New consultant work practices

MrCreosote

Just wondering what the take on the latest agreement is.

http://www.irishtimes.com/newspaper/breaking/2012/0917/breaking2.html

Sell out by the consultants- protecting their own salaries and shafting the future consultants?

Equal in "title, status and scope of practice"- cynical HSE-speak for lower pay for the same work?

RobFowl

My take is that they are selling out future consultants for their own gain. Not a good reflection on the profession as a whole IMO.

Nonoperational

Very disappointing. I'll really have to consider whether I'll work here in the future if this goes ahead.

his_dudeness

gpf101 wrote: »

Very disappointing. I'll really have to consider whether I'll work here in the future if this goes ahead.

I think there'll be a lot of us in the departure queues after todays news.

bill buchanan

Consultant jobs will still be oversubscribed and that's what matters to the HSE. Gonna be an awful lot of doctors here in a few years who are in too much debt and too old to move away.

The HSE know this fine well and there won't be a shortage of consultant applicants.

Ryder

bill buchanan wrote: »

Consultant jobs will still be oversubscribed and that's what matters to the HSE. Gonna be an awful lot of doctors here in a few years who are in too much debt and too old to move away.

The HSE know this fine well and there won't be a shortage of consultant applicants.

I disagree. I will have no problem in paying my mortgage from abroad, in fact will find it much easier. And its not just about the money, anyone with options will migrate/stay away because future consultant practice does not appear to be about collegial equality when a proportion will be have a co-located private practice, another proportion earn 30% more etc. Being on a fellowship at the moment its instructive to see the way in which other europeans, australians and americans look forward to consultant work (after less experience) for better pay and conditions.

bill buchanan

Ryder wrote: »

I disagree. I will have no problem in paying my mortgage from abroad, in fact will find it much easier. And its not just about the money, anyone with options will migrate/stay away because future consultant practice does not appear to be about collegial equality when a proportion will be have a co-located private practice, another proportion earn 30% more etc. Being on a fellowship at the moment its instructive to see the way in which other europeans, australians and americans look forward to consultant work (after less experience) for better pay and conditions.

I think that's great if you can rent your house out and get another mortgage abroad and are young enough that you can up sticks and go. A lot of people I know doing GEM won't be in a great position to move when they get their CCST.

I think consultant jobs at 120k+ per annum won't be hard to fill, regardless.

OMD

The possibly overlooked side effect will be the effect on NCHD salaries. This will definitely put pressure for those to be reduced. Consultants get very little extra for doing overtime. A reg with a lot of overtime could be looking at a salary cut whe he/she becomes a consultant.

bill buchanan

OMD wrote: »

The possibly overlooked side effect will be the effect on NCHD salaries. This will definitely put pressure for those to be reduced. Consultants get very little extra for doing overtime. A reg with a lot of overtime could be looking at a salary cut whe he/she becomes a consultant.

Would there be many Regs in Ireland pulling in over 120k with OT?

Thunder63

Definitely. Surgical SpRs would be. These have previously taken paycuts when becoming consultants.
If they bring in weekend pay, unsocial hours pay, then maybe the $50,000 pay cut won't be so hard to swallow.

OMD

bill buchanan wrote: »

Would there be many Regs in Ireland pulling in over 120k with OT?

Top of the salary scale for specialist reg is about €76k basic. New pay scales start at 116k? 12 to 15 hours overtime a week would put them up to €116? That's just 50-55 hours a week or so. I know plenty of consultants doing that every week.

nino1

Is this the kick up the ass NCHD's need to get them to stand up for themselves?


After this, why would you work overtime that you don't get paid for, work anti social hours for no extra pay etc etc?

They normally do this and don't complain to keep the consultants happy, the same consultants that have just shafted them to save their own skin.
Unbelievable!

sam34

RobFowl wrote: »

My take is that they are selling out future consultants for their own gain. Not a good reflection on the profession as a whole IMO.

have a look at the Irish independent app (apologies, am on phone so no link)- it says that neither the IHCA nor the IMO agreed to this lower salary, but that it can be forced by the HSE as new entrants are outside the remit of Croke Park.

so, to be fair, it doesn't look like a self-serving sellout.

RobFowl

sam34 wrote: »

have a look at the Irish independent app (apologies, am on phone so no link)- it says that neither the IHCA nor the IMO agreed to this lower salary, but that it can be forced by the HSE as new entrants are outside the remit of Croke Park.

so, to be fair, it doesn't look like a self-serving sellout.

Point taken, was going from RTE reorts at the time I posted!

Not overly impressed by the actions of the IMO/IHCA though. Think they could have made some more sacrifices on existing T+C's to protect those coming through. 120k is still a good salary though but means Irish consultants will probably be worse off than those in the UK for the first time (esp consiering taxation levels, lack of public healthcare provision, education costs, etc).

