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

JuliusCaesar · 04-10-2010 09:15PM

knipex wrote: »

Hospital cleaners on 30 to 35K plus overtime and allowances.

In what hospitals? Where I work they are all contract cleaners - certainly not on any huge wage.

knipex wrote: »

Electricians going to strike because other staff were allowed to change light bulbs or because they were no longer going to be paid a call-out fee to press a button on an alarm panel.

True, although I suspect the media reports didn't reflect exactly what was going on.

knipex wrote: »

Nurses striking for a 35 hour week and a 10% pay increase (a staff nurse starts on €30,234 rising automatically to €43,800 plus allowances and overtime).

This is wrong? What do you think nurses should be paid? Could that 43K be after 15 years service? Is that too much?
They should work more hours? A 35 hour week is normal.

knipex wrote: »

Porters on 35K plus that can never be found.
16% plus absenteeism in some hospitals.

Can't comment on the porters; again, where I work the porters are great.

Absenteeism? Yes I've had a hard time explaining to my GP why I need a sick cert for 10 days when in fact I've been ill for 3. The way the HSE counts sick days is CRAZY and guaranteed to give them a lousy sickness rate.

tallaght01 wrote: »

Which is just as much of a generalisation as anything said by the doc above.

........which was the point :rolleyes:

SleepDoc · 04-10-2010 10:40PM

JuliusCaesar wrote: »

A 35 hour week is normal

Ha!

knipex · 05-10-2010 08:16AM

JuliusCaesar wrote: »

In what hospitals? Where I work they are all contract cleaners - certainly not on any huge wage.

The vast majority of Hospitals retain a certain amount of in house staff. it varies from hospital to hospital but in the majority yes. Their title also varies from hospital to hospital but in some they are called ward attendants and split into two groups food and cleaning.

Base salary is 30 to 35K depending on hours etc. Overtime and weekend \ night allowances apply.

Contract cleaners earn a union rate of a little over €9 per hour.

JuliusCaesar wrote: »

True, although I suspect the media reports didn't reflect exactly what was going on.

Oh I agree and there are many many other stories that the media never hear about.

JuliusCaesar wrote: »

This is wrong? What do you think nurses should be paid? Could that 43K be after 15 years service? Is that too much?
They should work more hours? A 35 hour week is normal.

13 years actually of guaranteed increments. Pay increases associated with time served, not work ethic, not ability, not effort but time served........ How can anyone justify that ?

I know many many many people working in jobs equally as hard on far less than 43K after 20+ years. And don't forget that allowances and overtime are on top of that......

One other thing that confuses me. Nurses claim to be salaried but then are entitled to overtime ? I have never seen that elsewhere. A Salary is a Salary and you work what ever it takes to get the job done...

As for a 35 hour week being normal ? Normal where ? I don't know a single person who works a 35 hour week. 39 hours is probably normal but a large percentage of people work far more with no overtime.

JuliusCaesar wrote: »

Can't comment on the porters; again, where I work the porters are great.

I will have to take your word for that. Are they underpaid as well ??

JuliusCaesar wrote: »

Absenteeism? Yes I've had a hard time explaining to my GP why I need a sick cert for 10 days when in fact I've been ill for 3. The way the HSE counts sick days is CRAZY and guaranteed to give them a lousy sickness rate.

Its not that unusual actually. How absenteeism is measured is very different to how sick days are measured.

Pete4779 · 05-10-2010 03:59PM

SleepDoc wrote: »

Ha!

You realise the 35hrs is shift work right, it's not a 9-5 morkeshing suite in baggot street job. 35hrs is also average, excluding week of continuous night shift, then early or late shifts, MOnday to Sunday. Let's see you do 5 nights in a row including througha weekend from 8pm to 8am before making a judgement call eh, mate?

SleepDoc · 05-10-2010 06:12PM

Pete4779 wrote: »

You realise the 35hrs is shift work right, it's not a 9-5 morkeshing suite in baggot street job. 35hrs is also average, excluding week of continuous night shift, then early or late shifts, MOnday to Sunday. Let's see you do 5 nights in a row including througha weekend from 8pm to 8am before making a judgement call eh, mate?

I'm not your mate.

Lets see you do four on call shifts in eight days (88 hours in total) plus 2 "normal" days (16 hours).

I am eminently qualified to laugh at the notion of 35 hours being a normal week in the health service.

opinion guy · 05-10-2010 06:58PM

Pete4779 wrote: »

morkeshing

Guh ???

JuliusCaesar · 05-10-2010 09:50PM

I'm a psychologist; but I take my breaks with physios, SALTs, nurses, and various ancilliary staff.

I don't complain about my pay (which is fine) or my hours (9-5). However, my colleagues are paid less and the nurses do unsocial hours. The nurses now work 35 hours, but their breaks are no longer paid for, so they are at work the same length of time. Recently a consultant deigned to sit with us, and complained about their pay cut. It was hard to sympathise as we've all lost the same percentage.

