Hospital consultants and their pay deal

realitykeeper · 18-06-2018 02:55AM

thomasdylan wrote: »

I imagine there was no counterclaim because there was no legal basis for one. What kind of counterclaim could be offered?

A lot of your comments don't seem to make any sense.

Back pay for work not done. If the state doesn`t make it`s claim, the state won`t get what it is owed from the consultants. The existence of waiting lists is proof of this. There is also the litany of misdiagnosed patients and malpractice claims against the HSE for sloppy work carried out by the consultants. Then there is the unnecessary and expensive practice of outsourcing work that the taxpayers have already paid the contracted consultants to do. Etc.

wonski · 18-06-2018 03:22AM

realitykeeper wrote: »

Back pay for work not done. If the state doesn`t make it`s claim, the state won`t get what it is owed from the consultants. The existence of waiting lists is proof of this. There is also the litany of misdiagnosed patients and malpractice claims against the HSE for sloppy work carried out by the consultants. Then there is the unnecessary and expensive practice of outsourcing work that the taxpayers have already paid the contracted consultants to do. Etc.

Just my 2c, if you don't mind.

Got injured last year while playing football with guys from work. GP, hospital appointment, x Ray, consultant visit, sent for a scan, another consultant, torn ACL diagnosis. As expected tbh.

All the above took just 3 months, not a bad result considering I took a public route. Very professional, explained everything in detail and have a lot of respect to their work. I have met the surgeon on my last visit, a person who is going to drill your knee etc, so it was a nice touch to the overall experience.

It was after that that my waiting times have slowed down and still awaiting the surgery in Tallaght hospital.
Do you seriously think that it is the consultants fault that it takes so much time to get it done?
I don't think so. They are very dedicated to what they do, you don't become a doctor/consultant to make money. There are easier ways.

I was surprised how quick it went until you actually need a bed for a night in the hospital...

That's where the waiting time starts.

thomasdylan · 18-06-2018 03:22AM

realitykeeper wrote: »

Back pay for work not done. If the state doesn`t make it`s claim, the state won`t get what it is owed from the consultants. The existence of waiting lists is proof of this. There is also the litany of misdiagnosed patients and malpractice claims against the HSE for sloppy work carried out by the consultants. Then there is the unnecessary and expensive practice of outsourcing work that the taxpayers have already paid the contracted consultants to do. Etc.

That's stream of consciousness not an argument the government could have made.

realitykeeper · 18-06-2018 03:36AM

thomasdylan wrote: »

That's stream of consciousness not an argument the government could have made.

I disagree. After all, legal teams are made up of lawyers, not quack psychologists.

realitykeeper · 18-06-2018 03:43AM

wonski wrote: »

Just my 2c, if you don't mind.

Got injured last year while playing football with guys from work. GP, hospital appointment, x Ray, consultant visit, sent for a scan, another consultant, torn ACL diagnosis. As expected tbh.

All the above took just 3 months, not a bad result considering I took a public route. Very professional, explained everything in detail and have a lot of respect to their work. I have met the surgeon on my last visit, a person who is going to drill your knee etc, so it was a nice touch to the overall experience.

It was after that that my waiting times have slowed down and still awaiting the surgery in Tallaght hospital.
Do you seriously think that it is the consultants fault that it takes so much time to get it done?
I don't think so. They are very dedicated to what they do, you don't become a doctor/consultant to make money. There are easier ways.

I was surprised how quick it went until you actually need a bed for a night in the hospital...

That's where the waiting time starts.

Three Months! That`s appalling! If MacDonalds did consultancy you would have been in and out in no time.

pickarooney · 18-06-2018 05:37AM

When I did my ACL recently I had a diagnosis and prescription for physio within half an hour, and from the best knee surgeon in the area.

Fair enough, he happened to be reffing the match I got injured in, but still...

erica74 · 18-06-2018 07:11AM

It's very easy to blame consultants for the waiting lists etc, when in reality, the public are the main cause of long waiting times. If you are offered an appointment and do not bother to cancel or reschedule and just don't show up on the day, that is an appointment slot wasted that could have been offered to another member of the public. Half a million people failed to show up for appointments last year.

Corruptedmorals · 18-06-2018 07:26AM

The main cause of our waiting lists is the fact that all hospitals are receiving hundreds of referrals a week and don't have the capacity to see those patients within a decent time frame on top of the review patients already in the system, postoperative patients and emergency referrals from A&E. We have a bigger population who are living much longer.

