Sinn Fein - looming health service disaster?

FreudianSlippers

professore wrote: »

No it wouldn't - you could hire more doctors.

So instead of 1 doctor full time at, say €200k, you want 2 doctors working part-time for €100k?

That solves the budget problem how exactly?

awec

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Happyman42

awec wrote: »

This post is amazing. :pac:

Reducing stress and long hours by cutting their salaries. .

In order to fuel the hysteria, many on this thread are ignoring the fact that the primary reason for leaving is the stress and work load and work-life balance as evidenced by the testimony of two doctors in Qatar this morning on Sean O'Rourke. They said wage rises would not entice them back, a fixed health service would.

Permabear

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FreudianSlippers

Happyman42 wrote: »

In order to fuel the hysteria, many on this thread are ignoring the fact that the primary reason for leaving is the stress and work load and work-life balance as evidenced by the testimony of two doctors in Qatar this morning on Sean O'Rourke. They said wage rises would not entice them back, a fixed health service would.

How many medical doctors do you know? Seriously.

Medicine doesn't have a good work-life balance anywhere, particularly if you get into surgery. A fixed health service would include proper pay for the work that is being done.

There is a very good reason that I'm the only person in my family to do law instead of medicine and it's not because the work-life balance in medicine is so good.

awec

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Happyman42

Permabear wrote: »

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One of them seemed to be working for much less.
But keep inventing doomsday scenarios if it postpones actually doing something tangible to fix the problems.
One of the reasons (if not the main one) why Norway has no issues while paying around the 100,000 mark is because the work-life balance is reasonable.

BoJack Horseman

awec wrote: »

They said they would come back to work in a fixed health service for 100k a year?

By "Fixed", Shinners mean NHS style.

From what I know of the UK, staff are monumentally stretched by the demands of unlimited healthcare, free at the point of access.

More work & a €60k take-home may not be the panacea Shinners hope it to be.

awec

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BoJack Horseman

awec wrote: »

The NHS is a bag of crap. Certainly not a good case study for free healthcare at the point of treatment.

I'm dubious of its merits also, but it's their plan.

awec

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Chips Lovell

Shorter working hours = need for more doctors = need for more money to pay them.

There's no magic beans solution that will suddenly improve the health service. Anyone who reckons they've a solution that doesn't involve serious investment and the long slow grind of improving efficiency is away with the fairies.

Happyman42

awec wrote: »

Life in Qatar is basically tax-free. There is no income tax.

Of course, they're probably over there cause they're kind, caring and considerate individuals who are appalled at the state of the HSE in Ireland and nothing to do with the virtually tax-free easy life they can live in a nice sunny climate.

They seemed genuine people to me. Ignore what they are plainly saying though if it fuels the passion.

rrpc

awec wrote: »

Life in Qatar is basically tax-free. There is no income tax.

Did the doctors in question mention that?

Of course, they're probably over there cause they're kind, caring and considerate individuals who are appalled at the state of the HSE in Ireland and nothing to do with the virtually tax-free easy life they can live in a nice sunny climate.

Indeed:

There is no road tax, car tax, television licence fee, council tax, income tax or VAT in Qatar, although there has been speculation in recent years that VAT at five to seven percent may be introduced at some point in the future. At present there is no official policy stating that VAT is due to be introduced.

Also many ex-pats are provided with free housing and transportation as part of their employment and really only have to put their hands in their pockets to scratch themselves. Even at €200,000 pa here, you would be paying in excess of €75,000 a year in income tax/PRSI/USC and that's before you have to pay your VAT and mortgage and transportation costs.

It wouldn't take much before Qatar would look a better proposition if you're trousering nearly all your income.

Permabear

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awec

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Happyman42

awec wrote: »

I have no doubt they are genuine people. Being concerned about their income does not make anyone less genuine.

I just do not find it coincidental that these highly skilled and highly paid professionals have moved to one of the worlds best known tax havens.

Well I got told earlier on (very huffily) that greed wasn't a factor in some doctors leaving, so maybe one of those who objected to me saying it can field this one.

FreudianSlippers

Happyman42 wrote: »

Well I got told earlier on (very huffily) that greed wasn't a factor in some doctors leaving, so maybe one of those who objected to me saying it can field this one.

You make the false presumption that getting paid a commensurable wage for the job they are doing is somehow greedy.

In your world though I presume anyone making more money than you is inherently greedy.

awec

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Happyman42

FreudianSlippers wrote: »

You make the false presumption that getting paid a commensurable wage for the job they are doing is somehow greedy.

