Lower pay rates for hospital consultants appointed in recent years need to be addressed, but work practices also need to change, the head of the HSE has said.
Speaking at the annual conference of the Irish Hospital Consultants Association (IHCA) in Dublin on Saturday, Paul Reid also said the HSE was too big at its centre, and not connected strongly enough to the parts of the system delivering healthcare. "This can create a lack of clarity on ownership."
Mr Reid told the conference he accepted that pay parity for consultants appointed after October 2012 was an issue in terms of “equity and motivation”.
He also acknowledged that the two-tier pay system was proving to be a barrier to recruitment in the health service. He said a process to deal with this issue should be put in place as soon as possible to give clarity for the future.
Medical organisations have argued that consultants appointed since October 2012 can receive about €50,000 less per year than more longer-serving colleagues.
The IHCA said on Saturday there were 500 medical specialist positions not filled on a permanent basis, and more than one million people on hospital waiting lists. Much of this was down to the lower pay rates for new entrants which the IHCA said was driving young consultants abroad.
Mr Reid said consultants needed to work with management on finding solutions to problems in the health service.
“It isn’t just about pay and more beds. That is too simple. Process and work practices need to change. If we work together it can build the trust and confidence of the public.
“Collectively we need to talk about what is good about our health system...not just what is wrong. Consultants have a role in this too,” Mr Reid said.
The IHCA conference backed a motion calling on it to pursue pay parity “by whatever means necessary”.
IHCA secretary general Martin Varley said it had already had put in place a media campaign to highlight the pay issue and there was also potential legal action. The IHCA council would have to look at what other possibilities were available if the Government did not act.
The IHCA has a traditional policy of not engaging in industrial action. Mr Varley said the association would not take any measures that would disadvantage or discommode patients.
Fianna Fáil, meanwhile , has pledged to end the two-tier pay system for hospital consultants appointed since 2012 if it leads the next government.
The party's health spokesman Stephen Donnelly told the conference that ending pay inequality for senior medical specialists was one of the conditions necessary to reduce waiting lists and "to bring our young doctors abroad back home".
He estimated that in the first year providing equal pay for recent-appointed consultants would cost €20million to €30million.
Sinn Féin health spokeswoman Louise O’Reilly said her party would also end pay inequality and introduce equal pay for equal work. She said this could pay for itself by reducing expenditure on expensive agency personnel.
Minister for Health Simon Harris pulled out of attending the conference citing a clash of diary commitments. He was accused by individual doctors on social media of "cowardice".
The Department of Health said Minister of State Jim Daly would stand in for Mr Harris. However, on Saturday morning Mr Daly also indicated that he was unable to attend the conference.