Brain drain, Lack of junior doctors (NCHD), Role of Irish immigration

Star Trek

Is lack of NCHD training structure and training grant cuts leading current brain drain ??

or

Attitude of Irish immigration who is issuing 6 months visas to well qualified NCHDs and their families for a fortune and extremely slow naturalisation process causing the NCHDs to leave Ireland for UK and other countries ????

What are other countries doing to attract NCHDs ??? e.g ease in immigration policy for doctors in UK and Australia...

NON-EU NCHDs don't make more money by working outside Ireland ,, but they are happy with the immigration and tax system in those countries...

Is the government buying time and wasting money by creating new bodies like:
Human Resources and Integrated Services Directorate Group

or

They really want to change the system ,, What is the action plan????



Reference:http://www.kildarestreet.com/wrans/?id=2010-04-29.1200.0&s=nchd#g1202.0.r


Recent News:
Brain drain is leading to a shortage of doctors:
http://www.irishtimes.com/newspaper/health/2010/0202/1224263564344.html

Lack of junior doctors puts service on the critical list
http://www.irishtimes.com/newspaper/health/2010/0427/1224269144650.html

dissed doc

It's all of those factors:

1. Restricted working hours
2. No increased hours of consultant supervised training
3. Reduced salaries
4. No funds for attending training courses or conferences
5. High taxes
6. No job security
7. Paying into a pension that you will never get
8. 10% chance of ever completing specialist training and getting a consultant level post in Ireland.

Traumadoc

Having to fill gaps due to no filling of jobs or non provision of locums.

Paying a pension levy for a pension you will probably never get is disheartening.

Vorsprung

A plain lack of respect on the part of the Minister, the HSE and previous health authorities.

Star Trek

Email circulating recently:

As you may be aware, the IMO has scheduled a National IMO Meeting for Saturday 22nd May 2010 in the Radisson Hotel, Athlone, the agenda for which is set out below:
11.00am National Meeting of Non-EU Doctors
Welcome by IMO President Professor Sean Tierney
Introduction to IMO - Services for Non-EU Doctors
Visa Regulations
Medical Council Registration
New Registration Rules
Temporary Registered Doctors
Q&A

12.30pm Lunch

1.00pm National Meeting of Long Service Hospital Doctors
(including contract of indefinite duration holders)

Issues for Hospital Doctors with Long Service
Entry to NCHD Training Programmes
Recognition of Training
Contracts of Indefinite Duration
Terms & Conditions of Employment
Q&A
Please note that this is a closed meeting for IMO members only. Any doctor who is not currently a member of the IMO and who wishes to attend the meeting may complete the attached application form which should be returned to the IMO as soon as possible in order that the application may be processed in advance of the meeting of the 22nd May 2010.
Doctors need action from IMO not meeting behind close doors.

DrIndy

In fairness - the IMO is a union and their budget including legal fees to fight for doctors rights does come from their subscriptions - therefore doctors who don't subscribe are "freeloading" off the ones who do pay their tax deductible subscription.

Its not a closed door meeting - simply a normal union meeting for members of the union.

At times like this we need a union on our side more than ever. To make them do their job - they need information and co-operation from us as well as members to support their action either under the auspices of union protection and also in funds to face down the HSE. And believe me - the HSE ONLY hires the most expensive solicitors and barristers out there on their behalf - including michael mcdowell himself!

So its not really a conspiracy - more of a reminder in the call to arms for our rights. In fairness - no other quotient of workers in the workforce would allow overtime to be illegally not paid and terms and conditions to be shat on the way we do as we actually care about our job and the duty to our patients. This leaves us open to abuse and it is very unfairly doled out on NCHDs. I simply cannot understand any doctor who does not join at a time like this - and in fairness they represent the views provided to them - if you arse around complaining without giving them the issue and help provide possible remediation - they're not psychic and cannot provide this.

On the note of emigration - I have joined the ranks - I am staying in australia for the near future with no plans as of yet to return. T&C's are better here - moved to cairns which is a legend city nestled in the tropics and starting work at a good hospital.

dissed doc

DrIndy wrote: »

In fairness - the IMO is a union and their budget including legal fees to fight for doctors rights does come from their subscriptions - therefore doctors who don't subscribe are "freeloading" off the ones who do pay their tax deductible subscription.

Complete garbage. The IMO with its current and recent ineffective leaders has enabled the HSE and Department of Health to enact significanty deteriorations in training, work hours, employment conditions and remuneration over the past decade.

They are ineffective, and demand high subscription fees for that ineffectivness. It is no surprise that the more cohesive consultants group split from them in 1988 - they knew what the evolution of the IMO would be.

If the IMO were useful they would not have allowed the current mess to develop; therefore, they are just as likely to be unable to improve it.


[/QUOTE]

Narkius Maximus

dissed doc wrote: »

Complete garbage. The IMO with its current and recent ineffective leaders has enabled the HSE and Department of Health to enact significanty deteriorations in training, work hours, employment conditions and remuneration over the past decade.

They are ineffective, and demand high subscription fees for that ineffectivness. It is no surprise that the more cohesive consultants group split from them in 1988 - they knew what the evolution of the IMO would be.

If the IMO were useful they would not have allowed the current mess to develop; therefore, they are just as likely to be unable to improve it.

[/QUOTE]

In fairness, the strength of any union is only in its memebers. I dispute that the IMO have been ineffective over the past several years, the previous incarnation of the NCHD contract was pretty good, Doctor controlled training grant etc etc. The new contract I feel was rushed but the IMO did a sterling job in the face of incredibe pressure from the HSE, remeber they wanted rid of every single perk of being an NCHD. They planned to destroy the training in this country. The NCHD community, via 6 brave doctors, willing to put their names to paper, supported by concerned consultants, and organised by the IMO, halted a concerted effort by the HSE to remove all terms and conditions. In the face of that onslaught, it was a small but vital victory.

The EWTD is always going to be an elephant in the room, we don't have enough doctors to run the service as it has been. The HSE, DOH and medical council are to blame for this. It only suited them to reduce hours as means of saving cash, not for our or our patients safety. The HSE are now legally responsible for providing us with training. Continuing professional development is now law, if the HSE do not provide us with means to do this, they are in breach of law.

