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Is communist equal pay for all salary only hospital consultants hobbling recruitment?


Patslatt1

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See Hospitals 'face an impossible task' filling 450 consultant jobs - Independent.ie news%2Fhealth%2Fhospitals-face-an-impossible-task-filling-450-consultant-jobs-37928730.html
This article on the disastrous failure to fill vacant consultant positions didn't mention the difficulty of recruiting on equal pay for all new recruits. Obviously, in the international market for consultants in the English speaking countries which attract footloose Irish doctors, there are huge pay differences between specialties. So by ignoring this economic reality, the Irish health care system's equal pay dogma makes it very difficult to recruit scarce specialties in big demand. But if it raises pay to attract them, it will be overpaying specialties that are in plentiful supply. Given the high salaries involved, these overpayments could run into hundreds of millions.
In private sector companies, anybody proposing equal pay for all different professions would be considered idiotic.
 
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neiphin

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have you a solution ?
 

Patslatt1

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Sack the health minister.
Pay salaries competitive with the private sector to the top handful of key HSE executives including the CEO and finance director. The HSE bog needs extremely capable managers. Maybe reforming the HSE Is Mission Impossible.
 

Orbit v2

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Do you have a list of the numbers of the various consultants posts needing to be filled and can you relate them to salaries paid for those specialties abroad?
 

Ardillaun

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Show us the numbers, Pat. It's a fairly complex thing to arrange. BTW the highest earners in Canada are nearly all self-employed and fund their own pensions and other benefits.
 

RasherHash

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Jan 16, 2013
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See Hospitals 'face an impossible task' filling 450 consultant jobs - Independent.ie news%2Fhealth%2Fhospitals-face-an-impossible-task-filling-450-consultant-jobs-37928730.html
This article on the disastrous failure to fill vacant consultant positions didn't mention the difficulty of recruiting on equal pay for all new recruits. Obviously, in the international market for consultants in the English speaking countries which attract footloose Irish doctors, there are huge pay differences between specialties. So by ignoring this economic reality, the Irish health care system's equal pay dogma makes it very difficult to recruit scarce specialties in big demand. But if it raises pay to attract them, it will be overpaying specialties that are in plentiful supply. Given the high salaries involved, these overpayments could run into hundreds of millions.
In private sector companies, anybody proposing equal pay for all different professions would be considered idiotic.
You seem to want a US type system where people can't even get affordable health insurance.

Our society shouldn't just be for the few lucky insiders but should be for all our citizens, equality is the future.
 

Patslatt1

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You seem to want a US type system where people can't even get affordable health insurance.

Our society shouldn't just be for the few lucky insiders but should be for all our citizens, equality is the future.
Failing to pay or incentivise specialties enough to fill vacancies has consequences. The Irish system can't provide timely operations to prevent blindness from cataracts, relative simple procedures. This would avoid the enormous costs of blindness. There was a lot of media publicity about the cataract patients who were bussed to Northern Ireland for treatment.
 

Patslatt1

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Show us the numbers, Pat. It's a fairly complex thing to arrange. BTW the highest earners in Canada are nearly all self-employed and fund their own pensions and other benefits.
I'm sure Irish hospital consultants would prefer the Canadian system which generally works well,doesn't it? Do they work in public hospitals?
 

Ardillaun

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I'm sure Irish hospital consultants would prefer the Canadian system which generally works well,doesn't it? Do they work in public hospitals?
It’s almost all a state system (apart from some private MRI, orthopedics, Lasik surgery etc.) and doctors are paid in many ways. The guys in high volume, short procedure areas, like dermatology, radiology and ophthalmology, tend to go fee-for-service. I think this is an option that Ireland should consider. After all, it would surely be preferable for such hospital consultants to spend their days in the public hospital rather than at the private clinic? The catch is that the FFS guys are self-employed with no pension etc. There are big spending lads here of the grasshopper variety who didn’t make adequate provision for their later years and ended up in the locale formerly known as Queer Street.

In other areas Canada’s system has serious problems. Our insistence on a single state payer turns out to be unaffordable. Most patients who are not covered by employer insurance have to pay for their drugs and millions don’t have a GP. We will have to expand the private sector here.
 
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Lumpy Talbot

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No
Pardon my naivete on this question but dare I suggest that if there are 500 consultant vacancies could we review whether they are actually needed?

