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Warning to Reilly on consultant contract
[Posted: Tue 29/03/2011 by Niall Hunter, Editor www.irishhealth.com]
IMO President Sean Tierney has said there would be no point in the new Government pushing through a new contract for consultants in the absence of parallel changes in how the hospital system works.
Health Minister James Reilly, himself a former IMO President, has pledged to introduce a new consultant contract, with lower pay, to fit in with the eventual introduciton of a new universal health insurance system.
Asked about consultants' willingness to accept further pay cuts with a new contract, Mr Tierney said consultants had already taken substantial pay reductions.
Mr Tierney, who was commenting following the release of preliminary reuslts of a new IMO survey of consultants, said it would be illogical to talk about a new contract for consultants in the absence of any vision of how the service would work in future.
This, he said had been a flaw with the implementation of of the current contract, which had only been introduced in 2008 after a decade of talks.
"People assumed things would get better with the new contract but they are in fact worse than before," he told irishhealth.com
Mr Tierney said preliminary results from the survey of consultants showed their morale was very low at the moment as a result of limitations in the services they can offer to patients as a result of cutbacks and other resourcing and support issues.
Mr Tierney said it was pointless to promise, as the current contract had, a single 'public-private' waiting list in public hospitals for diagnostic tests such as colonoscopies when people who could afford it could get these tests done elsewhere if there were delays.
The IMO surveyed 1,600 consultants around the country - 400 responded to the survey, carried out on behalf of the organisation by Behaviour and Attitudes. The study found that morale was low among many consultants at the moment and there was much disillusionment.
Mr Tierney, who is a consultant vascular surgeon at Tallaght Hospital, said the survey did not ask about public hospital pay levels or private practice earnings.
He said consultants identified issues such as deficits in support services such as physiotherapy and occupational therapy, to which they wanted to refer patients on, caused by the non-filling of vacancies by the HSE.
The survey also found that consultants did not have sufficient administrative supports.
Mr Tierney said consultants had agreed to work more flexibly with longer hours under the 2008 contract, but many felt that they had fulfilled the terms of the contract while the HSE had not.
Asked why outpatient waiting lists currently stood at around 200,000, with some people waiting five years for an appointment, Mr Tierney said this was largely a capacity issue.
He said despite some increases in consultant posts in recent years, there were still severe shortages in some specialties like neurology and urology.
"Some specialties would still only have one-half or one-quarter of the consultant manpower needed to bring us up to European norms."
On consultant pay, Mr Tierney accepted that consultants were still paid well.
However, he pointed out that basic pay for their public work had recently been reduced by around 20% and fees from private insurers had been cut by over 16%.
Mr Tierney said consultants, like everyone else, had also been subject to recent tax and levy increases.
Currently, consultants working in public hosptals without any private practice earn around €188,000 under the 2008 contract, while those who also work in public hospitals but have private practice there earn around €165,000 for their public work.
However, these consultants' salaries have been reduced further for new entrants since January 1 to around €173,000 and €158,000 respectively.
Consultants who took up the 2008 contract before January 1 and work in public hospitals but are allowed 'off-site' practice in private hospitals earn around €165,000 for their public work.
In addiiton to their basic public salaries, consultants also receive more than €3,000 in on-call allowances.
Many consultants with private practice can earn substantial six-figure sums on top of their public salaries.
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