The good times have long gone, we now have to focus on doing the best we can with what we have managed to keep. I beleive the new contract solidifies, in a way previously never done, what we as employees must do and what our employers are responsible for. Remember, the new contract expressly states that all hours worked must be paid.We will hold our end of the bargain, will the HSE honour their side? Probabaly not, but the IMO now have set precedent for implementing cases if contracts are breeched and will continue to do so.

If you do not wish to join the IMO thats your perogative as an employee. Do what you like. Of course, you won't have the weight of a progressively strengthening union, with proven success, behind and supporting you.

I must stress that the IMO have previously sorted pay issues for me and so I have found my subscription worthwhile.

docbroc

Pull the other one. The only reason the HSE went for us in the first place is they saw how weak our union was. Do you really think they would have pulled that stunt if we were members of SIPTU ? The IMO is paralysed by its own ineffectiveness. Look at the never ending dispute over non payment in Castlebar ! What any competent union would have done was organise protracted industrial action starting out with say - non completion of HIPE coding forms as part of a patients dischare summary. Followed by a strict overtime ban and eventual all out strike if no progress was made. The dispute would have been sorted in a week. Instead we got this drawn out bull**** back and forth legal swinging go nowhere nonsense lasting years. Do you see the hospital porters , radiographers nurses being attacked like this ? No because they are capable of taking action, grassroots action. Im owed several thousand euro by the hospital I work in. Being a member of the IMO I've contacted them and did what they told me. 6 months on I havent a cent of the cash or even an acknowledgment that its owed.

But should a hospital porter (who could be replaced by a trained chimp) be questioned over his sick day doubletime scam or one hour overtime not paid you'd better believe that SIPTU would have them on the streets in the blink of an eye. The HSE has such little respect for us that they put a Nursing representative on the NCHD rostering comittee in our hospital but didnt put an NCHD. Even the Gardai who arnt allowed have a union have a better union than ours! Id join the INO/ICTU/SIPTU/bloody anyone tomorrow if I was able. At least they have some spine.

ergo

regarding the title of this thread - looks like emigration gonna increase massively this coming medical year

july 1st is gonna be interesting but in a very scary way -
I know of (much) lower ranking NCHD's being offered previously highly competitive jobs for July in big teaching hospitals, jobs that in times past only went to the cream of the crop - obviously the cream of the crop are heading off somewhere

I don't know who is going to staff the smaller hospitals

re IMO - well I have left recently - too expensive - and not too impressed with NCHD's losing annual leave in the new contract - study leave does not compensate for this

Narkius Maximus

docbroc wrote: »

But should a hospital porter (who could be replaced by a trained chimp) be questioned over his sick day doubletime scam or one hour overtime not paid you'd better believe that SIPTU would have them on the streets in the blink of an eye.

That's fine for porters who couldn't give a crap about patient safety. You're telling me you would go on protracted industrial action, using patients as leverage. Could you walk out? I know I couldn't. Other forms of action including non filling HIPE discharges-I've no idea what you are talking about, I've never had to do one, sounds like there is a civil servant who could do that job. It's not in the contract, don't do it.

docbroc wrote: »

The HSE has such little respect for us that they put a Nursing representative on the NCHD rostering comittee in our hospital but didnt put an NCHD..

Eh, if you were so bothered by that, you should have volunteered yourself for the job.

At the end of the day, you decided on this job, you've worked in the system for a while and you are unhappy. It's individuals who won't do anything that lead to inertia and will get trampled on. Get an accountant and a solicitor yourself, there are plenty at the moment, and get letters written. You are entitled to work done-sort it yourself, or do you not want to rock the boat??

TC80

I think it's dreadfully unfair to complain about ineffectual leadership in the IMO behind the mask of anonymity of the internet. The leadership you are slagging off is your fellow NCHDs who have gotten up off their backsides and tried to represent their colleagues and lobby to change things.

I know that the NCHDs who went to the negotiations last year took every single annual leave day they had in the LRC, labour court and high court and I think they deserve a bit of respect on that basis alone, as do those with the bravery to put their names to the high court challenge which was the one single thing that saved NCHDs last year. To "blame" the IMO for EWTD is not accurate. EWTD is law for NCHDs since August 2004, transcibed into Irish law by the Organisation of Working Time Act. The government had always opted out of this but when the derogation ran out in 2009, the government decided not to apply to have it extended. This is government policy. I don't think you can hold a union responsible for this decision.

Also, other than the removal of the higher degree allowance (for the half of NCHDs who got it) there was no salary cut in the new contract. Actually there was an increase in overtime premia for all NCHDs to time and a half for all hours, which cancels out the HD allowance. The cuts in your gross are due to the pension levies, income levies, health cuts and november budget PS cut. There are very few people in Ireland earning what they did 2 years ago.

Also I must take issue with the idea that the IMO don't have a spine. Taking and winning 2 high court cases against one of the richest and most powerful organisations in the country in 12 months is not the action of a spineless group. I'm sure you wouldn't suggest the 6 NCHDs who let their names go forward for the IMO action are spineless. Also it takes spine for all the IMO reps to go into meetings with consultants, training colleges, hospital admin, the HSE, the LRC, the high court. I've been an IMO hospital rep. It isn't exactly something that endears you to your consultants. Also it's a big time commitment writing position statements at nights and weekends. Those NCHDs involved with the IMO have the same commitments to work, study, research and family as you all do but choose to put in the hard yards. Some people might say this takes a lot more "spine" than writing the kind of bile that is regularly put up here against the IMO NCHD group from behind the anonymity of an internet handle.

I would be the first to admit that the IMO is far from perfect. I'm glad to be a member but there are quite a few things I'd like to change. I think though if you don't at least try to get active in it and change it you kind of lose the right to moan about it. As narkius said a union is the sum of it's members. I don't think in general that doctors are minded to strike.

As a final point, I did have a good chuckle when I saw the point about the consultants breaking away in 1988. The reason this happened was in response to the NCHD industrial action of 1987 when the consultants were greatly offended by the idea that the IMO would stand up for the rights of NCHDs if it inconvenienced them. As for a "more cohesive group", why don't you write to the IHCA and see how they are getting on in having the new consultant contract paid?

