Making medical specialists cough up
With the debate on consultants’ pay back in focus, some doctors complain they are being made the whipping boy for other failures, writes PAUL CULLEN,Health Correspondent
‘CONSULTANTS’ PAY is to the health service what Anglo Irish Bank was to the banking system,” declared one GP during an outbreak of the recurring debate about medical specialists’ pay last year.
That debate – and those kind of sentiments – have returned with a vengeance this year following the recent talks on pay and conditions between the Department of Health and the consultants’ representative bodies.
It is clear, for example, from their letters published in this newspaper over the past weeks, that consultants increasingly feel that they are being made the whipping boys for the failings of the health service and the country as a whole. All the long years of training and long hours of hospital rounds seem to count for naught as the search for scapegoats intensified within our fractured society, they argue.
For the rest of the population, though, consultants rank as the privileged few among public-sector workers, a group which has taken but a fraction of the financial pain endured by others and which, it has been claimed, could give a lot more.
Some consultants work exclusively in the public sector, others have contracts allowing them to perform both private and public work while a third group works exclusively in private hospitals and falls outside the current negotiations and the surrounding debate.
Most of the 2,600 consultants working in public hospitals are on contracts allowing them to also treat private patients.
Last March, the outgoing human resources director of the Health Service Executive, Seán McGrath, shone a light on consultant pay and conditions in an interview with The Irish Times.
He revealed that one hospital consultant received more than €400,000 from the public health service, while up to 500 senior doctors were earning more than €200,000.
He claimed some consultants were able to complete their 37-hour commitment to public hospitals by Wednesday lunchtime and to devote the rest of the week to their private practice, while receiving additional allowances for being “on call”.
According to Mr McGrath, there are more than 100 salary rates for hospital consultants, based on various contracts, ranging from €130,000 to €185,000. On top of salary there are “very generous allowances”. Clinical directors receive €46,000 in allowances and there are also on-call, call-out and continuing education payments.
No one questions the high standard of training and performance of Irish consultants, but critics repeatedly claim that the private work of specialists in Irish hospitals is assigned a higher priority than public work. Many saw as telling a passing remark made by a consultant in a fitness-to-practise hearing last month, during which he said in relation to the two-year-old child he was treating that “if I was aware the patient was private, I would have done the procedure myself”.