I am an IMO member btw..

nino1

sam34 wrote: »

have a look at the Irish independent app (apologies, am on phone so no link)- it says that neither the IHCA nor the IMO agreed to this lower salary, but that it can be forced by the HSE as new entrants are outside the remit of Croke Park.

so, to be fair, it doesn't look like a self-serving sellout.

Of course its a self-serving sellout, are you kidding me?

They didn't agree to this lower salary but they came to a cosy aggreement to keep existing consultants at existing pay knowing full well that the future consultants would be screwed over.
Sure if they were not self serving why didn't consultants agree to pay cuts for themselves so that future consultants wouldn't have to take such a big cut?

Not self serving me ar$e

Albection

MrCreosote wrote: »

Equal in "title, status and scope of practice"- cynical HSE-speak for lower pay for the same work?

Most certainly, or more like lower pay for more work in my opinion.

Traumadoc

nino1 wrote: »

Of course its a self-serving sellout, are you kidding me?

They didn't agree to this lower salary but they came to a cosy aggreement to keep existing consultants at existing pay knowing full well that the future consultants would be screwed over.
Sure if they were not self serving why didn't consultants agree to pay cuts for themselves so that future consultants wouldn't have to take such a big cut?

Not self serving me ar$e

You are talking sh*te, sorry but the one thing they did not agree to was two tier , yellow pack consultants.
Pay cuts were never tabled they cannot under the CPA.

Ryder

Pay aside, its at least something that the specialist grade/consultant level 1 dosent appear to have been set in place.

Would lower pay instead of the introduction of a new grade be a victory of sorts for us?

OMD

Traumadoc wrote: »

You are talking sh*te, sorry but the one thing they did not agree to was two tier , yellow pack consultants.

So what action will the IMO/IHCA take to stop it happening?
Strike?
Legal action?
Work to rule?
Intensive negotiations? Or
nothing

bleg

Kicking the can down the road. There's going to be further industrial disputes in 5-10 years when the new consultants get fed up of being paid 30% less for the same work.

Traumadoc

Negotiation would probably be the best way, there is a no strike policy in the IHCA, so that is out.
Legal action may be taken but I don't know if it will work.

However I am not sure the HSE has really thought this through.
What if they want a pediatric cardiothorasic surgeon? Or a head and neck surgeon?

Consultants are livid about the yellow pack consultant plan as well as the plan to do away with rest days.

Jammyc

Purely a question with not much educated opinion behind it, but how do ye think this will affect NCHDs in the next few years? A previous poster said it could be the kick up the arse they need to demand action but could it not also put greater pressure on junior docs to please their consultants who themselves are under more pressure than before?

SleepDoc

Jammyc wrote: »

Purely a question with not much educated opinion behind it, but how do ye think this will affect NCHDs in the next few years? A previous poster said it could be the kick up the arse they need to demand action but could it not also put greater pressure on junior docs to please their consultants who themselves are under more pressure than before?

I imagine it will encourage more NCHDs to leave.

drzhivago

SleepDoc wrote: »

I imagine it will encourage more NCHDs to leave.

and at earlier stage

go to UK for run through training OR go to USA for highly specialist training

his_dudeness

A point that Reilly mentioned a few times is the introduction of rosters for consultants, with an emphasis on reducing overtimes, unsocial pay etc.

Now, while I don't believe it'll happen, if they were to introduce rosters, 120k for a 40hour week wouldn't sound too bad.

Prob could only work in general specialities, i.e Medicine, ED, Gen surg, anesthetics

A potential big issue that hasn't been mentioned is continuity of care. While I'm all for more consultant-led decisions, if the consultant has worked his rostered hours, who takes over care of their patients? Will it be up to the "clinical director" to divvy up the patients?

Actually, seeing as I've brought up clinical directors, Reilly mentioned in his blurb on the 6one last night that clinical directors will be responsible for the rosters not just of consultants but of NCHDs too. Surely this should mean the abolition of the most useless of all HSE departments, medical manpower? Good luck to him taking on SIPTU etc with that one.

Ryder

Consultants already provide 24/7 cover so I presume all this rostering talk is further window dressing.....unless he really intends that consultants should be onsite at 4am etc.....and good luck to the clinical director making out that roster

ryathoe

I'd love to see that!

Annabella1

Its a disgrace that highly trained SPR's are being shafted....I assume most will emigrate(?)
Needless to say,Hospital Administrators remain untouched

mulletamoeba

The youth of Europe are being systematically ****ed by the establishment for the last four years this is more of the same as the burden of paying debt falls disproportionately on their shoulders. The total public service wage bill must be reduced but to do it in so unjust a fashion is despicable. Instead of implementing a 30% pay cut for the young, how would it go down if you had a 30% pay cut for women? or jews? The latter rightly would not be acceptable but yet the former is.

