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SERIOUS CONCERN HAS been expressed over staff shortages in Emergency Departments, following a survey that suggests the problem will worsen after July.
A recent medical staff survey by the Irish Association for Emergency Medicine (IAEM) confirms ongoing shortages of medical staff in the country’s Emergency Departments (EDs), the association has said.
It said that the worst shortages are at the middle grade level (senior doctors at a grade below Consultant), while the experience of departments in attempting to recruit medical staff for July 2013 to January 2014 (the next contract period for NCHDs [non-consultant hospital doctors]) suggests that the problem will “greatly worsen” after July.
There is a genuine risk that EDs will not be able to fill enough of their posts to continue to provide current levels of service. There is a real prospect therefore of certain EDs being obliged to reduce their hours of service.
The IAEM said that for many EDs there is a likelihood of fewer doctors on duty, which could lead to increases in waiting times and increased risk for patients. It is not just EDs in smaller hospitals that are at risk, as it is likely to significantly affect many larger hospitals, it added.
There are also increasing difficulties recruiting Consultants in Emergency Medicine (EM) around the country. “At the same time as new entrant Consultant salaries in Ireland are cut, other countries are offering very heavily incentivised packages to attract suitably qualified Irish doctors to staff their EDs,” said the IAEM.
The association said that unless the problems that make a career in EM in Ireland “so unattractive” are addressed, the staffing shortage will inevitably worsen. They warn this may lead to a downward spiral where current Consultants in EM consider relocating to other countries.
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There is a real danger of a downward spiral in this area. You have a combination of a very stressful, poorly supported working environment combined with the impending croke park 2 cuts which disproportionately affect staff who work shifts, nights and weekends.
Yeah but look at the bright side, the bond holders get paid right on queue (sarcasm)
No surprise there. If you don’t pay people what they’re worth they won’t stay. Something Sinn Fein etc haven’t factored into its vision for a communist paradise. Fine Gael and Labour however will be responsible for the flight of the best doctors from this country.
If a country doesn’t look after its patients properly along with the dedicated staff ,then we might as well pack it in,close the doors and say goodnight.
There will be no nurses or doctors left to run our hospitals the way this government are treating our newly qualified professionals, they will be gone to where they will be appreciated end of.
The government are great for putting a squeeze on these services, I mean we all have to take a hit……#sarcasm.
They needed a survey to tell us what every person in the country already knows?
@p1
P you must remember these people ie. the govt really are totally removed from reality and genuinely would not know what goes on in the real world. This system needs to change whereby politicians live real lives on a normal average income and pay bills like normal people.. And suffer the same stresses as the rest of the people .until then we have no hope.
Pay may be a big factor but I’d sat a lot of people look at the state the health so-called service is in and think that no money wouldd pay them to work here. And I’m not blaming frontline staff. The mismanagement comes from the top and has been going on for years.
As someone who’s trying to pave a career in a relatively new specialty in ireland- Emergency Medicine and starting in a busy ED in July, these reports make me more nervous and frustrated! I have given up apologizing to patients as I find I am not to blame for a system that overlooks patient and staff safety. I’m trying to get through the system to get out the other end either to stay in Ireland and help try change it or defeated, ill leave and be valued elsewhere. Other doctors are choosing to leave earlier and really you can’t blame them.
Public support for us front line staff and lobbying of the politicians to STOP making us choose the easier option of leaving, is needed. Try keep us here by NOT cutting our pay and taking away part of our salary that pays us (and makes us feel worthful) to deal with emergencies in society at 2am christmas morning. Frontline staff are not looking for pay rises or bonuses but for proper working conditions that will help us in our training . That will keep us here and help staff our EDs! :)
Hi Lisa, take it from me. Start ur career in a country that cares. Try Australia.
Ciaaaaaaaaan! I can feel the encouragement
Go Lisa. It’ll be a better quality of life and career. Being an NCHD in Ireland is viewed as a vocation for the NCHD, but in many ways its a vocation for those who support the NCHD – whether it’s parents, boyfriends, girlfriends, husbands, wives, children, friends, whoever.
Being an NCHD is not a vocation, it’s a career, a profession. It has to pay bills, it has to provide for children, families, it has to provide training, a means to an end, a means to providing the trainee with a path in life, a career in life. Not just a job. Or a vocation.
Being an NCHD in Ireland does none of those things in any way sufficiently. Being an NCHD pretty much anywhere else caters for all those needs.
Good luck whatever it is you do, especially if you decide to stay here!
Speaking to my friends from the subcontinent like Pakistan, the HSE have just hired 200 doctors from Pakistan to fill A&E posts. They are structuring it as part of their training at home and so would be obliged to leave after 2 years. they will get general registration.
Interestingly, they hired 190 doctors like this 2-3 years ago but IMC did not give registration so easily and many who want to stay and have spent 3 years being trained and getting used to the system will be forced to leave if they can’t pass subspecialty exams or the TRAS.
