ANALYSIS: THE LABOUR Court decision last week to back an extended working day for non-consultant doctors will provide an impetus to efforts being made by the Health Service Executive to introduce similar arrangements for other health sector staff, writes MARTIN WALL, Industry Correspondent
Running services over a longer day will, of course, be hugely beneficial for patients and should facilitate new rosters for non-consultant doctors that will comply with EU rules on maximum working times.
But at the same time this would also allow for a significant reduction in the HSE’s massive bill for overtime and other premium payments for personnel working outside of the traditional 9am-5pm working day.
For individual staff all this would come at the cost of reducing take-home pay.
In essence, up until now the HSE has been operating a 24-hour, seven days a week health service on the basis of most staff being paid basic salaries for a 9am-5pm, Monday to Friday working week with overtime or premium rates applying outside this.
At present, non-consultant doctors work a core 39-hour week spanning traditional working hours from Monday to Friday. However, in reality the average working hours of non-consultant hospital doctors are much longer, probably about 60 hours a week but with some doctors frequently working more than 100 hours weekly.
With overtime rates applying for work carried out outside of the core 39-hour week, the HSE’s staffing costs have soared in recent years.
Overall, the HSE pays about €280 million in direct salaries for non-consultant doctors and almost as much again – €220 million – in overtime.
Figures published last week revealed that 20 hospital registrars had earned more than €100,000 in overtime last year with one doctor receiving over €150,000.
Under the terms of the Labour Court recommendation, the core working week for nonconsultant hospital doctors – covered by basic pay rates – would run from 8am-9pm, Monday to Friday, and 8am to 7pm at weekends. The Labour Court also found that health service management should be able to roster NCHDs to work on any five days over a seven-day period.
If the Labour Court’s recommendation on extending the core working day to later in the evening and earlier in the morning, and particularly to weekends, is implemented following a ballot of doctors, it would shave millions from the HSE’s cost base.
One senior HSE figure told The Irish Times this week that the savings involved could be in the region of €30-€40 million.
But if the concept of an extended working day could be extended further to involve other groups in the health sector, the savings could be enormous as overtime and premium payments are equally common for other staff who work outside of the normal 9am-5pm arrangements in providing a 24-hour service.
Between overtime, premium payments and various allowances, and so on, the HSE pays out about €1.2 billion to staff in what is known as non-core pay.
The HSE had set targets to reduce this non-core pay bill this year as part of its overall cost- saving programme. But the board of the HSE was told by management in a report a fortnight ago that these savings were not being achieved.
Earlier this month the HSE raised the issue of the core working week again as part of new talks with trade unions on the Government’s public service reform programme.
At the meeting on June 3rd, the HSE indicated that it wanted personnel to work over an expanded day as part of the new reform plans.
Management indicated that this would mean an end to existing arrangements under which premium or bonus payments were made to staff for working after certain hours in the evening.
These public sector reform talks on the health sector have effectively broken down at the moment in a separate row over the suspension of early retirement and new career break schemes in the health sector.
However, it seems certain that management will again press for changes to traditional working hour arrangements when negotiations resume again on an overall public sector reform deal, particularly in light of the Labour Court recommendation in the case of non-consultant hospital doctors.
Informed sources said this week that it was also likely that management would seek not only to extend the concept of a longer core day to personnel such as nurses or radiographers in hospitals but also to health professional staff providing services in the community sector.