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HSE to slash doctors wages


fedup

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Feb 10, 2009
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Just wondering what you all think of the massive paycuts that the HSE are trying to implement (quietly!) for frontline staff. Most junior doctors face a pay cut of 25%, in addition to the pension levy. This does not, of course, apply to Mr. Drumm et al. There's a decent article about it Sunday Business Post, or a fiery thread on Boards.ie.

I'm very worried about this, the thought of working 80 hours plus a week and only getting paid for 48 of them doesn't do the morale any favours! The thing that really drives me nuts is the comments by some of the HSE staff, particulary Sean McGrath, that we seem to feel we are "entitled (!) to overtime". As if working 36 hours in a row is a thing anyone would do.

The fact of the matter is, interns, junior doctors and the like earn in some cases twice as much as the average earner in Ireland because in some cases they are working more than two standard working weeks in any given seven days. This has a shocking effect on your personal life - the general surgical registrar might drive a Merc, but that's because on average they clock up over 90 hours in the hospital every week, and the divorce rate among general surgeons is astronomical! I'd be interested to see the time-cards for any of the HSE head honchos, and how many hours they rack up a week for their hundreds of thousands.

Anyone any comments?
 


spidermom

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NOT A DOCTOR but would work within the health sector.
I think that the junior docs are now not giong to be paid for your ONE HOUR lunch break would be hilarious,if it wasn't so absolutely ridiculous!!
Nicking a few choccies from the nurses station on your way through is more like it!!!!

It just shows how completely out of touch with reality the head honchos in the HSE and the DOHC are!!!
 

FrankSpeaks

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The solution seems obvious to me, employ more doctors , hence we will not have to pay as much in overtime. The patients are also likely to benefit because they are less likely to die when a coherent doctor is in charge.
 

Grizzly Man

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I'm very worried about this, the thought of working 80 hours plus a week and only getting paid for 48 of them doesn't do the morale any favours! The thing that really drives me nuts is the comments by some of the HSE staff, particulary Sean McGrath, that we seem to feel we are "entitled (!) to overtime". As if working 36 hours in a row is a thing anyone would do.
Did the junior doctors not threaten to strike a few years ago because they'd get less overtime when the govt tried to implement shorter working hours for them ?
 

He3

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The solution seems obvious to me, employ more doctors , hence we will not have to pay as much in overtime. The patients are also likely to benefit because they are less likely to die when a coherent doctor is in charge.
Replace managers with doctors and nurses on a 1:2 ratio. For every two managers you let go, take on one medic.

Cost neutral I'm guessing.
 

PhoenixIreland

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NOT A DOCTOR but would work within the health sector.
I think that the junior docs are now not giong to be paid for your ONE HOUR lunch break would be hilarious,if it wasn't so absolutely ridiculous!!
Nicking a few choccies from the nurses station on your way through is more like it!!!!

It just shows how completely out of touch with reality the head honchos in the HSE and the DOHC are!!!
Indeed, it's not as if JuniorDocs had an easy work life to begin with!
I know how they feel, I had a private sector job last year that expected me to work 4 hours extra a week for free.

What ever happened to the European Working Time Directive btw?? It looks like the Hospitals are just plain ignoring it?
 

fedup

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Did the junior doctors not threaten to strike a few years ago because they'd get less overtime when the govt tried to implement shorter working hours for them ?
I've heard this brought up a few times, and it needs adressing.

The European Working Time Directive (EWTD) is meant to bring everyone's working hours in line, across Europe. In the medical sector, it's widely regarded as unworkable, at least under current staffing levels. Here's why.

In order to become a consultant, i.e. the most senior person on the medical team, the person with whom all medical decisions ultimately lie and on whom blame will ultimately fall if something goes wrong, you need to have a certain skill level. The only way to do this is to see patients, in your chosen speciality, time and time again until you've seen each of the dozen ways a given condition can present, a hundred times over. This takes years and years. The only way we can conclusively say that Dr. Grizzly is fine in the management of your mother with a Heart Attack is if he or she goes through this long and ardous training process. This is part of the reason why it takes about 10 years (give or take) to make consultant, and also part of the reason why the majority of people in any given medical school class end up doing GP (which is a 4 year training programme).

Similarly with surgery - if you're going to be a heart surgeon, you need to have clocked up many hundreds of heart procedures before you're deemed competent. This takes many thousands of hours in the operating theatre. You also need to get good at the management of acute medical emergencies, and slowly but surely gain confidence at managing them on your own, before you move up to the next level, e.g. Reg to SHO. This largely happens on call, i.e. when the consultant is gone home for the night.

The problem with the EWTD is that (especially in areas like surgery) it will cut the hours doctors spend in hospital, by about half for some surgeons (a speciality in which trainees routinely work 100-hour weeks in the hospital). This means that either (A) training will take twice as long, and people will be lucky to make consultant by the time they're 45, not 35; or (B) training will last the same length and standards will suffer immensely.