Jane5

Narkius Maximus wrote: »

That's fine for porters who couldn't give a crap about patient safety. You're telling me you would go on protracted industrial action, using patients as leverage. Could you walk out? I know I couldn't. Other forms of action including non filling HIPE discharges-I've no idea what you are talking about, I've never had to do one, sounds like there is a civil servant who could do that job. It's not in the contract, don't do it.


Eh, if you were so bothered by that, you should have volunteered yourself for the job.

At the end of the day, you decided on this job, you've worked in the system for a while and you are unhappy. It's individuals who won't do anything that lead to inertia and will get trampled on. Get an accountant and a solicitor yourself, there are plenty at the moment, and get letters written. You are entitled to work done-sort it yourself, or do you not want to rock the boat??

NM,
If you have never heard of and/or have never done filling in of HIPE code discharges, you must have been born an SpR.

"Other forms of action including non filling HIPE discharges-I've no idea what you are talking about, I've never had to do one, sounds like there is a civil servant who could do that job. It's not in the contract, don't do it."

These HIPE discharge forms are standard forms in all hospitals around the country, they are important in that they determine the amount of funding the hospital receives. The HIPE coders in every hospital look at the diagnoses and procedures in the boxes on the HIPE discharge, code them appropriately, and the complexity of cases, number of procedures, and type and number of diagnoses per patient are all submitted to the HSE, who use these to determine the workload and needs of the hospital, and allocate funding accordingly.

In addition, you cannot refuse to do discharge letters for patients-not every little task is specifically in our contract.

"That's fine for porters who couldn't give a crap about patient safety. You're telling me you would go on protracted industrial action, using patients as leverage. Could you walk out? I know I couldn't."

That's ridiculous. When I worked in NZ, we were losing juniors every day
because the pay was better in Oz, they had more time off and better quality of life generally. The consultants took us aside, and told us that we had a responsibility to take up the cause and strike for better pay and conditions now, before there were so few doctors left that patients suffered and even died. They told us to give management adequate notice to make any arrangements for patient care that they had to. They then offered their cover services to the hospitals for 500 dollars an hour during the strike.
This approach achieved the following:

1)That strike ended after two days because management got hit where it hurts the most-right in the goddamn wallet.

2)Patients were looked after by consultants during the strike, and hence were perceived to have had BETTER care than they would have had on a normal day in hospital.

The IMO is weak, and I do not accept that I should have to both pay them 700 something a year, AND arrange all my own litigation and sort out all my own industrial relations issues. That's crap.

Jane5

Irish NCHDs have got to get over this holier than thou "Oh I couldn't pawsibly STRIKE, I'm just SO indispensable that nothing else could possibly be arranged, and people would die".

That's utter bollocks.

If you give management a month's notice of a total walk out strike, that is enough time for them to arrange locum cover, strike some sort of cover deal with consultants, or bloody well sit down and discuss industrial relations with you. If they can't manage any of that, it's THEIR problem. NOT mine.

Jane5

Oh, and for the record, I wrote to them TWICE ASKING to be an IMO rep when they sent around a letter saying they were looking for them.
They never even got back to me. I would love nothing more than to try and introduce a bit of balls into this castrated eunuch of an union. But I can't even get my foot in the door. Funny that.

Narkius Maximus

Jane5 wrote: »

NM,
If you have never heard of and/or have never done filling in of HIPE code discharges, you must have been born an SpR.

"Other forms of action including non filling HIPE discharges-I've no idea what you are talking about, I've never had to do one, sounds like there is a civil servant who could do that job. It's not in the contract, don't do it."

These HIPE discharge forms are standard forms in all hospitals around the country, they are important in that they determine the amount of funding the hospital receives. The HIPE coders in every hospital look at the diagnoses and procedures in the boxes on the HIPE discharge, code them appropriately, and the complexity of cases, number of procedures, and type and number of diagnoses per patient are all submitted to the HSE, who use these to determine the workload and needs of the hospital, and allocate funding accordingly.

In addition, you cannot refuse to do discharge letters for patients-not every little task is specifically in our contract.

I never said I didn't do discharges, as na intern I had them to a fine art. However I never filled in a single HIPE number/form etc. I suppose there was always someone to do that kinda stuff.

Jane5 wrote: »

"That's fine for porters who couldn't give a crap about patient safety. You're telling me you would go on protracted industrial action, using patients as leverage. Could you walk out? I know I couldn't."

That's ridiculous. When I worked in NZ, we were losing juniors every day
because the pay was better in Oz, they had more time off and better quality of life generally. The consultants took us aside, and told us that we had a responsibility to take up the cause and strike for better pay and conditions now, before there were so few doctors left that patients suffered and even died. They told us to give management adequate notice to make any arrangements for patient care that they had to. They then offered their cover services to the hospitals for 500 dollars an hour during the strike.
This approach achieved the following:

1)That strike ended after two days because management got hit where it hurts the most-right in the goddamn wallet.

2)Patients were looked after by consultants during the strike, and hence were perceived to have had BETTER care than they would have had on a normal day in hospital.

The IMO is weak, and I do not accept that I should have to both pay them 700 something a year, AND arrange all my own litigation and sort out all my own industrial relations issues. That's crap.

Jane, I've read about the NZ strikes and it was impressive stuff. It helps if the people you work for are supporting you to the hilt? Do you think that would happen here? If the situation here gets to an untenable position, which is a real possibility, then perhaps I'd change my mind and walk out. But not without exhausting other possible means.

A union could do with someone like you, I'm surprised they didn't contact you. I've previusly repped but with another kid on the way it's just gotten too difficult. I don't think we've heard the last from the HSE knocking on our door.

Chiparus

The NCHDs have been shafted, why else are they leaving?

The IMO were forced into the 1999 action because the NCHDs were going to leave the union. It seems the only time that we have been respected is when we stand up for ourselves.

Michael Martin joked with Ahern that the conditions the NCHDs were looking for were introduced to the rest of the workforce in 1948!

When the government tried to impose the pension levy on the ESB workers ( they recieve the same pension) the response was " Go ahead punk, make my day". They dont care if the power they supply also supplies the ventilator - thats why they earn 100k + on average.


