Changes demanded of consultants make no sense
If the Government had the courage of its convictions, it would look beyond the medical consultant contract and salary by urgently addressing the overall costs of the service.
Bureaucrats outnumber doctors six-to-one and many problems in the health service are due to top-heavy administration and management within the Department of Health and the Health Service Executive.
James Reilly also claims there is a general consensus among consultants that the LRC “deal” was reasonable. This is a baseless statement and there is no such consensus.
It is important to note that the 2008 consultant contract was never honoured and consultants took a 12-15 per cent cut in salary in 2010, with a further cut in 2011 leading to a net paycut of 22-25 per cent (not including the universal social charge or pension levies). The Minister’s proposal to change the contract again and decrease the salary by a further 30 per cent will be the death knell for the academic hospital consultant in Ireland.
Many consultants return to Ireland in their late 30s with 15 years of postgraduate training. They bring international experience and expertise. They will now stay abroad because of the restrictive inward-looking contract and non-competitive salary on offer.
Ireland has already lost Prof Bill Powderly, head of UCD’s medical school, and Prof Dermot Kelleher, dean of medicine at Trinity College, both of whom have well-funded research and international reputations. This pattern is set to continue. In addition to working long hours for the care of their patients, the vast majority of medical consultants educate students, nursing staff and paramedics; act as advocates for their patients; develop programmes and bring research grants to employ doctors and scientists; host international meetings, bringing income into Ireland; promote fundraising; and assist with administration including the developing HSE clinical programmes.
Notably, the Minister for Health has acknowledged that flexible work practices by consultants saved 70,000 bed days and €90 million for the HSE. Encouraging this entrepreneurial spirit is what is needed. This latest iteration of the consultant contract will suffocate it. Consultants remain ultimately responsible for patient care. They, not managers, are sued when things go wrong. This huge responsibility is shouldered by consultants but their authority to ensure patients are safely treated is being eroded. This heralds grim prospects for the health of Irish citizens.
Prof Tim Lynch is a consultant neurologist and is clinical director of the Dublin Neurological Institute at the Mater hospital. neurologicalinstitute.ie