Dispute over consultants' conract

Madam, - Vilification of Irish hospital consultants regularly gets me humming my children's favourite ditty: "Nobody loves me…

Madam, - Vilification of Irish hospital consultants regularly gets me humming my children's favourite ditty: "Nobody loves me, everybody hates me, think I'll go and eat worms".

Seriously though, the notion that consultants deserve a running kick clearly resonates with many people, and not just Mary Raftery (Opinion, April 19th). Her understandable rage at bumptious, greedy consultants is manna from heaven for the Minister for Health. But in the current unpopularity contest between Minister and medics, people should remember that the first casualty of war is truth.

It is a fact, for instance, that the perceived power, affluence and hubris of Irish consultants stem from their scarcity, the brutality of their training and the bureaucracy in which they are daily mired. And it is true that the solution to "difficult doctors" is primarily economic, not political: increase their numbers (and accept that they need extraordinary training and resources).

Sadly, the Minister's preferred solution - a hastily-imposed, hyper-regulatory new contract and Medical Practitioners' Bill - is the riskiest political interference in the health service since its inception. It vividly illuminates her conviction that consultants are a root cause of bed shortages, cancelled operations, missing outpatient slots and sluggish reform of the health service, but it is based on prejudice. The fact is that Ireland depends on a tiny number of overworked, overpaid, and outspoken consultants doing the jobs of umpteen counterparts abroad. So why not learn from a few facts of recent UK history?

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This week, the UK's National Audit Office found that since the hurried, unilateral imposition of a new consultants' contract in 2002, consultants had received an increase in their salaries of 25 per cent and seen a significant reduction in their workload. The reason, according to Edward Leigh MP, chairman of the Commons public accounts committee which oversees the NAO, was "weak financial management by the Department of Health [ which]) drove through the new pay deal with scant regard for proper evidence" of what consultants actually did - which was much more than the Department thought.

Now, micro-managed, dispirited NHS consultants spend much of their time completing work diaries, and far less time than previously doing the clinical, research and educational work for which they once had a vocation.

Five years after a vicious, politically motivated smear campaign against UK consultants, bitter lessons are being learned. Doctors really are motivated more by professional values than by money. Straitjacket them contractually, forcibly stuff their mouths with gold, then depict them as untrustworthy plutocrats and you will witness a collapse in confidence, leadership and productivity.

It is clear from recent media coverage of healthcare staffing issues here that facts alone cannot speak for themselves. But, despite what politicians and journalists would have one believe, there is plenty of evidence that doctors really do tend to tell the truth. - Yours, etc,

Dr CHRIS LUKE, Emergency Department, Mercy University Hospital, Cork.

Madam, - I refer to the report in last Wednesday's edition of the IHCA press conference, in which I am quoted as describing a proposed salary of up to €205,000 a year as "Mickey Mouse". Mary Rafferty, in her column of April 19th, while not referring to me by name, again credits the IHCA with holding the same view regarding the proposed salaries which, incidentally, range from €160,000 to €205,000.

I was surprised to read your report which credited me with a statement which I did not make. For the record, the transcript of the press conference records my contribution as follows:

"Any young person that has spent six years at school slogging to get into medical school, spent six or seven years at medical school, and then gone abroad and trained for seven years to come back to an offer of a job that does not have a contract, that doesn't have a salary, I mean it's laughable.

"No one in this room would take a job without a contract and a salary. They're asking people to take jobs on contracts for that don't exist on salaries that don't exist and it's absurd.

"I've worked abroad, I've worked abroad [ sic] and I know how people think. I've worked in England and I've worked in America and I know how people think and they'll come back and see this as Mickey Mouse. Anyone who's working in a big centre. . ."

I do not expect that this letter will correct the damage that has been done to the reputation of the IHCA and consultants in general as a result of the widespread inaccurate coverage of our press conference, but I do hope that it will set the record straight for future reference. - Yours, etc,

Dr JOSH KEAVENY, Consultant Anaesthetist, Beaumont Hospital Dublin 9.