You have to ask youself "Is it better to be loved or feared?"

Jane5

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1375310/?page=1

The above article got pinned to the wall of our res in NZ-it makes for good reading. Something all holier than thou NCHDs would do well to read. You can strike. It's okay. Like NIKE-just do it.

NM, if there were unity here, if say, something like a UNION, got together and sent the consultants a circular stating-not asking-stating when, where and how the strikes will happen and what their options are-including getting together themselves and demanding massive amounts per hour to cover for striking NCHDs, then I guarantee it would work.

The consultants would not be offered a choice, they would be informed, of when and in what form the strike would take, like the HSE and public would be.

They would then be offered the option of making an obscene amount of money from the NCHD strikes in exchange for providing emergency ward cover.

The HSE, aware that there is strength in UNITY, and that both consultants and juniors were UNITED, would quake in its boots, and would not be long getting its ass back to the negotiating table-that or pay insane amounts of money to consultants to cover.

Ultimately, a scenario like the one I am suggesting may have to happen now anyway, as the HSE are intending to axe 900 NCHD posts in July, and this will create an unsustainable situation. Both consultants and NCHDs will be forced to unite to figure out a solution.

Chiparus

The IHCA has already told the HSE that they will not be filling in gaps in service.
Many consultants are pissed off at the way they were shafted by the HSE with the new contract.
New type B contract earn less than the old type I despite having a longer working week and being rostered on the weekend.

drkpower

Chiparus wrote: »

The IMO were forced into the 1999 action because the NCHDs were going to leave the union. It seems the only time that we have been respected is when we stand up for ourselves.

Precisely.
I am out of the game for a few years but the IMO have alwasy had to be dragged kicking & screaming into action. And most NCHDs dont like kicking or screaming. The conditions in '99/00 were more conducive to succesful action, and the conditions at the time were worse than now, but it still required a mass resignation of IMO membership in one hospital and the threat of same from a few others. Before that, there had beeen years of 'talk', but almost no action from the IMO. The 'lunchtime protests' that preceded the 99/00 strike were actually prompted and organised by one (non-Irish) NCHD who was not an IMO activist (he may have been an IMO member, I cant remember); but the point is that it wasnt the IMO who prompted the action.

And my heart sinks when I see those who say that NCHDs shouldnt strike; why the fcuk not? It was so disheartening in 99/00 when so many NCHDs said the same...... they took the pay rises/overtime payments achieved by those of us who were prepared to take that action, though, didnt they...?

As Jane5 says above, with appropriate notice and appropriate consultation with consultants beforehand, the system can cope, and the HSE have plenty of time to actually front up to NCHD grievances. So get off yer arses, stop moaning, threaten the IMO, and do something! Of course, in this climate you need to be extra-brave, but fortune favours ...... etc.

dissed doc

TC80 wrote: »

I think it's dreadfully unfair to complain about ineffectual leadership in the IMO behind the mask of anonymity of the internet. The leadership you are slagging off is your fellow NCHDs who have gotten up off their backsides and tried to represent their colleagues and lobby to change things.

If you put yourself in the public domain, as a representative, and ask for hundreds of euros a year, then you are fair game for journalists and private citizens who are not in the public domain.

I know that the NCHDs who went to the negotiations last year took every single annual leave day they had in the LRC, labour court and high court and I think they deserve a bit of respect on that basis alone,

You can polish Mary Harney's house for all I care. the RESULT is all that matters. Saying "boohoo, I tried" is not good enough, because its not good enough clinically. 2nd place is 1st place for losers. If you do not get the result needed you have failed. Respect goes to those who get things improved, like Mick molloy did in 1997. Furthermore, if you are an offical committee member in the iMO, you are entitled (well, you were under the old contract) to attend official meetings.

EWTD is law for NCHDs since August 2004, transcibed into Irish law by the Organisation of Working Time Act. The government had always opted out of this but when the derogation ran out in 2009, the government decided not to apply to have it extended. This is government policy. I don't think you can hold a union responsible for this decision.

EXACTLY. The EWTD is law, yet the IMO being run primarily by a bunch of surgical-orientated NCHDs who were picking up 100hr of overtime a week, were happy to ignore it, and ignore the low base salaries and lack of any improvement in training. Why not, in 2003 when the proposals were clear, did the IMO not say okay, lets get this in order now, get limited overtime but higher base salaries, etc.,. They didn't because it would have meant salary reductions. We are now half way into 2010. The 2004 was only by exemption anyway it should have been standard policy a decade earlier.

There are very few people in Ireland earning what they did 2 years ago.

Garbage. The money is being borrowed to pay for any number of situations. Better to get money for training courses, conferences, etc., . But no - its all gone and the entire control of training has now been handed to the HSE. WELL DONE IMO for that. What possible insane reason could you have to believe the HSE could do training? BEcause you never EVER had a policy on it, except to do what is suggested to you by the government.

..... from behind the anonymity of an internet handle.

You might as well decide to stop the internet then, because its how things work. This is an open forum. The IMO has been the NCHDs union, and the result of its attempts - good or bad - on behalf of NCHDs has been dramatic cuts in salary, inadequate training and excessive working hours with poor conditions. Like it or not, people are voting with their feet judging by the hospital vacances that are now becoming apparent. If the IMO did a good job, people would be queuing up for these jobs. 2 NCHD postsgone for every new consultant post? I don't see any ads for 450 new consultants anywhere, do you?

Trying is not good enough. You get a result or you fail - simple as that. Saying xyz should get respect, the work hard, etc., is nonsense. The end result is deterioration and the consequence is emigration. Denying this is lunacy.

for the record, doctors in 14 german states went on strike early on monday morning. Planned, organised and with a clear target. The "we are special" " we are doctors" is BS. Perhaps the type of doctor that no longer stands for themselves, no longer stands for their patients either.

TC80

add balls to a castrated eunuch????!!!!

Jane, every year every IMO member is sent a nomination for the NCHD committee as well as a motion form for the AGM. All you need to do is have yourself and one other NCHD member to propose yourself for the committee. This takes place every year and nobody can stop you.

How many times have you taken the five minutes to get nominated yourself? How many motions have you put before the meeting?once a motion is adopted at agm it becomes policy. In a democratic organisation there are always ways and means of effecting change.