It seems to me that your gripes would be less if you had an effective union. Or do you also deny the right of workers to organise?

PS As for the subject of this thread, I have heard stories of admin staff - by which I mean managers - going off to conferences abroad and within Ireland which can only be called junkets. Subject of conference has nothing to do with their job, although it does have to do with health. Where are the investigative journalists?
In the meantime, no paid CPD for me!

Nchd2010 · 05-10-2010 10:25PM

Recently a consultant deigned to sit with us, and complained about their pay cut

Not trying to be controversial here (honestly), but in fairness, whilst consultants in Ireland are indeed well paid, we do have a very high standard of consultant in Ireland, at least in the university teaching hospitals. Most Irish consultants will have published extensively in peer-reviewed, high impact journals and will have travelled extensively in order to further their knowledge.

Back to topic though, does anybody agree with any of the suggestions I made? Has anyone any other ideas that may help? Surely there's some thought and innovation out there...somewhere?

bleg · 05-10-2010 11:34PM

Nchd2010 wrote: »

Back to topic though, does anybody agree with any of the suggestions I made? Has anyone any other ideas that may help? Surely there's some thought and innovation out there...somewhere?

This was posted on another forum I post on:

For a while we were doing Health screening but had to stop for economic reasons. We had ten, all day health screenings and the following are the results.

Number of people screened.....................214.

Number with raised Cholesterol...............104.

Number with raised BP........................... 65.

Number with raised Blood
Glucose. (non -diabetic)......................... 24.

Number referred to GP............................143.

None of the people screened were on any previous medication. We put a notice in the window prior to each health screening day and asked people to call in and book a time. There was no charge to any person. The figures are very impressive. A nurse did each of the tests.

Using a quick calculation and based on 4 full days health screening in each pharmacy in the country per year; the above service could be set up for about €2.4 million per year.

The benefits to the people are obvious.
Pharmacists get to use our consultation areas.
Drug companies increase sales from new prescribing.
The Govt. benefits by reduced hospital visits.
The population gets healthier.

This could even be a joint funded public/private partnership between the HSE and IPHA.

bleg · 07-10-2010 12:55PM

I would be in favour of removing the GMS code for Glucosamine, Evening Primrose Oil, Omega 3 fish oils etc... A month's supply of Naudicelle (evening primrose oil) is fairly steep and the benefits of it are not well established.

The Hardship scheme also needs to be seriously looked at. People shouldn't get multi vitamins like Centrum on this scheme and it should be limited to essential medicinal items that patients need.

kelle · 07-10-2010 01:35PM

Nchd2010 wrote: »

1 Stop paying radiographers more than doctors just to take pictures. In fairness, there's a bit of skill involved in ultrasonography, but really, charging €200 plus standard overtime for an on call CT seems a bit much

We don't just point and shoot to "take pictures". We have standard positioning techniques we learn over a 4-year course and we are liable if we don't position a patient properly and a condition or fracture is not demonstrated. Some areas are very difficult to radiograph, such as C6 - T1 on an RTA if the patient has big shoulders. And you are required to get perfect radiographs on small children, despite the fact they are natural wrigglers and toddlers are SO strong! And all this while trying to keep radiation doses to a minimum.

Do we earn more than doctors? Link?

Can I find out where I would earn €200 for doing a CT? I don't earn anywhere near that for doing a CT on-call.

Nchd2010 · 07-10-2010 08:55PM

we are liable if we don't position a patient properly and a condition or fracture is not demonstrated. Some areas are very difficult to radiograph, such as C6 - T1 on an RTA if the patient has big shoulders

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Not true... If there are any consequences, the doctor, as clinician is responsible for ensuring that an adequate radiograph is performed.

Do we earn more than doctors? Link?

I certainly hope not. Though I'd imagine that on an hourly basis at a junior level there probably isn't a huge amount of difference.

Can I find out where I would earn €200 for doing a CT?

Yep. pm me, I'll let you know.

drkpower · 07-10-2010 11:12PM

Nchd2010 wrote: »

Not true... If there are any consequences, the doctor, as clinician is responsible for ensuring that an adequate radiograph is performed..

That's not correct actually. The radiographer wil be solely liable if the xray was negligently performed and the doctor, when reviewing it, could not be expected to have realised it was performed negligently.

Of course, if they work in a public hospital, neither will be liable as the State will be.

maninasia · 08-10-2010 04:17AM

Nchd2010 wrote: »

Not trying to be controversial here (honestly), but in fairness, whilst consultants in Ireland are indeed well paid, we do have a very high standard of consultant in Ireland, at least in the university teaching hospitals. Most Irish consultants will have published extensively in peer-reviewed, high impact journals and will have travelled extensively in order to further their knowledge.