We need more consultants with bigger teams. It's not the fault of our current consultants.

Most hospitals are validating their waiting lists because people don't bother removing themselves when they've been seen privately or no longer need to be seen. Hospitals are also holding extra clinics outside of regular clinics to see the patients waiting the longest. But nothing will solve the problem with current medical staffing levels.

18-06-2018 07:38AM

Graces7 wrote: »

Given the dire state of the health service,it would have been a deeply meaningful and appreciated gesture to forgo this pay increase.

Only a fool would forgo a pay rise. These are people doing a job, working hard to get where they are so why on earth would they refuse a pay rise? They are people with families and bills too and want to have the best live they can and that means getting they highest pay they can.

I always laugh when people suggest “x” or “y” should not take their pay increase when I’d be certain they themselves would never in a million years turn down a pay rise.

VinLieger · 18-06-2018 08:33AM

realitykeeper wrote: »

Back pay for work not done.

What work not done?

realitykeeper wrote: »

If the state doesn`t make it`s claim, the state won`t get what it is owed from the consultants. The existence of waiting lists is proof of this.

No its not, there are a multitude of reasons for the waiting lists being as bad as they are. The LACK of consultants is one of them.

realitykeeper wrote: »

There is also the litany of misdiagnosed patients and malpractice claims against the HSE for sloppy work carried out by the consultants.

Ahhh i forgot how easy top tier specialised medicine was that any joe off the street could walk in and practice it perfectly without making any mistakes....

realitykeeper wrote: »

Then there is the unnecessary and expensive practice of outsourcing work that the taxpayers have already paid the contracted consultants to do. Etc.

Evidence please......

EdgeCase · 18-06-2018 09:46AM

The biggest issue I keep seeing is a lack of resources in primary care that's dumping patients into A&E.

For example, last week a relative of mine was referred (by a gp) to the A&E for a diagnostic, non urgent X Ray. The A&E in a major, acute hospital, known to be overcrowded.

Not only that but she's a patient of the hospital, with a long term illness.

She was just told to go to A&E before 8am

They figured out she didn't need to be there and sent her to the X Ray department in the hospital, where she was seen in 20 mins in absolute calm and very pleasant conditions. All public hospital stuff and absolutely modern, pleasant and very high tech.

I think there's a major issue when you've stuff like this going on and it indicates a big issue with how A&Es are being used and a lack of primary care facilities. Why would a GP be using A&E as a referral point for a patent?

Something very wrong with that approach and shows system failure to me.

It's not entirely about consultants - it's about a system that's not being managed and resources that aren't available in the right areas to reduce queue times.

Subcomandante Marcos · 18-06-2018 09:49AM

kneemos wrote: »

Consultants are allowed work publicly and privately.

What you want is a Soviet style set up. What they do outside their allotted public hours is their own business.

The problem is that they use public hours to treat private patients, often during public clinic hours at that.

Anita Blow · 18-06-2018 09:57AM

Subcomandante Marcos wrote: »

The problem is that they use public hours to treat private patients, often during public clinic hours at that.

Which is incorrect because the state's own private investigators found consultants were working their contracted public hours, which is why the state had to make this settlement without a counter-claim.

18-06-2018 10:07AM

EdgeCase wrote: »

The biggest issue I keep seeing is a lack of resources in primary care that's dumping patients into A&E.

For example, last week a relative of mine was referred (by a gp) to the A&E for a diagnostic, non urgent X Ray. The A&E in a major, acute hospital, known to be overcrowded.

Not only that but she's a patient of the hospital, with a long term illness.

She was just told to go to A&E before 8am

They figured out she didn't need to be there and sent her to the X Ray department in the hospital, where she was seen in 20 mins in absolute calm and very pleasant conditions. All public hospital stuff and absolutely modern, pleasant and very high tech.

I think there's a major issue when you've stuff like this going on and it indicates a big issue with how A&Es are being used and a lack of primary care facilities. Why would a GP be using A&E as a referral point for a patent?

Something very wrong with that approach and shows system failure to me.

It's not entirely about consultants - it's about a system that's not being managed and resources that aren't available in the right areas to reduce queue times.

Out of curiosity was it for a chest xray? I think those and fractures are the only ones that can bypass an appointment like that

wonski · 18-06-2018 10:18AM

EdgeCase wrote: »

The biggest issue I keep seeing is a lack of resources in primary care that's dumping patients into A&E.

For example, last week a relative of mine was referred (by a gp) to the A&E for a diagnostic, non urgent X Ray. The A&E in a major, acute hospital, known to be overcrowded.