In your world though I presume anyone making more money than you is inherently greedy.

Absolute nonsense. More hysterical finger pointing.
It seems posters here want it two ways, I say that some are greedy and always have been ( I am wrong).
I quote two doctors who cite stress and work loads as being the primary reasons they have left and unless that is in someway fixed they wouldn't return regardless of wage (and I get told they are just being greedy) :rolleyes:

awec

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FreudianSlippers

Happyman42 wrote: »

Absolute nonsense. More hysterical finger pointing.
It seems posters here want it two ways, I say that some are greedy and always have been ( I am wrong).
I quote two doctors who cite stress and work loads as being the primary reasons they have left and unless that is in someway fixed they wouldn't return regardless of wage (and I get told they are just being greedy) :rolleyes:

Again, you mistakenly presume that your arbitrary salary is the correct one. Clearly it isn't, as the market dictates the salary and doctors are going to work where the salary is appropriate. That isn't greed; it's common sense.

You "quote" (and I'm using that phrase as loosely as I feel comfortable in so doing) two doctors who claim that regardless of their pay, they wouldn't return until stress and workloads are reduced. More money and less work aren't exclusive concepts and you can be damn sure that they wouldn't be saying the same thing if they weren't sitting in a tax-free oasis.

Happyman42

awec wrote: »

You were the first person to mention greed.

If your sole reason for emigration is for money, then that is greed in my book. Please pay attention to the word 'sole' as the OP states that reducing wages will 'solely' cause a 'mass exodus'
If that was the case the health service would have collapsed long long ago as earning potential in the Middle East has always been much much more lucrative than here.
My contention is, some will leave others won't, as has always happened, we just have to manage it by making sure the pool is large enough and the net is spread wide enough.

Permabear

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Godge

Happyman42 wrote: »

If your sole reason for emigration is for money, then that is greed in my book. Please pay attention to the word 'sole' as the OP states that reducing wages will 'solely' cause a 'mass exodus'
If that was the case the health service would have collapsed long long ago as earning potential in the Middle East has always been much much more lucrative than here.

Are all the doctors that come to Ireland from Africa and Southeast Asia greedy because they come here for the salaries? It certainly isn't for the weather.

Getting paid what you deserve is not greedy.

Happyman42 wrote: »

My contention is, some will leave others won't, as has always happened, we just have to manage it by making sure the pool is large enough and the net is spread wide enough.

You really don't get it. We have a shortage of doctors at the moment because we are losing quite a few to emigration who are leaving for better money, better living standards, better weather etc.

As a solution you are supporting a party that proposes to cut their salary and increase the taxation on the remainder of their income. Unless you are moving Ireland to the Mediterranean, you will be increasing the number leaving.

rrpc

Happyman42 wrote: »

If your sole reason for emigration is for money, then that is greed in my book. Please pay attention to the word 'sole' as the OP states that reducing wages will 'solely' cause a 'mass exodus'
If that was the case the health service would have collapsed long long ago as earning potential in the Middle East has always been much much more lucrative than here.
My contention is, some will leave others won't, as has always happened, we just have to manage it by making sure the pool is large enough and the net is spread wide enough.

So all the people who emigrated from here after the construction industry collapse were 'greedy'. The dole should have been enough for them, is that right?

Happyman42

Permabear wrote: »

This post had been deleted.

They have always recruited here and the money has always been a lot higher.
Are you suggesting we have match what they pay?

Happyman42

rrpc wrote: »

So all the people who emigrated from here after the construction industry collapse were 'greedy'. The dole should have been enough for them, is that right?

They didn't have jobs. :rolleyes:

Godge

Happyman42 wrote: »

They have always recruited here and the money has always been a lot higher.
Are you suggesting we have match what they pay?

No, but we need to pitch the salary at a level that along with the other factors (family ties, lifestyle, taxation etc.) that keeps them here. If you are going to cut their salary and increase their taxation as SF propose, you will lose greater numbers of Irish-trained doctors. Night follows day, inevitable.

Now, that may well be acceptable to SF. They may well have a plan to replace Irish-trained doctors wholesale with African and Asian-trained doctors (maybe even a few Cubans). But they will need a plan like that and I don't see it anywhere on their website which leads to two possible conclusions:

(1) The policy is a made-up publicity stunt to attract votes and will be dropped after the election
(2) The SF policy-makers are incredibly stupid and short-sighted and haven't thought through the implications of the policy and don't have a clue.

