Friday, January 26, 2007

Breaking the Consultants Stranglehold

It’s increasingly difficult not to see the hospital consultants as a group of arrogant and greedy professionals with a stranglehold on the Health Service and a willingness to hold hostage the most vulnerable members of our community - those in need of hospital care.

Doubtless there are many hospital consultants who do not believe they merit the above description, but they are either deluding themselves or, at least, failing to exert influence within their profession.

If press reports are to be believed, the new public-only contract proposed by the HSE will carry a salary of €200k+ per annum, while junior hospital doctors are currently earning up to €100k per annum in overtime alone. The Government routinely defends it’s performance in the Health arena by highlighting the additional billions which have been spent on Health over the past decade. It’s now clear to the ordinary taxpayer that the main result of this largesse is to make budding millionaires of far too many medical practitioners.

The Government needs to take decisive action as the country’s health service cannot continue to be held to ransom by this powerful, elite and wealthy clique.

A good starting point might be a “name & shame” policy: publishing a league table of consultants showing relevant information such as number of patients seen, procedures carried out, public salary paid etc..

The HSE should push through the proposed Public-only Consultant Contract and appoint consultants, with or without the cooperation of the existing clique.

Any non-cooperation should, following delivery of appropriate warnings, be deemed a breach of contract and used as the basis for termination and renegotiation of contracts on the following basis:
50% of salary for attendance in the public hospital for 40 hours per week, with the other 50% dependent on achievement of CHALLENGING annual targets e.g. number of patients seen, number of procedures performed etc..

If a significant portion of salary was dependent on OUTPUT, the hospital administrator's door would be beaten down by consultants with proposals as to how to see more patients, maximise use of operating theatres etc..

Footnote: Published as a letter in the Irish Independent & the Irish Examiner

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