Not only that but she's a patient of the hospital, with a long term illness.

She was just told to go to A&E before 8am

They figured out she didn't need to be there and sent her to the X Ray department in the hospital, where she was seen in 20 mins in absolute calm and very pleasant conditions. All public hospital stuff and absolutely modern, pleasant and very high tech.

I think there's a major issue when you've stuff like this going on and it indicates a big issue with how A&Es are being used and a lack of primary care facilities. Why would a GP be using A&E as a referral point for a patent?

Something very wrong with that approach and shows system failure to me.

It's not entirely about consultants - it's about a system that's not being managed and resources that aren't available in the right areas to reduce queue times.

Gp referral means that the patient only pays for their gp visit, xrays, consultants, scans etc following the referral remain free (except beds in hospital).

A&E is also used to shorten the waiting times for consultants appointments etc. It is just faster this way.

The GP use referrals to A&E to help their patients, to play the system they know better than their patients.

Subcomandante Marcos · 18-06-2018 10:21AM

bluewolf wrote: »

Out of curiosity was it for a chest xray? I think those and fractures are the only ones that can bypass an appointment like that

If you arrive in A&E with a letter from your GP for something specific that doesn't need immediate medical intervention you can often be passed on to the necessary department very quickly, provided they aren't swamped and have the time to take care of it there and then. Stuff like x-rays and other scans can be done very quickly if they know what they're checking when you arrive and have a spare 15 minutes to throw you under a machine.

The nurses and doctors in A&E and the doctors in the MAU's want simple cases like that in and out as quick as they can so it's not taking up their time or space in their units so if they can run you up a corridor to get a picture of dem bones real quick they will.

That said, we really need proper primary care centres where these sorts of things can be done instead over crowding emergency departments with non-emergency patients.

EdgeCase · 18-06-2018 10:41AM

It was a back x-ray to assess a swelling but, I'm not going into the specifics but it's linked to on going treatment for a form of cancer.

I would have thought that the referral should have been back to the oncology unit, absolutely not A&E.
The patient is even immunocompromised, so shouldn't really be anywhere near A&E if avoidable.

We are missing a layer of non-urgent specialist services at primary care level that keeps a lot of these things out of acute hospitals, unless they need to be there. I just keep hearing of people being sent to A&E for all sorts of things.

Another example was someone I know who had surgery for cataracts at a private hospital and the advice on all their letters was "if you've a problem and we cannot be reached" (which was pretty likely as they'd quite short office hours) contact your nearest A&E.

Another relative of mine has post op complications involving oedema and leakage from a wound and ended up in A&E due to a private hospital having zero support over a weekend.

It just seems to be a "catch all" for everything, including post operative support.

The whole thing needs to be analysed properly and the correct services and systems put in place.

I don't see the problems in the HSE being resolved as it seems there's an inability to even identify them, never mind resolve them.

The consultants' contracts seem to be more symptomatic of chaotic management / structures and double jobbing being used because the private system is (profitably) being used to paper over the cracks in a very messed up public system.

realitykeeper · 18-06-2018 10:47AM

erica74 wrote: »

It's very easy to blame consultants for the waiting lists etc, when in reality, the public are the main cause of long waiting times. If you are offered an appointment and do not bother to cancel or reschedule and just don't show up on the day, that is an appointment slot wasted that could have been offered to another member of the public. Half a million people failed to show up for appointments last year.

Lets put that theory to the test by taking appointments out of the equation. A & E departments are a notorious shambles. Therefore appointments aint the issue. Besides it is far more common to hear of consultants cancelling operations than patients cancelling appointments. In my experience, a lot of these appointments are a joke. My company doctor tells me to see a consultant every year, I do. The consultant cannot cure tinnitus so he says "how are you". I say "I have tinnitus." He says "don`t listen to it." I say "grand." Then the state pays the consultant for wasting my time.

realitykeeper · 18-06-2018 11:05AM

VinLieger wrote: »

What work not done?

The dead, formerly on waiting lists and the sick and the dying on existing lists. As for A & E, don`t get me started.

VinLieger wrote: »

No its not, there are a multitude of reasons for the waiting lists being as bad as they are. The LACK of consultants is one of them.

Consultants are lacking because they are skiving off to the golf course or to private practice instead on doing the work they were paid to do for public patients.

VinLieger wrote: »

Ahhh i forgot how easy top tier specialised medicine was that any joe off the street could walk in and practice it perfectly without making any mistakes....

