Mandatory service for doctors after graduating?

pc11

Senator Colm Burke has been getting attention for himself recently by proposing forcing medica graduates to stay for some years in Ireland or pay back the 'subsidised' fees. Apparently this would solve the shortage of doctors.

Now, this strikes me as addressing the problem from the wrong end entirely - it's a little like 'the beatings will continue until morale improves'. How will forcing people to stay in a broken system make things better in the long run? Surely he should focus on improving the system.

I can see such a scheme back-firing by making the doctors even more bitter and determined to leave afterwards.

Also, it's highly selective as no other college graduates will be forced to stay.

Wealthy students would be able to buy their way out so it's discriminatory. And grads who go to the US would probably be easily able to pay it back too with the better wages.

Would this even be legal? Would a court enforce such a restriction on personal liberty or would it consider it restraint of trade? How would you stop doctors just going abroad anyway?

One reason there is a shortage, particularly of GPs, is the large number of doctors in their 30s who decide to work only part-time or stop working entirely for family reasons. Now, I can't imagine a politician going after these doctors but they are just as much a loss to the system as emigrating doctors. Wouldn't it be very selective to target emigrating doctors?

I can't imagine nurses or any other graduates accepting it.

Part of the rationale is that it costs a lot to train doctors. Well, first of all how true is that? And does that really matter? It's not a doctor's fault it's expensive to train him.

It just seems barbaric and cruel to me to force unhappy staff to stay.

Thoughts?

bleg

Disgraceful proposal, that is effectively conscription. Illegal and unworkable. Typical politician with a populist sound bite. Sorting the pay and working conditions would be a better use of this guy's time.

sheesh

I assume it would be done on a contract basis so nobody would be forced to do anything.

there are some arguments for it though, the fact is that it does take alot of money to train a doctor. the state pays for this so that the state will have doctors. There is not much point in paying all that money if they all feck off to some other country is there?

An alternative would be I suppose some sort of student loan that the doctors pay back over time if they don't do some time in ireland

pc11

sheesh wrote: »

I assume it would be done on a contract basis so nobody would be forced to do anything.

there are some arguments for it though, the fact is that it does take alot of money to train a doctor. the state pays for this so that the state will have doctors. There is not much point in paying all that money if they all feck off to some other country is there?

An alternative would be I suppose some sort of student loan that the doctors pay back over time if they don't do some time in ireland

I don't know what you mean by they wouldn't be forced, that's exactly what was suggested.

It takes a lot of money to get everyone through primary school, secondary, college, etc etc. Why single out doctors?? How would you feel if you were told you had to stay here? How would they even enforce it?


Doctors don't just 'feck off' to other countries. A lot would love to stay here, but they leave because conditions here are so difficult. Why not fix those conditions first? What you're arguing for is forcing people to work in a dangerous, broken and illegal system. It's illegal as the EWTD is still largely ignored, and this makes it dangerous for patients and doctors alike. It's also morally wrong to make people work such hours and also to not pay them properly for these hours.

Also, it's not accurate to say the state pays this. In fact, non-EU students are the major source of funding.

RobFowl

2 main points, juniors doctors leave because they perceive training and working conditions better elsewhere

Trained specialists and GPs are the ones we really need to retain and even attract, they stay away due to poor working conditions and to some degree pay.

Mr Burke seems to feel compulsory work in bad jobs with poor training is better than fixing the actual problem.

It's the likes of him that got our health service in the mess it's in so god help us if we listen to him for advice...

No Pants

pc11 wrote: »

It takes a lot of money to get everyone through primary school, secondary, college, etc etc. Why single out doctors?? How would you feel if you were told you had to stay here? How would they even enforce it?

Exactly what I was going to ask; why just doctors? There are other educational channels that are funded and no restrictions placed on them. Yet.