I am leaning towards (1) because I really doubt people are as stupid as (2) but the way some people are defending SF policy on capping salaries on here means I can't rule (2) out.

Happyman42

You really don't get it. We have a shortage of doctors at the moment because we are losing quite a few to emigration who are leaving for better money, better living standards, better weather etc.

Money has always been better abroad, living standards have always been better, and the weather has always been better. Why hasn't the health service collapsed from mass exodus before now?

Somebody please explain.

Sierra Oscar

Happyman42 wrote: »

They have always recruited here and the money has always been a lot higher.
Are you suggesting we have match what they pay?

I don't understand your position.

You are saying that nobody in the health service should earn over €100,000 a year and you point to Qatar as an example of 'how to do it right'.

But in Qatar medical doctors don't pay tax, can get up to 50 days annual leave a year, free flights home and also get accommodation provided for you and your family. Also of course it is much cheaper to live in Qatar as opposed to Ireland.

Doctors in Qatar can expect to make at least €60,000 - €70,000. Tax free that is. Also Ireland is far more expensive to live in than Qatar. The Consumer Price Index is 92 here as opposed to 74 in Qatar.

You can't have it both ways. We already know that you do not attract the best candidates if you do not have a competitive remuneration package. The recent experiences in our own health system where we continue to find it difficult to attract candidates shows us that. It is a fact.

I would agree that the health system in Ireland is a stressful environment to work in. That needs to be addressed. However cutting people's salary by 50% + is not going to make it any less stressful.

Just one example of the attractive job offer for a consultant position in Qatar that many Irish people have been taking up - https://www.headmedical.com/Advert/637-Consultant-General-Internal-Medicine-Qatar-Jobs-Gulf-Region.aspx

Happyman42

Sierra Oscar wrote: »

you point to Qatar as an example of 'how to do it right'.

Where did I say that?

I think Qatar is an obscene working environment and I would not work there personally while they are doing what they are doing with the world cup workers and others unlucky enough not to be so privileged.

rrpc

Happyman42 wrote: »

They didn't have jobs. :rolleyes:

So 'sole' didn't really mean 'sole' then. :rolleyes:

Timberrrrrrrr

Happyman42 wrote: »

If your sole reason for emigration is for money, then that is greed in my book. Please pay attention to the word 'sole' as the OP states that reducing wages will 'solely' cause a 'mass exodus'
If that was the case the health service would have collapsed long long ago as earning potential in the Middle East has always been much much more lucrative than here.
My contention is, some will leave others won't, as has always happened, we just have to manage it by making sure the pool is large enough and the net is spread wide enough.

So carpenters, brickies, etc who left Ireland to earn a wage rather than be on the dole are in your eyes greedy?

Happyman42

Timberrrrrrrr wrote: »

So carpenters, brickies, etc who left Ireland to earn a wage rather than be on the dole are in your eyes greedy?

God, do I really have to explain this?
If you leave a well paid job (and 100,000 + is a well paid job) with the 'sole' reason of earning more and more, then that is 'greed'.

rrpc

Happyman42 wrote: »

Money has always been better abroad, living standards have always been better, and the weather has always been better. Why hasn't the health service collapsed from mass exodus before now?

Somebody please explain.

I'll let the RCSI do that:

The emigration of Irish-trained doctors is not a new phenomenon, but in recent years it has begun to have a greater impact on the efficiency and stability of the Irish healthcare system. With the highest number of doctors working abroad and more than half of those working in Ireland being non-Irish nationals, this is an issue not to be taken lightly, and it has led to a critical shortage in non-consultant hospital doctor (NCHD) numbers. Causes of this problem include falling income levels in Ireland, a better work–life balance available abroad, excessive working hours and an uncertain career pathway, among others. Australia, New Zealand, the UK and the USA are the most attractive destinations for doctors emigrating from Ireland as they address the above issues better than Ireland does. It is critical that all involved parties, including the Health Service Executive (HSE) in Ireland, solve this problem, as further decline will have negative consequences for Irish healthcare provision.

The rest of the document is here
It's dated from early 2013.

FreudianSlippers

Happyman42 wrote: »

God, do I really have to explain this?
If you leave a well paid job (and 100,000 + is a well paid job) with the 'sole' reason of earning more and more, then that is 'greed'.

Your theory is based on the flawed assumption that all jobs have equal value.