This is why most surgical trainees would be happy to opt out of the EWTD if they could, and indeed this is under serious consideration in Europe.

So you see, it's a catch 22. Do I want to work 80 hour weeks next year? Not if I can help it. But would I feel confident being in charge of patients on my own the year after, knowing I'd received about 40% less on-call (i.e. training) time than others? Absolutely not, and I don't think you'd want me looking after your relatives either.
 

turdsl

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Replace managers with doctors and nurses on a 1:2 ratio. For every two managers you let go, take on one medic.

Cost neutral I'm guessing.[/QUOTE

One sure thing the patients would be better off.but i guess that does not matter.
 

fedup

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I also forgot to mention about the EWTD in Ireland. There were a few pilot schemes a few years ago, in Galway among other places, implemented by the HSE but they fell apart and it was classified unworkable, as it has been in many other countries. Now all of a sudden, the HSE want to 'cut costs', so suddenly it's all "we want to comply with this directive that we didn't give a rats arse about a year ago, but do now because it's politically convenient".

(This is despite the fact that the HSE was created from the amalgamation of the health boards a few years ago, to make the health service 'more efficient', but no jobs have since been shed in the administration of this newly-efficient organisation).
 

He3

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Howdya Spell Efficiency?
 

jay_cork

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My partner is an SHO is one of the larger Cork Hospitals and I know how hard she works (on average 80 hours a week). She is on-call at least once a week, twice this week as it happens, and works one weekend in four and this is a 'forgiving' rota!

I'm sick of the sensationalist crap about how the wealthy i.e. anyone earning 50K are not paying their fair share. Your 'average' worker goes home at 5pm and does not have to bring the horrors of what they've seen during the day home with them. Doctor's do not have this luxury! Being a doctor is a vocation, and not everybody could do it.

Before I met my partner I probably would have been one of those people who scoffed that 'sure, all doctors are loaded'... well I'm afraid nothing could be further from the truth.

Doctors should be highly paid and people need to recognize that some professions are simply sacrosanct and not bound by the same economic rules as most others.

Do you want someone taking care of a loved one who has worked 30 hours straight and is not even being fairly paid for what they do?
 

smitchy2

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Hospitals need to manage things a bit better than what they have currently being doing.
Overtime is crazy in the system and I don’t think anyone should be working the hours that they do.
There is too much resistance to working practice changes.
This is a specialist area but overtime needs to be managed over the entire PS.
And yes services will be effected.
 

thetruthspeaks

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I've heard this brought up a few times, and it needs adressing.

The European Working Time Directive (EWTD) is meant to bring everyone's working hours in line, across Europe. In the medical sector, it's widely regarded as unworkable, at least under current staffing levels. Here's why.

In order to become a consultant, i.e. the most senior person on the medical team, the person with whom all medical decisions ultimately lie and on whom blame will ultimately fall if something goes wrong, you need to have a certain skill level. The only way to do this is to see patients, in your chosen speciality, time and time again until you've seen each of the dozen ways a given condition can present, a hundred times over. This takes years and years. The only way we can conclusively say that Dr. Grizzly is fine in the management of your mother with a Heart Attack is if he or she goes through this long and ardous training process. This is part of the reason why it takes about 10 years (give or take) to make consultant, and also part of the reason why the majority of people in any given medical school class end up doing GP (which is a 4 year training programme).

Similarly with surgery - if you're going to be a heart surgeon, you need to have clocked up many hundreds of heart procedures before you're deemed competent. This takes many thousands of hours in the operating theatre. You also need to get good at the management of acute medical emergencies, and slowly but surely gain confidence at managing them on your own, before you move up to the next level, e.g. Reg to SHO. This largely happens on call, i.e. when the consultant is gone home for the night.

The problem with the EWTD is that (especially in areas like surgery) it will cut the hours doctors spend in hospital, by about half for some surgeons (a speciality in which trainees routinely work 100-hour weeks in the hospital). This means that either (A) training will take twice as long, and people will be lucky to make consultant by the time they're 45, not 35; or (B) training will last the same length and standards will suffer immensely.

This is why most surgical trainees would be happy to opt out of the EWTD if they could, and indeed this is under serious consideration in Europe.

So you see, it's a catch 22. Do I want to work 80 hour weeks next year? Not if I can help it. But would I feel confident being in charge of patients on my own the year after, knowing I'd received about 40% less on-call (i.e. training) time than others? Absolutely not, and I don't think you'd want me looking after your relatives either.
I disagree about this, In Austrailia Docs in Hospitals have properly rostered working weeks which mean that they rarely work the crazy and downright dangerous hours (both for Docs and patients) that Irish docs do.
The Solution is properly structured training in teaching hospitals - this is best practice in countries like Canada and Austrailia.
I concede the situation is likely to be different in Surgery but for other specialities I don't agree with your arguement.
A properly trained, fully alert Doctor is a lot better than a poorly trained, tired one.
 