Evidence please......

What consultants can do is totally irrelevant if they don`t actually do it. This situation where investigative journalists and state agents have to keep tabs of AWOL consultants is another consequence of the dishonorable conduct of hospital consultants.

ohnonotgmail · 18-06-2018 11:06AM

realitykeeper wrote: »

Lets put that theory to the test by taking appointments out of the equation. A & E departments are a notorious shambles.

and how is this relevant to consultants pay? Do they decide how many beds are available in A+E? do they decide when wards should be opened so that patients can be transferred from A+E to a ward?

realitykeeper wrote: »

Therefore appointments aint the issue. Besides it is far more common to hear of consultants cancelling operations than patients cancelling appointments.

Do you have a source for that? that it is the consultant cancelling the operation rather than a theatre not being available due an emergency surgery or other surgeries overrunning?

realitykeeper wrote: »

In my experience, a lot of these appointments are a joke. My company doctor tells me to see a consultant every year, I do. The consultant cannot cure tinnitus so he says "how are you". I say "I have tinnitus." He says "don`t listen to it." I say "grand." Then the state pays the consultant for wasting my time.

How is that the consultants fault?

It seems to be that you are blaming consultants for all the ills of the health service. which is just complete nonsense.

ohnonotgmail · 18-06-2018 11:08AM

realitykeeper wrote: »

The dead, formerly on waiting lists and the sick and the dying on existing lists. As for A & E, don`t get me started.

Consultants are lacking because they are skiving off to the golf course or to private practice instead on doing the work they were paid to do for public patients.

What consultants can do is totally irrelevant if they don`t actually do it. This situation where investigative journalists and state agents have to keep tabs of AWOL consultants is another consequence of the dishonorable conduct of hospital consultants.

an investigation that found that consultants were not doing exactly what you are blaming them for. the investigation that found they were doing all of their contracted public hours.

Anita Blow · 18-06-2018 11:12AM

realitykeeper wrote: »

Lets put that theory to the test by taking appointments out of the equation. A & E departments are a notorious shambles. Therefore appointments aint the issue. Besides it is far more common to hear of consultants cancelling operations than patients cancelling appointments. In my experience, a lot of these appointments are a joke. My company doctor tells me to see a consultant every year, I do. The consultant cannot cure tinnitus so he says "how are you". I say "I have tinnitus." He says "don`t listen to it." I say "grand." Then the state pays the consultant for wasting my time.

Consultants do not cancel operations. Bed managers, theatre directors cancel operations either because there is no bed available post-op or not enough nursing staff for theatre.

You have zero clue what you're talking about.

realitykeeper · 18-06-2018 11:20AM

ohnonotgmail wrote: »

and how is this relevant to consultants pay? Do they decide how many beds are available in A+E? do they decide when wards should be opened so that patients can be transferred from A+E to a ward?

If consultants are so clever, why can`t they open a door?

As for having no beds, well we`d all love to run our work places like that. Supposing Dunnes Stores employees got fed up of selling stuff so they decided "let`s throw all the food and merchandise out into the skip, that way we can sit around twiddling our thumbs, drinking cups of tea and chatting all day while the customers queue for the next delivery."

This is why I say to anyone who will listen that the HSE will never work until consultants are paid for what they do instead of by the hour.

VinLieger · 18-06-2018 11:44AM

realitykeeper wrote: »

The dead, formerly on waiting lists and the sick and the dying on existing lists. As for A & E, don`t get me started.

So youve no actual factual argument just emotional hyperbole

realitykeeper wrote: »

Consultants are lacking because they are skiving off to the golf course or to private practice instead on doing the work they were paid to do for public patients.

Ohh look a wild tired stereotype appeared

realitykeeper wrote: »

What consultants can do is totally irrelevant if they don`t actually do it. This situation where investigative journalists and state agents have to keep tabs of AWOL consultants is another consequence of the dishonorable conduct of hospital consultants.

Like someone else already pointed out, the investigations found they were doing all of their contracted public hours.

You really need to get that giant chip on your shoulder looked at, I know a great consultant for that kind of thing.........

erica74 · 18-06-2018 11:44AM

realitykeeper wrote: »

Lets put that theory to the test by taking appointments out of the equation. A & E departments are a notorious shambles. Therefore appointments aint the issue. Besides it is far more common to hear of consultants cancelling operations than patients cancelling appointments. In my experience, a lot of these appointments are a joke. My company doctor tells me to see a consultant every year, I do. The consultant cannot cure tinnitus so he says "how are you". I say "I have tinnitus." He says "don`t listen to it." I say "grand." Then the state pays the consultant for wasting my time.