€100k might be well paid for a GP or a local solicitor, but isn't for a surgeon or a commercial lawyer.

rrpc

Happyman42 wrote: »

God, do I really have to explain this?
If you leave a well paid job (and 100,000 + is a well paid job) with the 'sole' reason of earning more and more, then that is 'greed'.

That's not what you said though, is it?

Happyman42 wrote:

If your sole reason for emigration is for money, then that is greed in my book. Please pay attention to the word 'sole' as the OP states that reducing wages will 'solely' cause a 'mass exodus'

Happyman42

rrpc wrote: »

That's not what you said though, is it?

We are talking about people already in jobs leaving (see OP) and that 'mass exodus' collapsing a service
People WITHOUT jobs leaving the country cannot cause a sector to collapse.

Happyman42

rrpc wrote: »

I'll let the RCSI do that:



The rest of the document is here
It's dated from early 2013.

Yes, and as I have been saying, 'salary' is just one of the issues.

Timberrrrrrrr

Happyman42 wrote: »

God, do I really have to explain this?
If you leave a well paid job (and 100,000 + is a well paid job) with the 'sole' reason of earning more and more, then that is 'greed'.

That's not what you said though was it?

Happyman42 wrote: »

If your sole reason for emigration is for money, then that is greed in my book.

What if someone changes company for a higher salary? Are they greedy too?

Happyman42

Timberrrrrrrr wrote: »

That's not what you said though was it?



What if someone changes company for a higher salary? Are they greedy too?

If it is solely for money when already well paid then yes.


greed (grēd)
n.
An excessive desire to acquire or possess more than what one needs or deserves, especially with respect to material wealth:

FreudianSlippers

Happyman42 wrote: »

If it is solely for money when already well paid then yes.


greed (grēd)
n.
An excessive desire to acquire or possess more than what one needs or deserves, especially with respect to material wealth:

Can I ask what you do for a living?

rrpc

Happyman42 wrote: »

We are talking about people already in jobs leaving (see OP) and that 'mass exodus' collapsing a service
People WITHOUT jobs leaving the country cannot cause a sector to collapse.

You made a bald statement about people emigrating which you contextualised by specifying money as their sole reason for doing so and called them greedy. There was no reference to the OP in that post, so stop trying to drag it in now.

Just for clarity, could you please tell us what would make emigration for money acceptable in your view?

Happyman42

FreudianSlippers wrote: »

Can I ask what you do for a living?

I run my own businesses. What difference does that make?

Timberrrrrrrr

Happyman42 wrote: »

I run my own businesses. What difference does that make?

So you never promote your staff and pay them more or hire someone from another company offering them higher wages for their skills/experience?

FreudianSlippers

Happyman42 wrote: »

I run my own businesses. What difference does that make?

Are you not obliged to ensure that your businesses receive maximum profits? Or are you saying that once your businesses receive a certain set amount of money you reject all further income?


(I was asking to illustrate a point rather than take a swipe)

Godge

Happyman42 wrote: »

If it is solely for money when already well paid then yes.


greed (grēd)
n.
An excessive desire to acquire or possess more than what one needs or deserves, especially with respect to material wealth:

What is well paid?

The minimum wage in Ireland is well paid compared to Africa. Are people who come to Ireland and work for the minimum wage greedy because they are better off than the people they left behind.

Who defines what is well-paid? You? SF? Somebody else? When did we go down this begrudgery road?

rrpc

Happyman42 wrote: »

Yes, and as I have been saying, 'salary' is just one of the issues.

Are you having trouble keeping track of what you are saying?

Happyman42 wrote:

Money has always been better abroad, living standards have always been better, and the weather has always been better. Why hasn't the health service collapsed from mass exodus before now?

Somebody please explain.

So I explained. I quoted a document that said it was near collapse and which gave reasons for that. That was two years ago. By all accounts, things have disimproved since then and reducing income can only accelerate the problem.

Happyman42

Timberrrrrrrr wrote: »

So you never promote your staff and pay them more or hire someone from another company offering them higher wages for their skills/experience?

FreudianSlippers wrote: »

Are you not obliged to ensure that your businesses receive maximum profits? Or are you saying that once your businesses receive a certain set amount of money you reject all further income?


(I was asking to illustrate a point rather than take a swipe)

Anybody I employ is paid a fair wage. I do need to make a profit but I give a good service and I get a fair return, 'maximising profits at somebody elses expense is anathema to me. I don't exploit or overcharge.