I'm speaking here on behalf of the "castrated eunuchs" of the IMO NCHD group who have the "balls" to put their real names (not some makey uppy Internet persona) on high court actions vs the HSE, who go into fora like the LRC after months of preparation to face down the highest echelons of the HSE. Who go into meetings with royal colleges where they are risk the wrath of their trainers for speaking up for NCHDs.

It's the easiest thing in the world to be an Internet hardman/woman and say strike this, strike that. There are nearly 5000 NCHDs in Ireland though who have often very different views and needs. And I don't think it's a "holier than thou" thing, more a fact that things are quite grim for patients in Irish public hospitals and a doctors strike would make them grimmer so shouldn't be undertaken lightly. I'll say it again, the last NCHD strike caused a massive split amongst Irish doctors which led to the formation of the IHCA (who have an official no strike policy). I've thought about this a lot I'd go on strike if there was a very clear need and a clear and definable objectives but my own opinion is you can't have a strike, (particularly at a time when public sector unions are about as popular as meningococcal septicaemia) just because things are generally a bit crap. I couldn't see it improving the lot of NCHDs in any positive way. Just my opinion which I'm entitled to, as you are to yours.

But if you really feel this needs to happen then there is absoutely nothing to stop you from getting on an IMO committee or putting a motion forward to the
AGM to that effect. Much as I don't agree with some of your points, I think they'd be lucky to have you and as an NCHD I'd be happy to have somebody articulate and dare I say it,outspoken, to represent me.

dissed doc

Jane5 wrote: »

Oh, and for the record, I wrote to them TWICE ASKING to be an IMO rep when they sent around a letter saying they were looking for them.
They never even got back to me. I would love nothing more than to try and introduce a bit of balls into this castrated eunuch of an union. But I can't even get my foot in the door. Funny that.

No rocking of the boat, Jane5. Can't have people changing the status quo.

TC80

Dissed doc, I don't think it's right to engage in debate by bandying around terms like insane and lunacy and garbage and fail and the like. it is not how adults do business.

Let me just put a few facts out there for you to consider and to correct any misconceptions your post might engender.

1. The IMO was seeking exactly what you said about the contract since 2004, however the HSE refused to engage on this until after the consultant contract was agreed, which was not until well into 2008. By whch time the national landscape was somewhat different, I'm sure you'll agree.

2. It is not garbage to say that earnings have dropped for The majority of people since 2008.

3. There were zero surgical NCHDs on the IMO NCHD committee for almost all of 2009. To suggest that some sort of evil cabal of surgeons sets the agenda is false.

4. The IMO have in fact, numerous policies on medical postgraduate training. These were put before the labour court who ultimately decided that the HSE should be allowed to bulk buy training from the royal colleges, in line with DOHC/HSE policy. Like you I am very worriedabout this and I think we need a strong representative IMO to fight this. incidentally if you read the medical practitioners act you will see that the only two bodies that are named in respect of having responsibility for postgraduate medical education are the medical council and the HSE. The royal colleges have no standing in the MPA. Therefore from a legislative point of view, you can't shut the HSE out of training, much as we'd all like to.

5. I don't want to "close the internet" only Al Gore can do that. All I'm saying is that it's a lot more difficult to make a stand in real life than online and that that somebody has to step up to the plate. If you feel those already there have failed, then you're entitled to that opinion, as you say, it's an open forum. However, If you feel you could add more than those you say are are lunatics and insane and what not, then I'm challenging you to have the moral courage to get off your high horse/mouse and do something about it.

Chiparus

TC80 wrote: »

add balls to a castrated eunuch????!!!!



I'll say it again, the last NCHD strike caused a massive split amongst Irish doctors which led to the formation of the IHCA (who have an official no strike policy).

Interesting revisionism there.- the IHCA was formed long before the last strike.

There was no massive split after the last strike: most of our consultants supported us - there was one consultant in a large northside hospital who pressurised his juniors, but was told where to go by fellow consultants.;)

TC80

Chiparus wrote: »

Interesting revisionism there.- the IHCA was formed long before the last strike.

There was no massive split after the last strike: most of our consultants supported us - there was one consultant in a large northside hospital who pressurised his juniors, but was told where to go by fellow consultants.;)

Don't take my word for it...have a read of this

www.imt.ie/opinion/2009/09/ihca_celebrates_20_years_of_da.html

TC80

By the way chip you might also take note from that article that the first IHCA AGM took place in 1989, so you are wrong to suggest it existed in any meaningful form before the NCHD strike

Chiparus

The previous strike in 87 was to be paid overtime - as a result NCHDs received half time.

The last strike was in 2000, the minister agreed to nearly all the NCHD requests the night before the action was due to take place.

The last strike generally supported by consultants.

Consultants have already been asked to fill service gaps caused by the lack of NCHDS- most believe the shortage of NCHDs is due to the drop in pay.
The expansion of the working day 8-8 that is being pushed to the rest of the HSE is about not having to pay overtime for the expanded working day.

This was already accepted by NCHDs and the loss of the training grant:rolleyes:

The consultants were shafted with the new contract- 86% signed in good faith. The HSE has not honored the pay rates promised.

Caoimhín

Vorsprung wrote: »

A plain lack of respect on the part of the Minister, the HSE and previous health authorities.

Wow, that is about the most arrogant thing i have ever read on Boards. Sure, you are entitled to your opinion as much as the next man but i doubt an unemployed carpenter/brick layer/laborer (whos tax may have part funded your education) would agree.

Chiparus

Caoimhín wrote: »

Wow, that is about the most arrogant thing i have ever read on Boards. Sure, you are entitled to your opinion as much as the next man but i doubt an unemployed carpenter/brick layer/laborer (whos tax may have part funded your education) would agree.

Really, thats the most arrogant thing you have read?

TC80

Chiparus wrote: »

The last strike was in 2000, the minister agreed to nearly all the NCHD requests the night before the action was due to take place.

Ergo what you are calling a strike in 1999 wasnt an actual strike at all, just a very advanced threat of one. Now who is being a revisionist?

So there are two known unknowns, as Donald Rumsfeld might say.