HQvhs

Although I understand that the IHCA and IMO could not stop the HSE from cutting the salaries of incoming consultants, that does not lessen my disappointment.

The consultants could have offered some show of solidarity with their younger colleagues by putting up more of a fight, or offering to take a lesser pay cut to share the burden, but they did not.

Between this, and the systematic poor treatment of NCHDs, it is more and more likely that my classmates and myself will be leaving Ireland earlier and earlier, and with it will go the €120,000 the Herald says it costs to train us (although I dispute that figure). What a short-sighted waste.

Thunder63

The consultants did take a pay cut a few years ago if I remember correctly. Another one would be too large of a cut.

I don't think it's fair to say 40 hours for 116k is acceptable in some specialities when others are getting 180k for the same roster.

I'm currently working in Australia and was planning on returning but to take a 80k dollar pay cut is just not viable now.

Is the opening 116-120k a starter rate that increases yearly? Will they ever reach the levels of other consultants? Is this their way of bringing in the junior consultant grade or is it 116k for life??

dissed doc

Thunder63 wrote: »

The consultants did take a pay cut a few years ago if I remember correctly. Another one would be too large of a cut.

I don't think it's fair to say 40 hours for 116k is acceptable in some specialities when others are getting 180k for the same roster.

I'm currently working in Australia and was planning on returning but to take a 80k dollar pay cut is just not viable now.

Is the opening 116-120k a starter rate that increases yearly? Will they ever reach the levels of other consultants? Is this their way of bringing in the junior consultant grade or is it 116k for life??

There are a few aspects to this.

1. The HSE's primary task is to reduce future salary and pension obligations
- reduced salaries now. They only affect future new employees.
- reduced pensions way into the future when the complete lack of pension funds become apparent: no more lump sum/2/3rds salary and so on.

2. The second purpose of the HSE is to reduce over public healthservice committments;
- such a salary will attract some people to counties with a low cost of living and the e.g., one remaining hospital in the region
- areas like Cork, Dublin and Galway are big enough to support private services. Specialists will be more likely to go for private work in the cities, with higher cost of living

3. Those that were think about leaving but on the fence, will now more likely leave, BUT on the opposite side, people that wanted to stay anyway will be stay *anyway*; having spoke to people a few years ago when this was just talk (around 2008-2009) it was clear that many are simply accepting of it; they don't want private practice, are happy living in e.g., Kilkenny, and the salary is pretty good in places like that. These people would stay if the salary was 80k.
- only a small group of consultants actually make significant income from private work.

4. Salary increments:
- there is nothing discussed regarding increments or clinical awards
- it is more likely that the only extras on the base salary will be a notional extra for providing that on-call cover; e.g., €5-10k/yr for being 1 in 3 on call for example.


Concerns that I have:
- they have also withdrawn the €3000/yr training allowance to do Continous Professional Development. It wasn't much to begin with, but how are people supposed to get the legally required CPD points? Spend your own money on non tax-deductible continuous training that your employer is supposed to do.
- a faster push towards closing and amalgamating rural hospitals
- no word on what exactly would happen if these new consultants actually only did their required work week and then went home. There are at the moment around 1/2 the specialists employed for the population and a lot provide 7 days a week cover and weekend work simply because.

Anthony16

Unfortunately ,i do believe the current consultants have looked out for themselves on this one. Their pay cant and wont be touched due to the croke park agreement.While many here view the cuts to future consultants as unjust,cutting home help to the elderly/disabled is more unjust. More public service pay cuts must come.We have a 15 billion sovereign debt per year currently.

iratira

Concerns that I have:
- they have also withdrawn the €3000/yr training allowance to do Continous Professional Development. It wasn't much to begin with, but how are people supposed to get the legally required CPD points? Spend your own money on non tax-deductible continuous training that your employer is supposed to do.
- a faster push towards closing and amalgamating rural hospitals
- no word on what exactly would happen if these new consultants actually only did their required work week and then went home. There are at the moment around 1/2 the specialists employed for the population and a lot provide 7 days a week cover and weekend work simply because.[/Quote]

And what about non scheme nchds who are netting 500-600 per week.
They NEVER had a cpd kitty. It came out of their net salaries as do exam costs (circa 1,200 for each exam) and with such low pass rates ( the establishment wants to maintain its exclusivity and squeeze money out of those who have no choice).
So boo hoo about the consultants cpd money.
Most consultants just looked quizzically at you if you pointed out you couldn't afford something or if you tried explaining the burden of cpd and exam costs.
They don't understand the circumstances of an nchd at all.