Back to topic though, does anybody agree with any of the suggestions I made? Has anyone any other ideas that may help? Surely there's some thought and innovation out there...somewhere?

No use if they are unavailable or too few though is it? Their knowledge will not be APPLIED. The best thing they could do is take a significant pay cut or to be contractually bound to public clinic only (this would immediately increase their productivity!).

kelle · 08-10-2010 08:56AM

Nchd2010 wrote: »

Not true... If there are any consequences, the doctor, as clinician is responsible for ensuring that an adequate radiograph is performed.

Before we had CT, we were crucified if we couldn't demonstrate this region! Believe me, lots of tears were shed trying...

Nchd2010 wrote: »

I certainly hope not. Though I'd imagine that on an hourly basis at a junior level there probably isn't a huge amount of difference.

You said it yourself in your OP!

Stop paying radiographers more than doctors just to take pictures

Nchd2010 wrote: »

Yep. pm me, I'll let you know.

Ple-e-e-e-e-ease!!!!!!!:D

drkpower wrote: »

That's not correct actually. The radiographer wil be solely liable if the xray was negligently performed and the doctor, when reviewing it, could not be expected to have realised it was performed negligently.

Thank you, Drk!

Fado Fado · 09-10-2010 01:54PM

maninasia wrote: »

No use if they are unavailable or too few though is it? Their knowledge will not be APPLIED. The best thing they could do is take a significant pay cut or to be contractually bound to public clinic only (this would immediately increase their productivity!).

I have no problems with contracts that ensure consultants work their contracted hours in a public hospital. I think it's a bit much, however, telling them what they can't do outside of those hours. After studying and working toward that position for well over a decade, surely they can be allowed to earn what they want on their own time, as long as it doesn't infringe on their public hospital duties?

Fado Fado · 09-10-2010 02:08PM

kelle wrote: »

Do we earn more than doctors? Link?

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.

Nchd2010 · 09-10-2010 09:24PM

At the risk of going off topic, I genuinely can't think of any instance where a doctor reading a radiograph could reasonably claim that in the event of the radiograph being inadequate, he would not know it was inadequate. Can drkpower suggest an instance? just out of curiosity.

Traumadoc · 10-10-2010 08:11AM

Fado Fado wrote: »

I have no problems with contracts that ensure consultants work their contracted hours in a public hospital. I think it's a bit much, however, telling them what they can't do outside of those hours. After studying and working toward that position for well over a decade, surely they can be allowed to earn what they want on their own time, as long as it doesn't infringe on their public hospital duties?

Or could we be paid for the extra hours we do outside our contracted hours?

maninasia · 10-10-2010 10:02AM

Traumadoc wrote: »

Or could we be paid for the extra hours we do outside our contracted hours?

Having a private clinic aswell as public will lead to a conflict of interest especially when the public system is overstretched (due to many reasons but not least the high paid few in number consultants). Why should they be the best paid in Europe but allowed to hold down another job. There's no way in hell they can fully devote themselves to both jobs. Why is there such a long waiting list in the public system? Costs are important, top salaries should be cut as these guys earn plenty already from both jobs.

Fado Fado · 10-10-2010 12:15PM

maninasia wrote: »

Having a private clinic aswell as public will lead to a conflict of interest especially when the public system is overstretched (due to many reasons but not least the high paid few in number consultants). Why should they be the best paid in Europe but allowed to hold down another job. There's no way in hell they can fully devote themselves to both jobs. Why is there such a long waiting list in the public system? Costs are important, top salaries should be cut as these guys earn plenty already from both jobs.

What conflict of interest can there be, as long as the consultant is working their paid number of hours in the public system. What they should do outside of that time is their own business. I'm sure your boss wouldn't mind if you got a job mowing lawns after work.

And even if a consultant surgeon was to work seven days a week in a public hospital, the number of operations he or she could do wouldn't go up, because most consultants can only get theatre time one day a week in their hospital. Now there's a lot of work they do that's non-operative - administration, teaching and so on, but there's this mentality that consultants swan off to the private hospitals every day and that it's because they couldn't be arsed working in the public. Many of the ones I know work in two or more public hospitals because that's simply the only way they can see more patients. There's a very finite number of resources in the public system, and it's dwindling every day.

looksee · 10-10-2010 12:48PM

Nchd2010 wrote: »

Not trying to be controversial here (honestly), but in fairness, whilst consultants in Ireland are indeed well paid, we do have a very high standard of consultant in Ireland, at least in the university teaching hospitals. Most Irish consultants will have published extensively in peer-reviewed, high impact journals and will have travelled extensively in order to further their knowledge.