1. Would the majority of NCHDs have actually gone ahead with the strike if agreement hadnt been reached the previous night?
2. Would the bosses have been as supportive if it had actually gone ahead and impacted on them over any sort of sustained period?

The only previous "form guide" on these questions comes from the actual strike of 1987 and we can see what happened there.

You cannot compare the industrial relations climate in 1999 Bertie Ahern, throw money at the problem, celtic tiger Ireland to that of 2009-2010 or even 1987, when things were an awful lot worse for NCHDs, but if I had to choose which would mostly approximate the ireland of today, it'd be closer to 87 than 99.

Chiparus

The strike of 2000 showed how when NCHDs stood up for themselves they would win. We all cancelled our OPDs and elective lists. Admissions were cancelled - the strike would have gone ahead with the full support of all the consultants in my hospital.

The strike was called off because they agreed to our demands.

I dont know why NCHDs pay subs to the IMO, as they agreed to a defacto paycut (loss in overtime eligible hours inc sunday)before the subsequent paycuts.

Senior public servants avoided the budget pay cuts because their pay was already cut- but NCHDs had 2 pay cuts and a pension levy for a pension most will never get.


Why should NCHDs waste money paying subs to the IMO?

TC80

Chiparus wrote: »

The strike of 2000 showed how when NCHDs stood up for themselves they would win. We all cancelled our OPDs and elective lists. Admissions were cancelled - the strike would have gone ahead with the full support of all the consultants in my hospital.

The strike was called off because they agreed to our demands.

I dont know why NCHDs pay subs to the IMO, as they agreed to a defacto paycut (loss in overtime eligible hours inc sunday)before the subsequent paycuts.

Senior public servants avoided the budget pay cuts because their pay was already cut- but NCHDs had 2 pay cuts and a pension levy for a pension most will never get.


Why should NCHDs waste money paying subs to the IMO?

You're completely misleading people again. It is absolutely false to suggest that sunday is no longer eligible for double time. This is not in any settlement. Check it out with the labour court. yes the working day was extended, but you still get overtime once you have worked an average of 39 hours in a week.

The problem is that there is nothing you can put in any document to stop individual hospitals acting the maggot. What happens then is that NCHDs often don't report it to IMO, they just get on with it. The reason that NCHDs should join the IMO is because the IMO will take cases through the relevant mechanism to fight them. There have been numerous individual cases in the last year that go through the painfully slow labour court system and don't get publicised. However there are literally hundreds of examples of people winning their cases and getting back pay. My vision of a medical union is not one that walks off the job at the drop of a hat, like some others do. An alternative vision is fine, it's just that I believe those that put it forward need to get off the fence and try to change it if they believe that strongly in it. Ample opportunities exist to do so.

I think the most salient point you raise is the one about paying subs. The problem with the IMO as I see it is that a lot of people think that you pay your subs and that should be it. I don't see that as how any union or organisation should work. It should be more like a political party where not only do you pay your subs but you are also expected to contribute your time, energy and activism to the group. But perhaps it's understandable that more people don't do this and have the courage of their convictions to take a stand (on an entirely voluntary and unpaid basis) when this makes them, as one poster said earlier "fair game" for anybody with a keyboard, an opinion and a username.

By the way I completely agree with you that its a disgrace that senior civil servants avoided the pay cuts.

Chiparus

Sorry but it was a pay cut - pay has been cut because of the change in the working day. The IMO agreed to it.

Why do you think the HSE wants to introduce these terms to the rest of the health service?

Why do you think NCHDs are leaving??

(It also suits the HSE as it will force the closure of some hospitals.)

The last strike was forced on the IMO- because we had begun to leave the IMO- suddenly they stopped worrying about GPs and began to take NCHDs seriously.

Vorsprung

Caoimhín wrote: »

Wow, that is about the most arrogant thing i have ever read on Boards. Sure, you are entitled to your opinion as much as the next man but i doubt an unemployed carpenter/brick layer/laborer (whos tax may have part funded your education) would agree.

Is it respectful to ask people to work for 72 hours straight, and then when people put down for their overtime, big lines are put through any hours over 48 hours, as happened in Castlebar a couple of years ago?

And save me the taxes line, do you think I haven't been paying taxes since Ive qualified?

TC80

Chiparus wrote: »

Sorry but it was a pay cut - pay has been cut because of the change in the working day. The IMO agreed to it.

If there were NCHDs who were
(a)not reaching an average of 39 hours per week over a pay period
AND
(b) were doing a considerable amount of their non 39 hours between 8 and 9 in the morning and 5 and 9 in the evening

Then yes, they got an inadvertant pay cut by moving to an extended working day, I would however think that it wouldn't be that many of the entire group. Plus the overtime rates were actually increased from T+1/4 to T+1/2 for all overtime, not just that after 54 hours which had previously been the case. You conveniently fail to mention this concession won by the IMO.

Chiparus wrote: »

Why do you think the HSE wants to introduce these terms to the rest of the health service?.

Because it is part of the national health strategy to have extended working hours in hospitals.

Chiparus wrote: »

Why do you think NCHDs are leaving??

Numerous reasons : Poor morale, abysmally funded health service, poor career progression prospects, increasing taxes and levies in this country. I think however that the best way for NCHDs to change this is actually to unite and engage more with their representative body, not less. particularly on number 3 which I think is the biggest challenge of all and the one that motivates me the most, because I love this country and want to settle here eventually after what will hopefully be a brief period of training overseas. Currently the chances of that arent great

Chiparus wrote: »

(It also suits the HSE as it will force the closure of some hospitals.)

You're hitting the nail on the head there. Expect pronouncements from the HSE about how they are having to close regional district hospitals because those awful, ungrateful NCHDs are emigrating.

Chiparus wrote: »

The last strike was forced on the IMO- because we had begun to leave the IMO- suddenly they stopped worrying about GPs and began to take NCHDs seriously.

Again a strike did not actually proceed, and I really dont think you can compare the climate for calling a strike in 1999 to 2010. We all know it's a very different country now.

These are my opinions. I accept they are in a minority here, but I'm willing to stand by them.

Chiparus

The HSE wants to introduce the longer working week to save on overtime with nurses and allied health workers - that is why they are fighting it.

