Q&A

My hospital appointment was cancelled today because of a doctors' strike. What's going on?
You're not alone – 15,000 appointments and elective procedures have been cancelled today because, for the first time since 1987, hospital doctors are on strike. Now, as back then, the dispute relates to working conditions and in particular the issue of long working hours. One-hundred-hour working weeks and single shifts of over 36 hours are all too common for non-consultant hospital doctors (NCHDs), despite the fact the EU has declared them illegal and successive governments have promised action.

I know, the hours are appalling, and it can't be good for patients to be seen by exhausted doctors, but weren't there talks going on about this?
Yes, the Irish Medical Organisation, which represents doctors, and the HSE have been in negotiations since August, and they seemed at one point to be close to agreement. A timetable was drawn up for the phasing out of shifts longer than 24 hours and the implementation of the European working time directive. Two weeks ago, the organisation said the proposals negotiated were significant and went "a considerable way to address our deep concerns on the working hours". But that was before negotiators went back to their NCHD committee.

What happened then?
The non-consultant doctors weren't having any of it. The issue arose out of what sanctions would apply where hospitals failed to limit long working hours. The HSE said it would agree to sanctions being imposed on hospital managers or hospitals budgets where the proposed deal was not adhered to. However, the IMO said junior doctors should benefit where sanctions were applied.

In what way?
The details have been the subject of public dispute over the past week. The HSE claimed the doctors were looking for triple time for each hour worked over the 24-hour limit. This was over-egging the pudding, because what the IMO sought was payment for the hours plus time off in lieu and, if this wasn't given within three months, a payment at 1.25 normal rates.

This is all detail, and it doesn't explain why my appointment is cancelled.
You're right. The fundamental problem is a lack of trust. The NCHDs don't believe that health bosses will implement any agreement. After all, budgets are being slashed and few new doctors are being appointed, so where are the replacement hours and staff to be found when doctors are working shorter days and weeks? Only in the largest hospitals will it be possible to rejig rosters to provide the same level of cover.

Is there anything more to it?
Yes, you can't ignore the growing feeling of persecution among doctors. Successive pay cuts, increased taxes, cuts in allowances and growing amounts of unpaid overtime have embittered many NCHDs. Yes, other groups in society have suffered cuts, but the doctors feel they are being singled out for "special" treatment. The goal of NCHD training is to become a consultant but the Government has slashed the salary of new consultants by 25 per cent, leading to more resentment.

I hear the strike in 1987 was very successful. Maybe the old guard could give advice?
Yes, an all-out strike on that occasion saw the pay for overtime bumped up from 50 per cent to 125 per cent of normal pay. They could try asking one of the prominent members of the IMO council back then, Dr James Reilly, for help – except that he's currently Minister for Health.