Hospital doctors and dispute with HSE


Sir, – I find the headline “Irish hospitals hit by wildcat work stoppages by doctors in pay row” ( September 4th) rather pejorative.

As a recently retired consultant in emergency medicine, I am familiar with both sides of this argument.

The Health Service Executive has taken a firm stance in relation to employing locums via agencies, as the costs are so high.

I have little doubt that this is in keeping with instructions from the Department of Public Expenditure and Reform. That is the function of the “real government”.

Unfortunately, it had previously taken a position in regard to overtime payments, and other elements of the employment contract for both consultant and non-consultant hospital doctors, which made it rather unpalatable for those employees, to such an extent that they voted with their feet.

Working in Irish emergency departments has become so unpleasant for professionals that those who previously valued a permanent pensionable contract are no longer so keen on it.

In fact, they abhor it.

Look at the recent headlines in relation to filling consultant posts with doctors not on the specialist register, despite that being a mandatory requirement.

Many who would previously have been prepared to work difficult, unsocial, hours in overcrowded conditions, in order to complete their postgraduate training in emergency medicine, have now decided that it is better to work the same hours on a part-time basis, for better pay, shunning the less acceptable aspects of an organised roster, in order to pay for childcare and their mortgage. This mirrors the approach in the US. But it leaves the Irish health service in a very difficult position.

No one has stopped work, despite your headline, as they had no ongoing contract to work. They have simply opted not to seek work with a monopoly employer who has reduced the previously offered wages.

As is recorded elsewhere, in Hosea 8:7, “For they shall sow the wind and reap the whirlwind”. – Yours, etc,


(Retired Consultant

in Emergency Medicine),

Mount Merrion,

Co Dublin.

Sir, – Prior to the new framework that the HSE introduced at the start of September, locum doctors working in certain specialities (including A&E, paediatrics, and anaesthetics) received a premium payment to encourage doctors to fill shortages within these hard-to-fill specialities. In addition, out-of-hour shifts are paid at a slightly higher rate, as expected. The rate you quote refers only to general (ie not premium rate) senior house officer (SHO) on 9am to 5pm shifts.

The truth of the matter is that premium speciality staff, of which A&E locum doctors are but one, are expected to accept a €10 per hour reduction in normal working hour pay (9am to 5pm), a €12.80 per hour reduction in out-of-hours pay (5pm to 9am), and a €13.20 per hour reduction in Sunday and bank holiday pay for premium SHO shifts.

Bearing in mind that locum doctors work on a no-work, no-pay basis (they are not entitled to sick leave, annual leave or study leave), and that there is no obligation from the HSE to provide regular shifts, I can understand why they have decided to make their grievances known.

Maybe the Minister for Health Simon Harris should put his money where his mouth is, and instead of reducing the pay of doctors who are currently propping up the services, work on his goal of bringing healthcare salaries in line with international counterparts. Then maybe locum doctors would make the move into full-time, regular, leave-inclusive, pensionable employment. – Yours, etc,



Co Kildare.