IHCA survey confirms health service facing exodus of consultants due to ‘blatant discrimination’

The Irish Hospital Consultants Association (IHCA) has released the results of a survey of 317 recently appointed Consultant members that, it has claimed, confirms acute hospital and mental health services face an escalating and unprecedented consultant recruitment and retention crisis due to “ongoing blatant discrimination by the State and health service employers” against new hospital Consultants.

Almost all respondents (99%) agree that lower salary terms are having an adverse impact on the delivery of patient care due to the large number of consultant posts that are unfilled or filled on a temporary basis.

The new IHCA President Dr Donal O’Hanlon said that over 70% of the new Consultants have confirmed that they will seriously consider resigning from their public hospital posts unless the discriminatory salary terms are corrected. Furthermore, the vast majority of respondents (95%) strongly agree that the lower salary terms do not reflect the importance of the work and level of responsibility that they hold in their public posts.

Dr O’Hanlon said: “The survey has provided categorical evidence that our highly trained specialist consultants will not continue to work in our health services if the persistent and blatant discrimination against them continues. Recently appointed Consultants are on salaries significantly below those of their pre-October 2012 colleagues who are currently being paid up to 57% more.

Dr O’Hanlon said it is “not surprising” that 72% of new Consultants ranked equal pay for equal work as the most important aspect of their working terms and conditions given the ongoing extreme discrimination they are being subjected to by the State as their ultimate employer.

In addition, 92% of the respondents confirmed that they are personally aware of colleagues working abroad who will not return to work in the Irish Public Health system as a direct result of the lower salary terms.

Dr O’Hanlon said that the results of the survey should set alarm bells ringing at Government level as it is “now abundantly clear that 100 consultant posts advertised but not filled The health service failed to fill 100 consultant posts advertised by the Public Appointments Service between 2015 and 2017.

Over three years the HSE was unable to fill up to one-third of consultant posts sought, including 39 in 2015, 30 in 2016 and 31 last year, according to the Irish Hospital Consultants Association (IHCA).

During the timeframe 39 advertised hospital consultant posts received no applicants, and a further 153 received between one and two applicants only.

A HSE spokeswoman said the lowest number of applicants were for posts in psychiatry, emergency medicine, radiology and pathology. Smaller hospitals were also adversely affected.

According to the IHCA, the failure to recruit staff is having an adverse impact on most medical specialities and hospital types across the country.

“The shortage of consultants and the fact that approximately 450 approved permanent consultant posts [a full 15 per cent of the total] cannot be filled on a permanent basis is undermining the quality of care that can be provided to the public,” said IHCA secretary general Martin Varley.

“It is contributing to growing waiting lists for consultant outpatient appointments, and is overstretching the capacity of hospitals to provide the type of care that patients need and deserve.”

Irish Medical Organisation (IMO) president Dr Peadar Gilligan estimates there are over 1,400 fewer consultants employed than are needed.

According to the IMO, Ireland is “precariously short” of doctors, with only 2.9 practising physicians per 1,000 population compared with an EU average of about 3.4. consultant delivery of services to patients is on a cliff edge because it is being fundamentally and critically undermined by the State’s persistent discrimination against internationally sought after specialist Hospital Consultants”.

Dr O’Hanlon continued: “Our acute services are increasingly uncompetitive in recruiting and retaining the number of consultants required to provide timely, high quality, safe care to patients.
“There are approximately 450 approved consultant posts, a full 15% of the total, which cannot be filled on a permanent basis and the age profile of the Consultant workforce suggests this problem will increase as 25% are over 55 years old. About half of the 450 posts are vacant and some are filled on an agency basis, at costs which are up to three times the discriminatory salaries being paid
to recently appointed consultants.”

The IHCA President continued: “The current two tier pay system for consultants is the major obstacle to recruitment of new Consultants. The “New Entrant” salary is not competitive in the global market for Consultants and it is discriminatory in the extreme towards new hospital Consultants. High Court orders issued on 15 June 2018 require that the 2008 Consultant Contract salary must be paid to hospital consultants. The opposition of the State and health service employers (during the High Court settlement talks and since) to paying the corrected salaries to new appointed consultants exacerbates the discrimination.

Dr O’Hanlon said that such unacceptable discrimination against new consultants must be ended without delay.

“It convinces new consultants that they are not valued and that they will not be treated fairly by the Health Service. It is the major factor in the decision of many doctors to emigrate rather than to build their career in Ireland. If the issue is not fully addressed by the Government without delay the IHCA will continue to vigorously pursue the ending of the discrimination through legal and other actions to ensure full parity for new consultants, as the Association has consistently demanded since 2012” he added.

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