I was told that many of them were put up in the hotels around Limerick with full board plus salary for months including a return flight home to Pakistan all paid for by the HSE while waiting 8-10 months for IMC registration because the HSE forgot to talk to the IMC before brining these doctors over. We’re talking tens of thousands of euro doing nothing. As one colleague said. He was paid €2k/mth to stay at the South Court Hotel for 7 months and watch tv.
And you wonder where all the money is going. HSE is a joke. If they put this money towards paying their own doctors and keeping the doctors that they trained who knew the system instead of a doctor who had never been in the country and would have difficulty like anyone would learning a new culture and system.
The next time you want to complain about doctors expecting to be paid well and on time, for all hours worked, in clean hospitals supported by appropriate levels of nursing and allied health staff, with training and career prospects – stop and think.
This is what happens when doctors are treated poorly.
Get FAS to do a FETAC in emergency medical consulting and have interns from that course do the work for free.
Yes. That’s who you want treating your loved ones in A&E – amateurs
Dear god they will job bridge it next. I have been told by people though that we have to feel the pain. The never worked in health either. They have no notion of the chaos of healthcare. The imminent danger of doing something dangerous while stressed angry and upset(like paul o connell last night). The beds on wards situation is akin to paying to stay in a hotel and being put on a trolley on a corridor to sleep. The public are expected to tolerate this! The staff are “lucky to have a job! the receivers for the hotel state that they should never have closed the beds. Meanwhile the “hotel ” has 2500 hotel beds free but it won’t open them as they pay too many managers and advisors to sit in hotels elsewhere in the country devising cutting more staff and rooms! The staff that are there continue to b harassed by the public and get the complaints though while 380 starving people wait in the queue for reception. The staff tell the customers that they will b with them as soon as but if a more hungry person arrives they will b fed first. Complaints rise and staff are penalised and blamed. Staff get paycut as the hotel owner buys a new Aston Martin. Better jobs available in other countries. Bit of a no brainer.
“At the same time as new entrant Consultant salaries in Ireland are cut, other countries are offering very heavily incentivised packages to attract suitably qualified Irish doctors to staff their EDs,” said the IAEM . What other Eurozone countries have a better package for these Irish doctors and what are the incentives? difference in salary etc? Just curious to know the answer?
Why are you picking the Eurozone?? Are Irish doctors not free to work outside the Eurozone??
Just because we are part of the Eurozone group of countries and we can compare against them, no other reason really. Do you know the answer to my question? I’m just curious to find out?
Shorter working hours in the UK with better work conditions equipment and resources fewer on calls per month and equal footing with other consultants.
@warren, it’s not to other eurozone countries that Irish doctors are being lost to, its Australia, NZ, Canada and the States that most doctors leave for. The enticements are simple, better hours, better pay, better training and better working conditions. Despite what the government might say about Irish doctors wages being above the EU average, compared to the countries I mentioned earlier, they are amongst the lowest paid.
Thanks for that, but the UK is not in the Eurozone. How do the wages compare in the UK?
I can’t speak for pay but what I can say is that Ireland offers worse conditions, no training despite being on training programmes, working shifts that are longer than many people’s working week, longer length of training (7-10 yrs here, 4-7yrs pretty much anywhere else). Australia, Canada and the US offer Visas that are designed specifically for NCHD’s, Ireland is the only EU country not to abide by the EWTD – which is a major incentive for NCHD’s. NCHD’s consistently say that it’s not about the money – and it’s not. Many countries offer similar packages by way of salary and such, but they offer training schemes, working week limits, safer working environments…
If you can earn 50K here and 50K in another country that offers a better quality of life then why would anyone choose to stay here? It’s really a no brainer!
A quick addy – in many cases the NCHD looses overtime when they do leave – which pretty much says it all – if the money ain’t keeping them here – you’re not doing it right!
Point taken. However, it would be fair to say that in most professions you would be paid more in these countries. You cannot compare a small isolated economy like ours to that of a resource rich nation like Australia or Canada who have faired pretty well during the financial crisis. Agree?
Not typically the eurozone. US, Canada, Australia even the UK you’d earn more after tax with a lower cost of living, a lot more colleagues sharing the responsibilities and better resources. It’s worth pointing out that its the ED registrars who do a hell of a lot of the triage and even in the teaching hospitals we just can’t hire them never mind the counties.
In general they’re actually taking home less in other countries – due to not working overtime. If you want doctors in your hospitals you have to train them, offer decent work/life balance, proper job support, proper facilities, proper training schemes with a realistic prospect of obtaining gainful employment (ie – a consultancy post), and at the moment, Ireland meets none of those bar in very very very few occasions – most in the area of GP.
And in the UK happier patients because no frustration due to over crowding and queues Due to the fact James Reilly and Enda Kenny have been closing A&E’s and overcrowding hospitals that were already over crowded………….. And More A&E’s on the list for closing too no-one is safe with this Government
It’s not European countries, it’s oz, Canada, New Zealand and the states. We’re part of English speaking world when it comes to health care staff. Europe not even in their mindset. There the countries competing with us and offering much more lucrative salaries and far far better working environments.
New consultant pay in NHS is 94000 euro, in Ireland new type B contract is 109000 (pre the proposed cut from croke park 2, which will bring it closer to 100000).
