Madam, - In the same week that our own Comptroller & Auditor-General reported that there are no measures in place within the health system to assess the productivity of consultants here, the UK National Audit Office has revealed that NHS consultants there earned an average £110,000 (circa €162,000) per annum for working an average 50.2-hour week in 2006.
This level of productivity has been criticised by the Commons Public Accounts Committee because NHS consultants were given a 25 per cent salary increase in 2003 on the basis of increased productivity. However, in the interim their average weekly hours worked has actually decreased from 51.6 to 50.2.
Sir John Bourn, UK comptroller & auditor-general and head of the National Audit Office, said: "Consultants deserve to be paid properly for the work that they do.
However, the new contract was introduced to benefit not only consultants but patients and the health service in general." The €162,000 earned by UK consultants for a 50-plus hour working week contrasts starkly with the new HSE consultants public-only contract basic salary of €205,000 per annum for a 39-hour week, plus €20,000 on-call allowance and a €40,000 performance-related bonus.
Yet the new HSE contract has been rejected out of hand by the IHCA on behalf of its members.
It seems that when you're a consultant, the more you have the more you need.
- Yours, etc,
PETER MOLLOY, Haddington Park, Glenageary, Co Dublin.
Madam, - Comparison has been made between the salaries offered by the new Irish consultant contract and that offered by the United Kingdom's NHS. At a cursory glance the Irish salary offered is more attractive than the headline salary of an NHS consultant (£71,000 rising in increments to £96,000).
A closer look reveals that the NHS salary is payable for 10 sessions per week giving a rate per session of €10,500 to €14,100 per year. The Irish equivalent for a 13-session contract is €12,300 to €15,800 per session per year. However, there are additional permanent and pensionable payments available to NHS consultants under the clinical excellence award system. The local clinical excellence awards run up to £34,000 per annum and national clinical excellence award to an additional £73,000. This takes the top NHS salary to £203,000 (€300,000). The majority of NHS consultants benefit from payments from these schemes.
In addition, the NHS contract imposes no financial or time limit on private practice once the contracted NHS sessions are met. Private practice is allowed on off-site private hospitals, which is forbidden by the Irish contract. The NHS contract is flexible and family friendly.
There is no scheduled weekend or after-hours working without the agreement of the individual consultant. The option of part-time working is freely available.
Consultants are entitled to six weeks' annual leave, as opposed to four weeks in Ireland. Most importantly, NHS hospitals are in general well organised and resourced and the normal working day is unhindered by the organisational issues which plague the Irish hospitals.
If the Minister expects a deluge of NHS consultants seeking employment in the Irish service under the terms offered, she will be disappointed. Doctors unable to secure an NHS consultant post, for whatever reason, will apply.
There will be doctors who for family and personal reasons will wish to return to Ireland. They do so in the knowledge that what is on offer in Ireland is inferior to that on offer elsewhere. They do so knowing the chaos that awaits them in Ireland's unreformed public hospitals. They know that these hospitals cannot be reformed without a contract which has the support of both employers and the majority of consultants.
- Yours, etc,
CJ COTTER FRCS (Glas), Wilton Street, Glasgow.
Madam, - As a consultant in the public service, and one who returned to work in Ireland just two years ago, this is my first experience in 20 years of the run-up to a general election.
As one with an active interest in healthcare reform, it is saddening to see this very public discord played out, while our patients look on in horror. Everyone knows healthcare is in trouble. The finger-pointing is breathtaking.
Consultants do and should take their share of the blame for the mess we are in. However, when the dust settles after the election, the public disputes are no longer on the airwaves, everyone's fingers are well and truly worn out from pointing, eager new consultants are being bussed in from wherever, we'll still be left working in inadequate facilities, with outmoded work practices, and patients will continue to pay the price. The only difference is that by then there will be even more consultants unable to take adequate care of their patients in Ireland.
Makes you glad to be home. . .
- Yours, etc,
FRANK SULLIVAN MB, MRCPI, Consultant Radiation Oncologist, University College Hospital, Galway.