This is just another senator looking for publicity.

sheesh

link http://www.finegael.ie/latest-news/2014/state-should-provide-stru/index.xml?

pc11 wrote: »

I don't know what you mean by they wouldn't be forced, that's exactly what was suggested.

pc11 wrote: »

It takes a lot of money to get everyone through primary school, secondary, college, etc etc. Why single out doctors?? How would you feel if you were told you had to stay here? How would they even enforce it?

pc11 wrote: »

Doctors don't just 'feck off' to other countries. A lot would love to stay here, but they leave because conditions here are so difficult. Why not fix those conditions first? What you're arguing for is forcing people to work in a dangerous, broken and illegal system. It's illegal as the EWTD is still largely ignored, and this makes it dangerous for patients and doctors alike. It's also morally wrong to make people work such hours and also to not pay them properly for these hours.

Also, it's not accurate to say the state pays this. In fact, non-EU students are the major source of funding.

i wouldn't worry about it he is just flying a kite for some attention

this is his web page

http://www.colmburke.eu/ advertising free online games, linked from his facebook

which i got from his finegael.ie page

his points seem to be that the tax payer is paying alot for this and so you would be contractually obliged to stay in ireland I assume you would have to sign a contract stating you will either pay the money or do your 3 years so they would have you under contract law.

It would be easy to counter it by saying that it would lead to an elitist profession that the 3 year rule is a barrier to entry to poorer students.

your right it is not fair.

they will not change the situation for age either though.

Xeyn

I dont have a problem with the principle. In South Africa you have to do 'community service' after your intern year before you are eligible to register as a independent practitioner. The reasons however are different - in that it provides rural communities where its extremely difficult to attract doctors , to provide a service to that community. This is not quite the same situation as Ireland. Ireland has a lot more resources and the ability to fix the numerous issues that are driving doctors away, its just the HSE has been crippled by decades of incompetency.
I dont believe asking a doctor to stay and help the health service after being trained in the country is unreasonable. I dont at all. Forcing someone to do it as quasi-punitive measure where better alternatives exist is very unreasonable.

The carrot is a much better incentive than the stick, but politicians rarely heed that.

I know a few graduate entry doctors who will be emigrating soon because they need to pay back their loan and they cant do so effectively in Ireland any more. They also see the opportunity of a better lifestyle and working conditions as an added bonus. This is an area they can tap into and I believe has been explored (although i think it hasnt made much headway) Im sure if they were given extra tax credits or some sort of easing of their loan burden many would happily stay.

his_dudeness

The precedent is there in other countries, many of my Malaysian classmates studying in Ireland had 10year contracts waiting for them back in Malaysia when they graduates, in return for the government funding their education.

In his defence, Colm Burke has largely been supportive of nchds over the years, particularly leading up to last year's strike, though I don't agree with the proposal of mandatory time. Chris Luke in CUH has been spouting it regularly too.

My big issue is the perceived high cost of training medical students. I know the Fottrell report (i think it was that report anyway) said is costs 200k to train a med student but I can't see how. Most of the clinical medicine I learnt was from ad hoc tutorials from tired NCHDs, very little from tutors and certainly not what I would have considered value-for-money for 200k. There also seems to be a lack of comparitor data for other degrees; architecture and dentistry runs of 5 years and no mention of costs to be repaid by time worked by students.

Vorsprung

When everyone else whose education is publically funded is made to work in the public service for a couple of years (I include engineers, architects and arts students), I won't have a problem with medical graduates being made to do the same.

letsdothis

I posted this link in the Gamsat thread http://www.breakingnews.ie/ireland/new-tax-proposal-aims-to-keep-junior-doctors-in-ireland-638713.html It seems it's aimed at GEM students. Between cut salaries, no loans for living costs and the necessity for a guarantor, GEM effectively excludes those that haven't worked for years to save money or that are not from privileged backgrounds (or both). Anything that could have the potential to widen access has to be a good thing. I don't think anybody can complain about the prospect of a marginal rate tax relief either.

pc11

letsdothis wrote: »

I posted this link in the Gamsat thread http://www.breakingnews.ie/ireland/new-tax-proposal-aims-to-keep-junior-doctors-in-ireland-638713.html It seems it's aimed at GEM students. Between cut salaries, no loans for living costs and the necessity for a guarantor, GEM effectively excludes those that haven't worked for years to save money or that are not from privileged backgrounds (or both). Anything that could have the potential to widen access has to be a good thing. I don't think anybody can complain about the prospect of a marginal rate tax relief either.

If you support this, please contact your local TD to ask him/her to support it.