They already have saved money on this - especially on those NCHDs that are ETWD compliant- shift workers such as A&E NCHDs.

BTW are A&E NCHDs still entitled to the 1/6th loading?

TC80

Chiparus wrote: »

The HSE wants to introduce the longer working week to save on overtime with nurses and allied health workers - that is why they are fighting it.

They already have saved money on this - especially on those NCHDs that are ETWD compliant- shift workers such as A&E NCHDs.

BTW are A&E NCHDs still entitled to the 1/6th loading?

I think A&E people generally get a pretty raw deal in general. I'm not aware that any previous premia they got have been taken away but I couldn't be certain on that.

I think a lot of the problems about abn extended working day is that as a country we are coming from a paradigm where in the good times the unions would have been given a pay rise to shift working patterns to one where things are financially tighter and the tide of public opinion has swung. A lot of the extended working day in the health service stuff is actually covered in the croke park agreement so it looks like a lot will depend on the eventual outcome of that.

TC80

Caoimhín wrote: »

Wow, that is about the most arrogant thing i have ever read on Boards. Sure, you are entitled to your opinion as much as the next man but i doubt an unemployed carpenter/brick layer/laborer (whos tax may have part funded your education) would agree.

Why is it arrogant for him to expect a respectful relationship between employer and employee?

Chiparus

TC80 wrote: »

I think A&E people generally get a pretty raw deal in general. I'm not aware that any previous premia they got have been taken away but I couldn't be certain on that.

I think a lot of the problems about abn extended working day is that as a country we are coming from a paradigm where in the good times the unions would have been given a pay rise to shift working patterns to one where things are financially tighter and the tide of public opinion has swung. A lot of the extended working day in the health service stuff is actually covered in the croke park agreement so it looks like a lot will depend on the eventual outcome of that.

The comercial semistate recieves similar T&C as public service. The government tried to introduce similar pay cuts and were quickly told where to go . NCHDs voted for industrial action in 08 but leadrship let them down. Now there is little reason to stay here especially those in service jobs so they are leaving.

TC80

Chiparus wrote: »

The comercial semistate recieves similar T&C as public service. The government tried to introduce similar pay cuts and were quickly told where to go . NCHDs voted for industrial action in 08 but leadrship let them down. Now there is little reason to stay here especially those in service jobs so they are leaving.

Ah here, the commercial semistate is a completely different kettle of fish. The govt is only a stakeholder in this. It is the sole owner and funder of the public health service.

I am firmly of the belief that most of the fall off in take home pay is down to pension and income levies and is nothing to do with the new contract. I also think that pay is by far not the most important thing driving NCHDs overseas. AFAIK pay in USA and Australia is not significantly better and worse in many areas. People go abroad for lifestyle, training and career progression reasons.

I have done my best to highlight these issues which I think will massively impact the standard of care delivered in Irish hospitals, to the point of lobbying a national newspaper to cover it. They eventually did and I did an interview with them. They originally palnned to do a full page feature and asked for quotes from several NCHDs who were leaving, at which point I could find only one of the many departing NCHDs I approached that was willing to be quoted in the newspaper on it. It becomes hard at that point to convince people of influence in the media that there is a flood of people going. I also know for a fact that many of those who said No were fully paid up members of the "The IMO needs to get more in the media" Brigade. Go figure.

My view is that those who choose to stay should get on board with the IMO and fight for these things. You can either stand up and be counted or be like some of the other posters on here and whinge about those who do.

Chiparus

TC80 wrote: »

It is the sole owner and funder of the public health service.

Who do you think owns esb?
I suppose VHI ,Quinn and Aviva pay nothing then.

It tried to impose the pay cuts on the public semistate and then faced with workers and unions who did not care about public opinion they dropped it like a hot potato.

http://www.irishtimes.com/newspaper/frontpage/2009/1214/1224260655491.html


then a day later

http://www.independent.ie/national-news/ministers-back-off-in-semistate-pay-battle-1975096.html

No pension levy no pay cut - a pay rise instead.

TC80

Chiparus wrote: »

It tried to impose the pay cuts on the public semistate and then faced with workers and unions who did not care about public opinion they dropped it like a hot potato.

Thats an oxymoron. You are talking about for profit entities that the state is a major shareholder in. As regards the private insurers they purchase some services from the public hospitals and vice versa. Not comparable to ESB, Bord Gais etc in my opinion.

The pension levy and PS paycuts are hardly an IMO or NCHD centric issue but maybe the entire trade union movement needs to think about it. There are some pretty harsh economic realities out there at present though, galling as it is to see billions of borrowed money thrown into propping up banks.

Chiparus

TC80 wrote: »

Thats an oxymoron. You are talking about for profit entities that the state is a major shareholder in. As regards the private insurers they purchase some services from the public hospitals and vice versa. Not comparable to ESB, Bord Gais etc in my opinion.

The pension levy and PS paycuts are hardly an IMO or NCHD centric issue but maybe the entire trade union movement needs to think about it. There are some pretty harsh economic realities out there at present though, galling as it is to see billions of borrowed money thrown into propping up banks.

They may be for profit but they include highly unprofitable organisations such as Irish rail. The profits are supposed to go to the exchequer - if they had a pension levy and pay cut there would more money for government spending.
The reality is the government sought to introduce a paycut and a pension levy but the unions showed them that Machiavellian addage "it is better to be feared than loved"

Caoimhín

Chiparus wrote: »

Really, thats the most arrogant thing you have read?

Maybe not. I can understand where you are coming from. 8 years studying is a long time, but to say you wont work in Ireland because of the disrespect of an elective representative despite the same electorate having paid your way through med school seems to like a slap to the hard working people who depend on you.

I was under the impression that people entered the medical profession because they had a desire to help people who are ill. Rather than expecting respect from ministers or pay and advancement.

May i put forward the proposition that many of you entered medical school because your parents pushed you into the profession or that you thought you would make lots of money or prestige?

It had fúck all to do with caring about people who were sick.

You will lash at me because i said this, but look into your own hearts lads and ladies...