Why are we taking appointments out of the equation if they are what I posted about?

Many posters have referenced waiting lists and that is what I responded to.

I work in a hospital in admin. Just to give you an idea on the numbers of patients not turning up for appointments weekly - recently across 3 days, out of 45 appointment slots at my clinics, 16 patients didn't bother to show up, nor contact to reschedule. That's 16 appointment slots that could have been offered to 16 other patients who are sitting on waiting lists. And that's just one department in one hospital.

I fail to see how it's the consultant's fault that your company doctor insists you go to a consultant annually?

Anita Blow · 18-06-2018 11:46AM

realitykeeper wrote: »

If consultants are so clever, why can`t they open a door?

As for having no beds, well we`d all love to run our work places like that. Supposing Dunnes Stores employees got fed up of selling stuff so they decided "let`s throw all the food and merchandise out into the skip, that way we can sit around twiddling our thumbs, drinking cups of tea and chatting all day while the customers queue for the next delivery."

This is why I say to anyone who will listen that the HSE will never work until consultants are paid for what they do instead of by the hour.

So where do you propose a patient go after surgery? Or how do you propose a surgeon operate with no nursing staff?
What do you propose the consultant do? They would be struck off and put in jail if they were to recklessly endanger a patient's life.

Have you considered how frustrating it is for consultants in the public system to turn up for work only to be told on the morning that their theatre list has been cancelled? Or a consultant who wants to perform more procedures to clear a waiting list but the HSE will only fund one procedure a week while their waiting list for that procedure grows by 10 patients a week?
Or to maintain the minimum competency they more perform X amount of a given procedure per year but because of HSE budgetary constraints and bed/staff capacity they can't reach that target unless they do private practice?

You're woefully misinformed about the real issues facing our health system. Nice to see the DoH propaganda machine is working. As long as attitudes like yours remain where your willing to scapegoat frontline workers then there's no impetus for the HSE administration to change

ohnonotgmail · 18-06-2018 11:50AM

realitykeeper wrote: »

If consultants are so clever, why can`t they open a door?

As for having no beds, well we`d all love to run our work places like that. Supposing Dunnes Stores employees got fed up of selling stuff so they decided "let`s throw all the food and merchandise out into the skip, that way we can sit around twiddling our thumbs, drinking cups of tea and chatting all day while the customers queue for the next delivery."

Because it isnt what they are paid for. They are doctors not administrators.

realitykeeper wrote: »

This is why I say to anyone who will listen that the HSE will never work until consultants are paid for what they do instead of by the hour.

They sued precisely because they were not getting paid for the work they contracted to do. They sued and they won. Your anger at the health service is massively misplaced.

wonski · 18-06-2018 11:56AM

realitykeeper wrote: »

Three Months! That`s appalling! If MacDonalds did consultancy you would have been in and out in no time.

Not really. I have witnessed health service in two other countries and there are similar issues all over Europe.

Health service was and always will be difficult to maintain. Improvements are possible, but will never be perfect. Blaming only one group is not fair.

Mikenesson · 18-06-2018 12:04PM

EdgeCase wrote: »

The biggest issue I keep seeing is a lack of resources in primary care that's dumping patients into A&E.

For example, last week a relative of mine was referred (by a gp) to the A&E for a diagnostic, non urgent X Ray. The A&E in a major, acute hospital, known to be overcrowded.

Not only that but she's a patient of the hospital, with a long term illness.

She was just told to go to A&E before 8am

They figured out she didn't need to be there and sent her to the X Ray department in the hospital, where she was seen in 20 mins in absolute calm and very pleasant conditions. All public hospital stuff and absolutely modern, pleasant and very high tech.

I think there's a major issue when you've stuff like this going on and it indicates a big issue with how A&Es are being used and a lack of primary care facilities. Why would a GP be using A&E as a referral point for a patent?

Something very wrong with that approach and shows system failure to me.

It's not entirely about consultants - it's about a system that's not being managed and resources that aren't available in the right areas to reduce queue times.

True

Doctors are sending people to a+e needlessly

I'm finding more and more that specialty nurses in casualty are subsequently dealing with minor issues that are being passed on by doctors

Dr Brown · 18-06-2018 12:08PM

Most of the consultants I've met are rip off merchants.

Hospital consultants and their pay deal

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