While Consultants did improve for a while a few years ago after public anger about their off-hand, ill-mannered, ivory-tower attitudes, they seem to have slipped again. In the past two years I have dealt with four Consultants who charged me €150 a time for pathetic consultations, for three of them eventually it turned out that the first one had not read a simple, straightforward test correctly, directly concerned with his area of expertise and essential to diagnosis. He did the same thing twice. Very pleasant person though :rolleyes:

The person he referred me to turned out to be pretty well irrelevant to the problem, but prescribed drugs without reading my records which cause me to be hospitalised within a couple of days for a flare up of an existing condition.

The third one was so perfunctory that he didn't really prove much at all, though he did recommend someone (not a consultant) who actually showed some professionalism and is sorting the problem. Except that there is nothing wrong with the Consultant's accounting and records system, as he called me back three weeks later. I didn't go.

The other one was just plain ignorant.

I am trying to pursue the 'wrong test result' situation, but I am not having much success getting my records from the HSE.

bleg · 10-10-2010 02:07PM

We could probably start by working together instead of having a go at each other...

drkpower · 10-10-2010 02:51PM

Nchd2010 wrote: »

At the risk of going off topic, I genuinely can't think of any instance where a doctor reading a radiograph could reasonably claim that in the event of the radiograph being inadequate, he would not know it was inadequate. Can drkpower suggest an instance? just out of curiosity.

Even when i used to read x-rays, I wasnt the best, and that was years ago, so Ill have to plead a large dose of ignorance on that one:eek:. My understanding is that an xray (particularly c-spines) may miss a fracture because of poor positioning and/or under-exposure which should have visualised the fracture, yet a doctor (particularly, an ED SHO/Reg who must read it in the acute context) may not reasonably appreciate that there was any error in the techincal performance of the xray. If such an eventuality is completely impossible, then, its probably fair to say that the doctor would be solely liable (although there probably would be an argument for sharing liability if both radiographer and doc fcuked up).

Bear in mind that there are entire legal textbooks devoted to legal liability and negligence of radiographers so there is no doubt that radiographer's practice can attract legal actions. But dont get me wrong, there is no doubt that negligence in the wider practice of medicine is massively dominated by the negligence of doctors. Not because they are more prone to fcuking up (;)), but because they bear the vast amount of responsibility for patient care. Just not all of it.

opinion guy · 10-10-2010 05:51PM

looksee wrote: »

I am trying to pursue the 'wrong test result' situation, but I am not having much success getting my records from the HSE.

You need to contact the medical records department of the relevant hospital, request our records, sign data protection yokey form thingy for them, sometimes pay a small fee and they are legally required to give you the records within a certain time as far as I know. If they don't, sick a solicitor on them ASAP

Traumadoc · 10-10-2010 10:13PM

maninasia wrote: »

Costs are important, top salaries should be cut as these guys earn plenty already from both jobs.

If you cut our salary those of us who do not do private work will have to.

maninasia · 11-10-2010 04:29AM

This is a sick joke right? The average consultant salary 175,000 euro per month (some on significantly more than this)..if they took a hit to half or even 2/3rds they'd still be doing very well and equivalent or more than many other European countries.
You should be public or private and make a choice..no way a person who needs to think carefully and research their job can contribute 100% to both..no way, you are not giving 100% to the patient. It's also a conflict of interest and almost 100% private companies (and many public services) expressly forbid this type of arrangement.

Fado Fado · 11-10-2010 06:50AM

maninasia wrote: »

You should be public or private and make a choice..no way a person who needs to think carefully and research their job can contribute 100% to both..no way, you are not giving 100% to the patient. It's also a conflict of interest and almost 100% private companies (and many public services) expressly forbid this type of arrangement.

If I do an operation from cancer on a patient from 2-5pm today, having worked 12 hours in my public job, and then, rather than go home to my family, decide to go up the road to a private hospital and do another operation from 6-9pm, how is that not 'giving 100% to the patient'. And also, how is it a conflict of interest? Seriously, I'm curious here.

theg81der · 11-10-2010 07:44AM

I wouldn`t fancy a surgeon working on me that had just done a 12 hour day and a 3 hour op unless of course your job is easy and doesn`t require a huge amount of concentration and dexterity. In which case why are you getting payed so much?

Are you super human in some way, cause I`m pretty sure us human require sleep and rest to adeqately perform?

tallaght01 · 11-10-2010 07:52AM

theg81der wrote: »

I wouldn`t fancy a surgeon working on me that had just done a 12 hour day and a 3 hour op unless of course your job is easy and doesn`t require a huge amount of concentration and dexterity. In which case why are you getting payed so much?

Are you super human in some way, cause I`m pretty sure us human require sleep and rest to adeqately perform?

You're aware that there are docs all over the country working 12, 24, 36, 48+ hours routinely? Why should long shifts only occur when they are of no net benefit to the doctor?

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

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