Last edited:

Leftfemme22

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I disagree about this, In Austrailia Docs in Hospitals have properly rostered working weeks which mean that they rarely work the crazy and downright dangerous hours (both for Docs and patients) that Irish docs do.
The Solution is properly structured training in teaching hospitals - this is best practice in countries like Canada and Austrailia.
I concede the situation is likely to be different in Surgery but for other specialities I don't agree with your arguement.
A properly trained, fully alert Doctor is a lot better than a poorly trained, tired one.
The HSE does not have the funds to set up specialist training Hospitals, instead it utilizes the University Hospital system which has been swamped with overspill and are underequipped for the growing demands placed on them. It’s a legacy issue in that the training structure was inherited from the bad old days.

Its not much better in the NHS which does have at least three dedicated training hospitals that I can think of but they can only cater for certain specialisations.

The fact remains that to acquire the necessary on the job training, doctors need to be exposed to patients and as many as possible and the only place for that, for most specialisations, is in the General Hospitals and rehabilitation centres.
 

InReality

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Jan 16, 2009
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So the on-call experience ( night-time ) is crucial ?
Why not get some doctors to work nights only then ?
.. Do 40 hours a week on nights to get the experience without the cost and danger doing 80 hours a week ?
 

X-ray

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I am not a doctor but i am a health professional that does alot of overtime and on call for the hse. I think the junior docs are treated like dirt. There really is no need for all the hours in the week to learn their profession. Most learn little at nite other than how to repeat the same mistakes over and over. There is nobody there to teach them, nurses and other professional staff who work along side them tire of the constant inflow of new recruits that are clinically useless in many cases.

The way doctors are selected for career progression is also a joke, real old boys clubs. It makes it difficult to stand up as a SHO or whatever and say your consultant is a bastard and not training you I woudl guess.


It is too much of a burden on them as individuals and takes a huge toll on many. I would gladly see shifts come even if it reduced my pay. But the HSE will not go down that route as it will cost more money. You cannot force someone to do 90hours of duty but you can if its called on-call. The whole health service starts from a point of having no repsect for the service provider and goes down hill from there.

I think medicine is a dreadful career for anyone in ireland today and its sounds like it is about to get alot worse.:roll:
 

Leftfemme22

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The way doctors are selected for career progression is also a joke, real old boys clubs. It makes it difficult to stand up as a SHO or whatever and say your consultant is a bastard and not training you I woudl guess.
You hit the nail on the head there; the Consultant calls the shots and can make or break a career. Registrars and SHO's (in particular) are actually doing the bulk of the work anyway (and juggling thesis and research on top of that). I'm sure you as a radiographer (???) can testify to that. (Perhaps there is a exception in this case though as radiographers in my view are more competent than some Consultant Radiologists)

The problem with interns is the very fact that they are bright eyed but essentially clueless when first thrown into the deep end of the madness of a busy hospital. Your assertion that they are actually a hindrance is not far wrong.

I don’t think there are enough JDs though to implement split shifts and you are lengthening their career path as well.

It’s not perfect by any means but the calibre of doctor (non GP) produced in this country is none the less very high.
 
Last edited:

cyberianpan

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Interesting thread ... also there's a "gap" I've been wondering about for a long time:

What do consultants do with junior doctors ? Do they interact much at all ?

Given the ratios we might expect consultants to supervise junior doctors and thus engage in some clever division of labour... but as far as I can see they operate in 2 parallel worlds. Junior doctors man the hospitals and the consultants occasionally come in for rounds + planned procedures & then see patients in out clinics/rooms.

Now I know that consultants are very hard working & accomplished and that many of them work 60+ hour weeks - but how much of that time is actually spent in contact with the junior doctors ?

cYp
 

Oppenheimer

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Why is there a huge demand for medicine in college if it is such a degrading job to do? Serious question - the "cream" of the Leaving Cert points achievers are not unintelligent so surely see and hear some of this. I understand it is a "calling" for some but for a lot it is seen as a meal ticket....some of the posts on here just contradict that view.
 

Leftfemme22

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Why is there a huge demand for medicine in college if it is such a degrading job to do? Serious question - the "cream" of the Leaving Cert points achievers are not unintelligent so surely see and hear some of this. I understand it is a "calling" for some but for a lot it is seen as a meal ticket....some of the posts on here just contradict that view.
The bulk become GPs which is a far less strenuous career option.

Surgical Consultants are the creme de la creme and they don't half love to remind you of such.. I digress, they are often heroes and in my view earn every penny.

The problem is the old boys network.
 

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