We might have to revive the cult of the actual general practitioner in diagnosis and rely on the specialist teams in sections in most hospitals for expertise.

Could we not just cancel the ads and see how we get on?
 

Ardillaun

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Pardon my naivete on this question but dare I suggest that if there are 500 consultant vacancies could we review whether they are actually needed?

We might have to revive the cult of the actual general practitioner in diagnosis and rely on the specialist teams in sections in most hospitals for expertise.

Could we not just cancel the ads and see how we get on?
AFAIK you have far fewer consultant posts per capita than Canada as it is. Expert specialist care cannot be provided by GPs, excellent as they are.
 

Sweet Darling

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There is no shortage of General nurses in Ireland, But there are shortages in a number of nursing specialties like ICU.
But the general Nursing crowd have voted down any separate pay rises for these posts to attract candidates to the jobs.
The coppers in sleepy small town Ireland have also in the past voted down premium rates for working in the cities busy stations.
 

Sweet Darling

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AFAIK you have far fewer consultant posts per capita than Canada as it is. Expert specialist care cannot be provided by GPs, excellent as they are.
We have a higher requirement then Canada to attend the position of Consultant, Thanks to the Irish Consultants closed shop racket.
 

Patslatt1

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It’s almost all a state system (apart from some private MRI, orthopedics, Lasik surgery etc.) and doctors are paid in many ways. The guys in high volume, short procedure areas, like dermatology, radiology and ophthalmology, tend to go fee-for-service. I think this is an option that Ireland should consider. After all, it would surely be preferable for such hospital consultants to spend their days in the public hospital rather than at the private clinic? The catch is that the FFS guys are self-employed with no pension etc. There are big spending lads here of the grasshopper variety who didn’t make adequate provision for their later years and ended up in the locale formerly known as Queer Street.

In other areas Canada’s system has serious problems. Our insistence on a single state payer turns out to be unaffordable. Most patients who are not covered by employer insurance have to pay for their drugs and millions don’t have a GP. We will have to expand the private sector here.
The UK still gets by with the single payer system, which is more cemtralised than Canada's provincial single payers. There seems to be a lot of "rationing by queue" in the UK as GPs paid capitation fees often send people away with an aspirin instead of referring them for expensive treatments.
 

Patslatt1

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Joined
Nov 18, 2009
Messages
3,681
Pardon my naivete on this question but dare I suggest that if there are 500 consultant vacancies could we review whether they are actually needed?

We might have to revive the cult of the actual general practitioner in diagnosis and rely on the specialist teams in sections in most hospitals for expertise.

Could we not just cancel the ads and see how we get on?
The GP as a generalist is also a specialist in deciding which specialty to guide the patient to.
 

Patslatt1

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Nov 18, 2009
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3,681
We have a higher requirement then Canada to attend the position of Consultant, Thanks to the Irish Consultants closed shop racket.
I understand it takes way longer to qualify as a consultant than abroad. A doctor told me that was a government policy introduced to hold down costs in the 1980s.
 

Patslatt1

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Nov 18, 2009
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There is no shortage of General nurses in Ireland, But there are shortages in a number of nursing specialties like ICU.
But the general Nursing crowd have voted down any separate pay rises for these posts to attract candidates to the jobs.
The coppers in sleepy small town Ireland have also in the past voted down premium rates for working in the cities busy stations.
The trade union public sector aristocracy know how to manipulate weak governments. The average garda pension is worth about 1.4 million euros in today's money.
 

Ardillaun

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I understand it takes way longer to qualify as a consultant than abroad. A doctor told me that was a government policy introduced to hold down costs in the 1980s.
Much longer for both hospital consultants and GPs. In Canada, GP training takes two years after med school and most hospital specialties take 5-6 years. Here in Canada, we just finish our training and expect to get independent specialist jobs right away.
 

Ardillaun

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The UK still gets by with the single payer system, which is more cemtralised than Canada's provincial single payers. There seems to be a lot of "rationing by queue" in the UK as GPs paid capitation fees often send people away with an aspirin instead of referring them for expensive treatments.
In Canada, the health system is paid for by both the provincial and federal governments, but mainly at the provincial level. The fundamental legislation governing health care is federal.
 
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