Major clash likely on junior doctor pay

[Posted: Mon 19/10/2009 by Niall Hunter, Editor]

Junior hospital doctors are seeking salary increases of between 25% and 40% as a result of loss of earnings due to cutbacks in their overtime pay.

Changes to the way juniors are paid and the resulting new pay claim could lead to a major clash with the HSE and the Government.

The trainee doctors' union, the IMO, has been in talks at the Labour Relations Commission (LRC) on a new contract for junior doctors, but these broke down recently.

Outstanding contract issues are now expected to be referred on to the Labour Court for adjudication, and the IMO is pressing for major pay hikes for junior doctors as part of this process.

The IMO says junior doctors are facing major changes to their pay and working conditions as a result of recent cuts in overtime and a separate reduction in their overall working hours under EU legislation.

While the pay claim appears radically out of synch with current economic circumstances, the IMO argues that the pay rise is needed to compensate for the fact that trainee hospital doctors' remuneration being radically reduced by the cuts to their working week under EU law, and by recent major changes in the way overtime is calculated.

Asked how the IMO could countenance making such a large pay claim with the public finances in their current state, Finbarr Murphy of the IMO told irishhealth.com it would be fair to say that many junior doctors were facing estimated cuts of at least one-third in their existing incomes as a result of the recent changes.

He pointed out that non-consultant hospital doctors (NCHDs) as they are officially termed, had agreed to the recently-imposed radical changes in their hours, working conditions and work practices, but were seeking compensation for the effect this was having on their remuneration.

NCHDs would also have been subject to the recent tax and pension levies and may face a further public service salary cuts after the Budget.

Currently, the basic pay of junior doctors ranges from €35,000 at intern level to €85,000 at senior registrar level.

However, many junior doctors have in the past been able to earn a similar amount to their basic pay each year in overtime.

Under changes to EU law, juniors' working hours are being reduced to 48 per week. This has diminished the potential for overtime, as the basic working week is 39 hours but many juniors would previously have worked in excess of 48 hours.

Traditionally, many NCHDs worked 70 hour-plus weeks. 

In addition, the Labour Court recently ruled that junior doctors' working day should be extended, and this also limits the opportunity for doctors to earn overtime pay.

The Court ruled that the doctors' core working day should span from 8 am to 9 pm Monday to Friday and 8 am to 7 pm at weekends, with juniors working their basic shifts within these timeframes. Previously, overtime pay kicked in after 5pm and at weekends, as the core working day was deemed 9am to 5pm Monday to Friday.

The IMO recently accepted this recommendation in a ballot of junior doctor members. Now, while juniors can still tecnically earn some overtime pay, this pay has been radically reduced.

The HSE's yearly overtime bill for junior doctors is around €260 million, and it expects to make major savings as a result of the changes to the junior doctor overtime system.

The IMO has claimed that junior doctors' basic salaries have been suppressed over the years as a result of their qualifying for high overtime payments. A compensation package for loss of earnings is also been sought by the IMO for the hospital doctors, according to this week's Irish Medical News.

The IMO also says the HSE has yet to fully implement the new 48-hour week for junior doctors and is in breach of EU legislation on this issue.

A cash-strapped HSE is expected to strongly resist any major increase in junior doctors' pay on budgetary grounds, as, apart from the likelihood of it pleading inability to pay, conceding the claim would negate any savings the HSE is gaining from reductions in the doctors' overtime levels.

Following changes made to the consultant contract, it is Government policy to increase the number of consultants and reduce the number of junior doctors, with a view to having a more consultant-provided hospital service, with more senior decision-making by consultants on the hospital site outside normal hours.

The current policy is to suppress two junior doctor posts for every new consultant post filled.

A total of 221 new consultant posts have been created between March 2008 and September 2009 and there are now 2,300 consultants in public hospitals. Many of the new posts, however, had been put on hold during the protracted consultant contract negotiations.

However, the long term plan is to increase consultant numbers to around 4,000. There are currently around 4,500 junior doctors in hospitals and the long-term plan would be to reduce this number by around 50%.

Mr Murphy said, however that to date their was little evidence of junior doctor posts being cut and of consultant posts being increased.

He also pointed out that there would be problems with this policy, as if you reduce the number of junior doctors to this extent it will be very difficult to deliver a hospital service and stick to a maximum 48-hour working week, even with additional consultants.

The recent Bord Snip report called the extension of the core working day to be applied throughout the health service, in order to save on overtime payments, and called for no premium payments to be made to hours worked within the span of 8am to 8pm.

Anonymous  Posted: 27/10/2009 11:14

I think that it's long past time that juior doctorsz working ours were cut. Afterall if it is illegal for an office clerk to work those kinds of hours, why should a junior doctor who havs people lives in his hands work to exhaustion However, what made tem think that overtime pay - which is exactly pay over your normal salary, is somehow now part of their salary and therefor some sort of an entitlement?

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