine and I am not even bothered in making a suggestion where you should cut.

It gets very smug where she implies there is something wrong with us for not protesting about the cuts in her particular area.

doctor knows best


as for the letter

the number of beds being cut is due to policy change regarding psychiatric patients , under whats called CARE IN THE COMMUNITY , several mental hospitals have been closed , the liberals ( who now dominate the system ) eventually intend to close all hospitals and release patients into the community , the idea is to decentralise the system and set up local support clinics where patients can attend on a regular basis , doesnt seem to matter if the patients is mary from drogheda who suffering from post natal depression or henry from kerry who hacked his neighbour to death because he thought he was the devil

drkpower

dan_d wrote: »

But I do always see a huge amount of irony (and not the funny sort), in letters and soundbites from consultants on the subjects of the various problems in the HSE, when they themselves (willingly or unwillingly) are a huge part of the problem. Of course they can comment, but.....I for one, find their comments a bit difficult to take, given the background against which they are made.

I hear what you are saying but those of you who discourage those at the coalface of service delivery from speaking out as regards deficincies in the service only do every single patient, present & future, a grave disservice.

It may feel good to be having a pop at the consultants but all you do is damge the service provided to patients. Perhaps when those best placed to comment on the health service feel pressurised not to, you might realise your error.

Brussels Sprout

drkpower wrote: »

I hear what you are saying but those of you who discourage those at the coalface of service delivery from speaking out as regards deficincies in the service only do every single patient, present & future, a grave disservice.

It may feel good to be having a pop at the consultants but all you do is damge the service provided to patients. Perhaps when those best placed to comment on the health service feel pressurised not to, you might realise your error.

I don't think the issue here is with them offering constructive criticism about hospital services. That is to be encouraged. It's that in doing so perhaps they should acknowledge that their own massively overinflated wages are sucking money out of the capital funds for the hospitals in which they work.

The same goes for teachers who complain about teaching in prefabs and guards who complain about their crappy radios and ancient stations when their own pay has risen massively over the past 15 years.

dissed doc

Tim Robbins wrote: »

They are entitled to their opinions but there's something extremly smug about them deliberately avoiding their very high salaries in any analysis regarding cost of providing health services.

This consultant didn't even offer any constructive suggestion. All she is saying is: my area is very important, don't cut mine and I am not even bothered in making a suggestion where you should cut.

It gets very smug where she implies there is something wrong with us for not protesting about the cuts in her particular area.

The probably avoid it as the cost of the entire consultant workforce every year is €238 million (1400 consultants, 170k salaries), before half that is recouped back in taxes. The net cost to the state every year for all consultants is around €130 million. Without them, you don't have a health service to spend the other €19 billion on.

Consultants got a dedicated consultant-only 15% paycut, on top the 10% new entrants cut for all new consultants, on top of the 10% average pension levy. It's why there are no job applications any more.

As the consultant in the letter is a psychiatrist, she is likely to be advocating mental health services; this is particularly significant as suicide is the largest killer of young males in the country every year (more than road traffic accidents, more than cancers, more than alcohol), and publically funded mental health services are steadily being cut, every year, without fail.

Chuchoter

Honestly I think this is just begrudgery. It takes 10-15 years to become a consultant, on top of university. These are highly qualified people and deserved to be paid for their work. If they were in it for the money there are several other jobs they could have made as much money in for half the work. If we don't pay them this, we will lose whatever up and coming Irish doctors we have left to Australia and NZ.

Robxxx7

BAAAH

Bits_n_Bobs

The holier than thou attitude of consultants 'commenting' on the chaos that is our health system tends to bug me a bit as well. Leaving aside what may or may not be excessive pay for a minute, they make up a powerful lobby group within the health sector - hence a consultant (Mr. Drumm) being appointed as top dog in the HSE.

As such they are at least as much to blame as the bloated administration, nurses, dept of health, HSE and myriad other groups that together manage to blow €15 billion per annum, of tax payers money, while providing a service so poor that those who can, in any way afford to, get raped by the likes of the VHI, gladly do so.

The fact is they are not part of the solution, they are part of the problem. Until all these individual groups are faced down by a leader of some stature we will be stuck with this rotten fetid corpse of a health service.

dan_d

Bits_n_Bobs wrote: »

The holier than thou attitude of consultants 'commenting' on the chaos that is our health system tends to bug me a bit as well. Leaving aside what may or may not be excessive pay for a minute, they make up a powerful lobby group within the health sector - hence a consultant (Mr. Drumm) being appointed as top dog in the HSE.

As such they are at least as much to blame as the bloated administration, nurses, dept of health, HSE and myriad other groups that together manage to blow €15 billion per annum, of tax payers money, while providing a service so poor that those who can, in any way afford to, get raped by the likes of the VHI, gladly do so.

The fact is they are not part of the solution, they are part of the problem. Until all these individual groups are faced down by a leader of some stature we will be stuck with this rotten fetid corpse of a health service.

Precisely! Of course they're entitled to comment - but it doesn't change the fact that it's a bit hard to take when they are one of the most powerful lobby groups in there. And I don't buy this "we have to pay people loads to get the best" attitude either - at that rate, we should be paying massively inflated wages to everyone - and last I checked, that's a major part of what got us into this mess in the first place.

jmayo

crayolastereo wrote: »

Honestly I think this is just begrudgery. It takes 10-15 years to become a consultant, on top of university. These are highly qualified people and deserved to be paid for their work. If they were in it for the money there are several other jobs they could have made as much money in for half the work. If we don't pay them this, we will lose whatever up and coming Irish doctors we have left to Australia and NZ.

From experience of health care in New Zealand, it didn't cost and arm and a leg to see a doctor or visit a clinic (both private), so some how I doubt our latest would be batch of consultants will want to go to the other side of the world and not get a very nice salary.

This is the old argument preferred by politicans, high ranking civil servants, bankers, etc that if you pay peanuts you get monkeys.
Well we might not get or want monkeys in the health care profession, but it would be nice to get them outside of the hours 0800 to 1730 Monday to Friday. :rolleyes: