Ireland on the brink...how can health professionals help???

Nchd2010

That wasn't my logic tbf. I was illustrating the FACT that doctors are very highly qualified. I wasn't focussing on the fact that we might have three degrees intentionally. The main point is that we are highly qualified and motivated and would tend to be a bit more accommodating than other professionals.

Incidentally, you might want to ask what qualifications I have before judging them. I'm pretty sure the NUI is a higher authority than lonestargirl, and they've given me a level nine qualification.

sam34

ok can we get this back on topic please, instead of the personal sniping

kelle

ThatDrGuy wrote: »

Even took a portable xray on xmas day once (no radiographer then - surprise,surprise)..

Where did you work when this happened? I doubt it was in this country or the UK. You would have been reported to the Radiation Protection Board had this been discovered.
Everywhere I've worked there is always a Radiographer 24/7!

joolsthedog

The caring professions are outnumbered by administrators in the HSE 2:1 - we need to save money - put somebody with a business approach and proven track record in charge - the sooner the better

SleepDoc

kelle wrote: »

Where did you work when this happened? I doubt it was in this country or the UK. You would have been reported to the Radiation Protection Board had this been discovered.
Everywhere I've worked there is always a Radiographer 24/7!

Seen it happen too. No radiographer. Surgical NCHD took an x ray in theatre. Worked out ok.

resus

Hate to say it, I've also seen screening done in theatre in an emergency when there has been no available radiographer.. IN IRELAND, IN A "CENTRE OF EXCELLENCE"

lonestargirl

kelle wrote: »

Where did you work when this happened? I doubt it was in this country or the UK. You would have been reported to the Radiation Protection Board had this been discovered.
Everywhere I've worked there is always a Radiographer 24/7!

Who are the Radiation Protection Board?

I don't think what he did was illegal, the medical ionising radiation act (SI 478) requires a prescriber (member of medical or dental council) and a practitioner. There's no requirement that they must be seperate people, dentists act in both roles all the time. If the exposure was medically justified, and there was no radiographer in house, I don't even think it violates ALARA.

RobFowl

I've never seen an X ray done by anyone other than a radiographer/radiologist but would not be surprised that it happens.

I think the OP has actually highlighted part of our problems. There seems to be little respect for other professionals here.

What started out as a question as to how we can help in this time of crisis has descended into tedious bickering about who's the more important, who works harder, who gets paid too much, to little, who works more hours etc.

It's quite disappointing TBH if this is the type of response in a time when every one should be trying to come together and offer logical and cohesive leadership.

kelle

lonestargirl wrote: »

Who are the Radiation Protection Board?


I don't think what he did was illegal, the medical ionising radiation act (SI 478) requires a prescriber (member of medical or dental council) and a practitioner. There's no requirement that they must be seperate people, dentists act in both roles all the time. If the exposure was medically justified, and there was no radiographer in house, I don't even think it violates ALARA.

Radiation Protection Board


A doctor was disciplined for screening without one of us being present. He was reported and caught in the act. He had not selected half-dose, nor did he select pulsed fluoroscopy which would have ensured lower radiation doses. One needs to be trained to use this equipment before being allowed to use it, and the doses have to be recorded.

Anyway we changed the rules and we always ensure all portable equipment is switched off, the key removed and kept in our department so no mischief:D.

Anyway, to get back to the topic of this conversation I would love a shift system like nursing and work nights only - it has been looked into but unfortunately it is much cheaper to have one person on-call from 5pm to 9am.

Nchd2010

I think the OP has actually highlighted part of our problems. There seems to be little respect for other professionals here.

What started out as a question as to how we can help in this time of crisis has descended into tedious bickering about who's the more important, who works harder, who gets paid too much, to little, who works more hours etc.

Ah now. that's a bit harsh tbf. 75-80% of health spending goes on wages. I think it's more than reasonable to question whether wages are fair and appropriate. In some cases, the wages are neither.

lonestargirl

kelle wrote: »

Radiation Protection Board

I know who the RPII are, I was just confused by your reference to a Radiation Protection Board

kelle wrote: »

A doctor was disciplined for screening without one of us being present. He was reported and caught in the act. He had not selected half-dose, nor did he select pulsed fluoroscopy which would have ensured lower radiation doses. One needs to be trained to use this equipment before being allowed to use it, and the doses have to be recorded.

Anyway we changed the rules and we always ensure all portable equipment is switched off, the key removed and kept in our department so no mischief:D.

That's a hospital procedure/ALARA issue rather than it being illegal. In that case if there is a radiographer present in the hospital no doctor should be taking an exposure themselves. Radiographers spend 4 years in their degree for a reason and their knowledge and experience should be valued.

kelle wrote: »

Anyway, to get back to the topic of this conversation I would love a shift system like nursing and work nights only - it has been looked into but unfortunately it is much cheaper to have one person on-call from 5pm to 9am.

I agree, and that's kinda what I was getting at in extending the working week. Even if there were 2 shifts 6-2 and 2-10 paid at standard rates this would cut the overtime bill.

opinion guy

lonestargirl wrote: »

I agree, and that's kinda what I was getting at in extending the working week. Even if there were 2 shifts 6-2 and 2-10 paid at standard rates this would cut the overtime bill.

It would cut the overtime bill, but it would increase the total wages. You need two people to work for the day instead of one. Its cheaper to pay one person overtime, than hire an extra person and pay employers PRSI etc tfor both. I actually think this is a huge problem for the public health services at the moment.

The government need to make it less expensive on employers to hire people at the moment - especially in health care. There would not be so much pressure to cut jobs and workers wages, if you made it cheaper from a business point of view to hire new workers. Then you would easily cut down on overtime bills. You would also have more workers paying tax. Yes you would lose tax take from employers PRSI etc but that would be compensated by the decreased OT bills and having more people in the tax net.

ORLY?

kelle wrote: »

Where did you work when this happened? I doubt it was in this country or the UK. You would have been reported to the Radiation Protection Board had this been discovered.
Everywhere I've worked there is always a Radiographer 24/7!

There wouldn't be any reporting of the doctor in this case. If anything it would be the hospital who would stand to get themselves into trouble for not having a radiologist/radiographer on hand. If the X-Ray was necessary it had to be done.

locum-motion

kelle wrote: »

Radiation Protection Board ...

So, that would be the Radiological Protection Institute of Ireland, then, would it?

JuliusCaesar

RobFowl wrote: »

I think the OP has actually highlighted part of our problems. There seems to be little respect for other professionals here.

What started out as a question as to how we can help in this time of crisis has descended into tedious bickering about who's the more important, who works harder, who gets paid too much, to little, who works more hours etc.

It's quite disappointing TBH if this is the type of response in a time when every one should be trying to come together and offer logical and cohesive leadership.

Indeed. But I would say this just reflects the situation in the HSE. I've been spending the Bank Hol weekend reading up on MDTs for a presentation to my own profession, because I've never worked in one here in Ireland - oh, they call it an MTD but it isn't a team in any sense of the word. (It was very different in London)


I have wondered if doctors think that the other professions just have a 'slice' of medicine? That everyone is a kind-of mini-doctor by subject? (Would appreciate an honest answer on this from the docs. It'd save me some turgid sociological reading!)

dissed doc

Nchd2010 wrote: »

Ah now. that's a bit harsh tbf. 75-80% of health spending goes on wages. I think it's more than reasonable to question whether wages are fair and appropriate. In some cases, the wages are neither.

And under 10% of the health bill is wages on medical staff (that is all consutlants, NCHDs, etc., combined) (around €550 million per year). The netx cost to the state after tax is ~ €300 million. That is the net cost to the state for doctor's wages, all of them.

You could pay all doctors absolutely nothing, for the next decade, and it would make no difference as the money is not wasted on actually worker wages but in health-budget siupported quangos and management-led justifcations for their useless exitences.

Cameron is allowing a large axe to fall on management in the UK NHS. IN Ireland, the axe will fall on self-deprecation lack of self-esteem medics and as they consititute sucha little cost of the health service in ireland, it will make NO difference.

locum-motion

kelle wrote: »

It must have been called that in the past, the bosses refer to it as RPB. Sorry for the confusion...

For fcuk's sake...
If it was the RPII in the past, why TF does their website call them the RPII today?

I would have serious reservations about entrusting my health to a health professional who, in the first instance, doesn't know the name of the body that regulates them, and then in the second instance gets the name wrong yet again while simultaneously linking to that body's website, and then falls back on the argument of "Well, maybe they changed their name recently..." (Which, by the way, they didn't... it's been the RPII for many years now).

When you're at the bottom of a hole, I suggest you should stop digging.

maninasia

dissed doc wrote: »

And under 10% of the health bill is wages on medical staff (that is all consutlants, NCHDs, etc., combined) (around €550 million per year). The netx cost to the state after tax is ~ €300 million. That is the net cost to the state for doctor's wages, all of them.

You could pay all doctors absolutely nothing, for the next decade, and it would make no difference as the money is not wasted on actually worker wages but in health-budget siupported quangos and management-led justifcations for their useless exitences.

Cameron is allowing a large axe to fall on management in the UK NHS. IN Ireland, the axe will fall on self-deprecation lack of self-esteem medics and as they consititute sucha little cost of the health service in ireland, it will make NO difference.

Are you including nursing staff in there? It's hard to believe it's only 10% of the total budget if 75-80% is wages?

dissed doc

maninasia wrote: »

Are you including nursing staff in there? It's hard to believe it's only 10% of the total budget if 75-80% is wages?

No just medical staff.

~ 1400 Consultants, salary of €186k

~ 4000 NCHDs, average salary of €75k.

maninasia

Plenty can be cut off the top line there. Basically savings need to be made in every area but ESPECIALLY wages, this is the area that would affect quality of service the LEAST. Ah but sure what do I know, as pointed out here a few times I'm not a doctor.

tallaght01

maninasia wrote: »

Plenty can be cut off the top line there. Basically savings need to be made in every area but ESPECIALLY wages, this is the area that would affect quality of service the LEAST. Ah but sure what do I know, as pointed out here a few times I'm not a doctor.

Not true.

Consultants can make a shed load more than that in the private sector.

A significant drop in wages would presumably push a lot of the experienced guys into the private sector, or back to the states, leaving the public sector jobs to be taken by the brand new, inexperienced consultants.

maninasia

Depends on the hospital right..if they want to work in Ireland they can like it or lump it, 20-30% off is still signficantly higher than other European countries. There's always good candidates available for plum roles. Are you telling me they will all go to the private sector....I don't think so. Plus private sector will not neccesarily always pay higher, it fluctuates and is less stable and less chances for them to do research and training I imagine.

My point goes for wages across the board...it's obvious, it's self evident. 80% of cost are in wages, therefore cutting wages is the quickest and least painful way to decrease costs without cutting back on services. You've got a finite pot to go around.
You try to put all the the cuts in infrastructure..no service. You cut jobs...no service.

Why wages must be cut to maintain current service , because the cuts will be LOADED into 20% of the total budget that is non-wages, thus damaging that part of the budget so badly the whole system will seize up. Don't need to have 7 years training to figure that out.

maninasia

tallaght01 wrote: »

Not true.

Consultants can make a shed load more than that in the private sector.

A significant drop in wages would presumably push a lot of the experienced guys into the private sector, or back to the states, leaving the public sector jobs to be taken by the brand new, inexperienced consultants.

No evidence for this at all, I'm sure there are plenty of guys in America and Australia who would like to take their vacant slots (and I'm not talking about regional hospitals that always struggle with hiring).

tallaght01

maninasia wrote: »

No evidence for this at all, I'm sure there are plenty of guys in America and Australia who would like to take their vacant slots (and I'm not talking about regional hospitals that always struggle with hiring).

no evidence for what?

Docs earning more in private? Loads of evidence for that?

Or for consultants following the money? It won't be all of them, but if you look at the international pattern, then there's reasonable evidence that the private sector flourishes with lower doc salaries, and there's more trouble attracting docs to public service.

I doubt there's hordes of docs here in Oz waiting to go back to Ireland. Don't know much about the states. But every Irish consultant I know over here are marries and settled with kids here, and it was a lifestyle choice.

The one thing that does correlate very well with most health outcomes is the Gini coefficient, or inequity in income distribution within a country. So you could argue your point on a sort of macroeconomic basis, but it wouldn't be all that convincing, unless all the high earners (public and private) pay more taxes than the more vulnerable in society (which is what I think should be happening. I know they already do, but there's room for more taxation/levies/whatever before they go penalising the OAPs and the unemployed)

maninasia

I think it's a scare tactic, public sector consultant jobs are competitive, I know people who train for them and would jump at the chance in Ireland even at reduced salaries...there is a surfeit of good candidates. Remember costs have come down in Ireland too especially for housing. You don't need the best of the best, just a competent and qualified candidate who is dilligent and works hard and interested in their job. Nobody is worth more than the organisation, every position is replaceable. Remember even with 20-30% reduction of consultants salaries they are still out earning almost all their European equivalents.

Then you go on about lifestyle issue. Many people would consider moving back to Ireland due to the exact same reason.

You ignored my point about wage reduction being fundamental. I don't understand what you are going about regarding GINI coefficient, it doesn't seem relevant to the debate at hand. This is about cost reduction since cost is the number 1 issue. The easiest way is to cut cost across the board and especially where there is obvious fat to be cut.

I feel this is heading for a rehash of my other debates here where I take position A and an assortment of other people take the position B for no credible reason other than to oppose me!

opinion guy

maninasia wrote: »

Depends on the hospital right..if they want to work in Ireland they can like it or lump it, 20-30% off is still signficantly higher than other European countries. There's always good candidates available for plum roles. Are you telling me they will all go to the private sector....I don't think so. Plus private sector will not neccesarily always pay higher, it fluctuates and is less stable and less chances for them to do research and training I imagine.

My point goes for wages across the board...it's obvious, it's self evident. 80% of cost are in wages, therefore cutting wages is the quickest and least painful way to decrease costs without cutting back on services. You've got a finite pot to go around.
You try to put all the the cuts in infrastructure..no service. You cut jobs...no service.

Why wages must be cut to maintain current service , because the cuts will be LOADED into 20% of the total budget that is non-wages, thus damaging that part of the budget so badly the whole system will seize up. Don't need to have 7 years training to figure that out.

OR - you could just fire 80% of the management wasters and not punish the hardworking clinical staff for management inefficiency

tallaght01

maninasia wrote: »

I think it's a scare tactic, public sector consultant jobs are competitive, I know people who train for them and would jump at the chance in Ireland even at reduced salaries...there is a surfeit of good candidates. Remember costs have come down in Ireland too especially for housing. You don't need the best of the best, just a competent and qualified candidate who is dilligent and works hard and interested in their job. Nobody is worth more than the organisation, every position is replaceable. Remember even with 20-30% reduction of consultants salaries they are still out earning almost all their European equivalents.

You ignored my point about wage reduction being fundamental.

Yo're just plucking figures out of the air. "I reckon you cold take...eh....20....or 30%....off salaries and we'd still get great candidates". Those sort of points are very difficult to argue with, because they're not based on any kind of proper analysis.

Wage reduction is fundamental. But high earners, public and private need to take the pain before the lower earners. There's an inequity in the reductions as they've happened already. Guys in my dad's public sector workshop whoa re on feck all money got lashed with more wage cuts recently, while lots of my mates haven't taken pay cuts in the private sector. Make higher paid people in both sectors pay, and leave the low paid alone in both sectors, and those on welfare.

maninasia

Private sector workers will get taxed more I am sure...but REMEMBER they are the ones that contribute revenue to pay for the health service yet in general their pay is lower, their pensions crappy or non-existent, their jobs tenuous and often demanding.

Let's not get into the debate, suffice to say that a cut in consultants wages is almost certainly not going to make them all up and leave, any that do will easily be replaced. All I need to do is take 25% off the average consultant figure, that leaves about 140,000 euro basic salary. I'm sure they have other perks and incentives and pensions etc, plus they can get to do private sector ANYWAY (you present it as if there is a choice of one or the other which is untrue). What's their average total earnings, 200-300 k/year? I think 25% is very doable, maybe they could change their Porsches less often instead of jumping into the cold world of the private sector, what do you think?

maninasia

opinion guy wrote: »

OR - you could just fire 80% of the management wasters and not punish the hardworking clinical staff for management inefficiency

Sure a mix of stategies would be best, it is only in Ireland where they tend to have ridiculous blanket bans on 'wage reduction' and 'redundancies' in the middle of the worst crisis that has hit the state since independence (well maybe except for the emergency)!

tallaght01

maninasia wrote: »

maybe they could change their Porsches less often instead of jumping into the cold world of the private sector, what do you think?

I'm pretty sure you post crap like that so people will disengage with you, and not expose the flaws in your back-of-a-beermat predictions.