PS; Its not sour grapes, I have a PhD myself...

docbroc

Wading back in on this:

IMO cares too much about patient safety - my arse. Is this the same IMO that let the Mater staff the hospital with one doctor at night? The same IMO that has cheerfully ignored the practice of untrained doctors drawing up and giving medications despite it resulting in more than one death and huge amounts of morbidity ?

The new contract. It is entirely irrelevant whether we dont get paid 1.25x 1.5x 2x or 10000x for that matter. The point is we are not getting paid it. In terms of hospitals acting the maggot there is a very clear pattern - screw the NCHDs. You dont see nurses getting shafted their overtime or porters or pharmacists or anyone else. This is because of our weak union, plain and simple.

Similarly more study leave is useless if your not allowed take it. The loss of the training grant is no sweat to those on the NCHD committee but believe me if your doing exams its a huge pocket emptying deal. To believe the HSE will provide any education whatsoever beyond the farce that the colleges intermittently throw up is at best obscenely naive .

The labour court is labourisly slow. Indeed. That is why we shouldnt be using it. I for one cant wait several years to get my overtime paid to me. You think other unions fight local disputes through the courts? You know damn well they dont. Local disputes are solved
with local action. Not whining off to the labour court every time medical admin decide your not worth paying.

As for striking ? Nuclear option. Not needed! We do ten thousand and one things a day that are not our job. Many moons ago a half dead haematology SHO working 80 hours a week was hauled in at the weekends to take bloods because the haematology nurses were afraid of central lines. 7 years later and whats happening ? Exactly the same. Except the SHO in question is not doing "overtime" anymore. Thanks to the IMOs collusion with the HSE your destroyed weekend is "study time". Studying how to do the phlebotomists job for them.....

I know the IMO wanted to protect salaries by such a classification, wanting to avoid a situation where the EWTD was used as an excuse to not pay more than 48 hours. But you deal with the devil look what happens!

A good starting point is to hit these extraneous jobs. Make an announcement that no NCHD will give iv medications unless they are trained to do so. Say on x day this will stop. Its dangerous and inefficient. I guarantee the total support of everyone I know. If we win - patient safety improves, we remove a ridiculous practice and we save time, so we can actually get home once and a while. Even if we lose we will at least be the flea that hiccuped. We couldnt possibly sink any lower in the HSE's eyes.

And finally let me convey something that has become abundantly apparent as my "training" draws to a close. We have no future in Ireland. So much toadying, kow-towing, kissing ass. For what ? Come July I am unemployed. My options ? Leave the country (likely never to return) or take some piddling 10,000 a year research grant. The IMO comittee need to recognise one important fact. YOU WILL NEVER BECOME CONSULTANTS. Prove me wrong, fine but there is an 80% plus chance i will be right. Dont destroy your lives struggling and hoping and waiting for something that will never happen. So many are willing to put up with Dickensian conditions for the sake of a glorious consultant afterlife that just wont happen. We need to sort out the horrible working situation in Ireland that drives so many of our best and brightest out. We need to focus on the years we spend as NCHDs because chances are they will be our only years.

Caoimhín

docbroc wrote: »

Wading back in on this:

IMO cares too much about patient safety - my arse. .

You have a valid point, however my proposition remains that many doctors entered the profession for esteem, pay, respect, and a degree of power.. Rather than a genuine care of ill people.
This comes from a long experience of doctors in hospital practice rather than GP's.

In my humble opinion, you were funded by the tax payer to study and be educated and yet you feel entitled to leave to leave the country for better conditions and ultimately the opportunity to earn more money.

Shame on you.

SleepDoc

Caoimhín;65958691]Maybe not. I can understand where you are coming from. 8 years studying is a long time, but to say you wont work in Ireland because of the disrespect of an elective representative despite the same electorate having paid your way through med school seems to like a slap to the hard working people who depend on you.[/B]

I paid my own may through medical school.

I was under the impression that people entered the medical profession because they had a desire to help people who are ill. Rather than expecting respect from ministers or pay and advancement.

There are easier ways to make money than medicine. Most medical practitioners are conscientious and hardworking. But we are not chumps. We don't like being taken advantage of. I expect good pay AND advancement.


May i put forward the proposition that many of you entered medical school because your parents pushed you into the profession or that you thought you would make lots of money or prestige?

I think most parents encourage their children to do their best and study what they are interested in. And what exactly is wrong with money and prestige?

It had fúck all to do with caring about people who were sick.

That may well be the case initially but so what? To do the job you have to look after the sick.

You will lash at me because i said this, but look into your own hearts lads and ladies...

Deep.

PS; Its not sour grapes, I have a PhD myself

How does that not make it sour grapes?

Vorsprung

Caoimhín wrote: »

In my humble opinion, you were funded by the tax payer to study and be educated and yet you feel entitled to leave to leave the country for better conditions and ultimately the opportunity to earn more money.

Shame on you.

How many consultants in Ireland do you think have done all of their training without having had to leave the country? I'd happily wager that there are in fact none. Not one. And I am earning a lot less abroad than I would be at home, and this is the case among most doctors who work abroad. And I'm quite happy with the way things are panning out at the moment.

And yes I do feel entitled to leave the country if I should so think I need to, for further training or otherwise. In fact, every single person in the country has had the majority of their education funded by the taxpayer. Do you think every engineer, nurse, tradesman (who would have been funded by the taxpayer via FAS) who has left the country should be hanging his or her head in shame? Or is it just doctors?

Caoimh&#237 wrote: »

May i put forward the proposition that many of you entered medical school because your parents pushed you into the profession or that you thought you would make lots of money or prestige?

Nope, I did it because I wanted to work with people and be involved with science. I enjoy my job just fine. There are no doctors in my family and no-one pushed me in. The same goes for the vast majority of my friends, and for a lot of doctors who post here, having read their replies on similar topics on the past. Perhaps we could keep the sweeping and seemingly uninformed generalisations to a minimum?

Chiparus

Would you allow any graduate to leave or just the unemployed ones?
http://boards.ie/vbulletin/showpost.php?p=65780202&postcount=222

Troll anyone?

Vorsprung

Chiparus wrote: »

Would you allow any graduate to leave or just the unemployed ones?
http://m.boards.ie/vbulletin/showpost.php?p=65780202&postcount=222

Troll anyone?

Nice find.