Doctors say they would emigrate rather than sign public-only contract

Survey finds 90% of trainees have concerns over Sláintecare draft consultant contract

More than 1,100 higher specialist trainees and fellows in training to become consultants were surveyed for the study, published in the Journal of Medical and Health Studies. Photograph: iStock

More than 1,100 higher specialist trainees and fellows in training to become consultants were surveyed for the study, published in the Journal of Medical and Health Studies. Photograph: iStock

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The vast majority of doctors in training reject the draft consultant contract under Sláintecare and say they will emigrate rather than accept it, according to a new study.

Some 87 per cent of trainee doctors say they are unlikely to consider the public-only contract being offered, and 94 per cent say they would consider working abroad rather than accept its terms.

More than 1,100 higher specialist trainees and fellows in training to become consultants were surveyed for the study, published in the Journal of Medical and Health Studies.

Over 90 per cent reported being significantly concerned about the contract, in relation to their ability to advocate for patients and to provide patient care, and also in relation to potential working conditions in the future and the difficulty in changing the contract once it is agreed.

Earlier this year, at the opening of contract talks with representative bodies, the Government offered salaries ranging from €210,000 to €252,000 for hospital consultants from mid-2022 who will work exclusively in the public system.

Private practice

Under the proposals, consultants working under the Sláintecare contract would not be permitted to carry out private practice either in public or private hospitals.

Initial talks took place in early May, but medical organisations were unhappy at what they maintained was the “not for negotiation” stance of the department.

A barrister has since been appointed to chair the talks and the Department of Health has removed a controversial proposal in the draft contract which would have imposed restrictions on the right of consultants to advocate on behalf of their patients.

In the study, respondents were asked a series of questions before, and after, reading the contract.

Before reading it , 55 per cent said they wished to pursue a mixed public-private practice and 38 per cent stated a preference for a public-only contract; after reading the document, only 6 per cent preferred the public-only option.

First-choice option

Emigration was the first-choice option for 1 per cent of doctors before reading the draft contract, but 40 per cent afterwards. Exclusive private-only work was the first choice of 0.2 per cent before reading, and almost 20 per cent after.

A significant majority (82 per cent) said they had concerns over possible deskilling if they were confined to public hospital practice, due to an anticipated lack of theatre access.

“Almost all respondents have stated they may emigrate rather than accept the current conditions, which will have catastrophic implications for training, service provision and workforce planning,” the study notes.

“The aim of the Sláintecare contract is to attract and train the very best clinicians. However, the currently proposed contract seems highly unlikely to retain these very clinicians.”

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