Call to end two-tier pay structure for consultants

Future of public hospital care at stake unless Government acts, says specialists’ association

Public hospital care will be irreparably damaged unless the Government ends the system of lower pay for recently appointed hospital specialists, the Irish Hospital Consultants Association (IHCA) has said.

In a letter to Taoiseach Leo Varadkar, Minister for Health Simon Harris, Minister for Finance Paschal Donohoe and main political party leaders, IHCA president Dr Donal O’Hanlon said the acute hospital and mental health services would increasingly fail patients due to approved permanent consultant posts that cannot be filled as a result of “the discriminatory salary cuts imposed by the State on new entrant consultants”.

“Acute hospitals are in a serious crisis with nearly 20 per cent of permanent consultant posts not filled,” said Dr O’Hanlon.

"Either the country's political representatives are unaware of the scale of the problem or have been ignoring the fact that the State's actions are preventing the filling of over 500 permanent consultant posts throughout the country's acute hospitals. On a population basis, Ireland has one of the lowest number of hospital consultants in the OECD [Organisation for Economic Co-operation and Development], at approximately half the OECD average. It is clear that the Irish population and patients can ill afford to have nearly 20 per cent of the approved permanent consultant posts unfilled due the actions of the State which is driving highly trained specialists to practise abroad."


Waiting lists

Dr O’Hanlon said the State’s actions were proving extremely damaging for patients due to the unacceptable delays in the provision of hospital care which were leading to ever-increasing and record waiting lists.

He said it was unsurprising that 514,000 people are now on waiting lists for consultant outpatient appointments and that more than 74,000 patients are awaiting surgical appointments.

“The Government position is illogical as ending the discrimination would be cost effective, resulting in significant health service benefits and cost reductions when considered fully. It would reduce health service costs through the provision of earlier patient care, better patient outcomes, reductions in outsourcing costs and shorter waiting lists. It would also reduce agency consultant costs which are up to three times the salary being paid to permanent new entrant consultants.

“Over the past three years 2015 to 2017 the health service has failed to fill up to one-third of the consultant posts advertised by the Public Appointments Service. During those three years, over one-third of the posts advertised received between zero or one application and over half received between zero to two applications. The failure to fill a third of the advertised consultant posts is having an adverse impact on practically all medical and surgical specialities and most hospitals throughout the country.”

Health system

Dr O’Hanlon said a survey the IHCA carried out of recent entrant hospital consultants confirms that they were personally aware of colleagues working abroad who would not return to work in the Irish public health system due to the lower salaries.

“In addition, over 70 percent of the new entrant consultants have confirmed that they will seriously consider resigning from their public hospital posts unless the discriminatory salary terms are corrected.”

Dr O’Hanlon said the country had already lost a large percentage of the highly trained specialists who qualified in the past decade. If the Government does not end the discrimination we will have lost, in another decade, most of a generation of the specialists that the country absolutely needs.

Earlier this week the Irish Medical Organisation, which also represents consultants, said under current arrangements those appointed since 2012 could earn up to €50,000 less than more longer-serving colleagues.

It said the prospect of industrial action by consultants in hospitals was more likely after the Government failed to table proposals at talks on Wednesday for tackling the two-tier pay system.

Martin Wall

Martin Wall

Martin Wall is the former Washington Correspondent of The Irish Times. He was previously industry correspondent