You have to take into account other factors such as, Ireland has higher tax, you’d be expected to work longer hrs in a department with half the staff of most UK emergency hospitals. Most big ED departments in London would typically have 14 consultants verses approx 3-4in the big Dublin hospitals. Then you have to take into account that the new consultant contract donest allow you to do any of site private work whereas in the UK conusultants pay would be significantly topped up with private work and target met bonsus.
So poorer training, tougher conditions, less staff, longer hrs, higher taxes all factors not just the bottom line pay. More complex than that.
In addition, in the UK, that pay rises quickly after only a few years on a scale. In addition, consultants in the UK get all sorts of additional payments. To summarise: more money for less work in a system which doesn’t abuse it’s staff and patients.
All fair and valid points guys and I can see where you are coming from. When you become a consultant in places like the US would you be paid like you would here while also splitting your time with private clinics like blackrock mater private etc? I always wondered how they can double job like this?
Look up their contracts on the HSE website and you’ll see how they divide their public/private commitment. What their paid then check other websites like the NHS this will give you all the info your looking for factually and clearly outlined.
When you become an Attending (consultant equivalent in the US) they earn multiples of what they earn here. Double jobbing in the US doesn’t happen to the extent that it used to here (more anon), as their system is different. Double jobbing doesn’t happen here to the extent it used to, and when it does, it’s between public hospitals. Consultancy contracts filled in the last few years are public only contracts, specifically barring any private work.
@ Warren:
You’ve already been burned by Cliodhna. Twice. Give up already.
New contracts only let you do either all public or onsite private. So if you work in vincents public a and e you cant do sessions in the Blackrock clinic. Hence alot will be atracted now to just do private only and wil be full time in the private hospitals with better pay and conditions or will go abroad. This is only the tip of the iceberg. In 5 years time there will be a serious crises with staffing.
@Warren, Emergency Medicine consultants don’t normally do any private work. You can go see a orthopaedic consultant privately about your sore hip, or a cardiologist about your palpitations in order to speed up your diagnosis or treatment, but obviously emergency medicine doesn’t work like that. It possibly one of the reasons why it was considered a less attractive position by many doctors in the past.
My sister went to hospital last week CUH last week in an ambulance no doctor on ambulance had to wait an hour with her. And then wait 12 hours to see the doctor what a joke
Welcome to understaffed healthcare. Prepare for worse. Much worse.
Well when 2,500 odd beds are closed and hundreds of patients are shoved on corridors up the wards, how do you think the already busy medical and nursing staff can keep taking in more patients? In dublin, ambulances are regularly held up for hours outside ED depts as they cannot get patients off and onto trolleys as the ED is jammed to the door. all that has happened is that we shoved patients somewhere else. We regularly face issues in theatres, that stop our lists…. no physical bed for patient to be cared for in… if the patient has surgery (and there may be several of these patients) then they cannot get out of recovery, and that stops the lists as you cannot keep operating people if the staff who should in theory care for them, have the previous patient still there. The back logs of sick and vulnerable people needing care in our recovery rooms is a disgrace.
Sadly senior HSE management and Dept of health would rather pay through the nose for “consultants” to come in and do a report (not like the findings) and then have the report written in favour of the management system that is stuffing everything up…. than to perform management by walkabout…. fix the small things, the bottlenecks (this usually costs a pittance, ie fixes broken trolleys, gets patients transferred out of hospital to nursing homes etc). Mangement by walkabout was what our Directors of nursing should be doing, it was called Matrons round in the past, and it was the quality aspect of the job, ensuring standards are met, sending staff to busy wards, ensuring issues of the day are fixed promptly. Instead we have a plethora of clinical managers swamped by paperwork that should be ditched. Imagine we still have the vast majority of nursing managers Ordering supplies for their wards! Instead of being paper based, they now get the extra step of data entry on computers! And we wonder why our care has deteriorated? Theres no time, as we spend our time performing the work that our Administrative colleauges should and would gladly do (i hope) and in fact neglecting the supervison that we should be doing. However, in nurse managers dont do the ordering, there are no supplies with which to operate on patiaents with, nor care for patients… We have huge procurement depts all over the HSE….. let procurement do just that… Procure away and let the nurses nurse, and the doctors treat patients (not spend hours on teh phone looking for patients and organising tests). In the good years, administrator grades grew by 60%( but thats how bureacracy works, it is like a malignant disease, as i ts never about doing the work but getting more staff under you to supervise), and we got worse and worse output! And to the detractors, and windup merchants here, we are losing all our medical staff to Australia, where they are thrilled to get them… Theres something about the Stupidity of the Irish alright! We train them and lose them, through abuse, poor working conditions and finally financial remuneration for a difficult and accountable job (nursing and medicine, being the only 2 profs in health that can be struck off for poor standard of care)…. ever see an administrator lose their job for wrecking the system? No its those of us on the frontline who get to suffer that. I wonder how many patients were on trollies in Galway last October when the current case in the headlines was occuring… Our systems in hospitals badly let us down, but our duty of care should be based on humane working conditions, not the current shambles
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