I know a thread on a contractual issue is never going to be one of the greats. But my Irish colleagues might take industrial action and it’s important to tell people why, before inevitable political mudslinging starts. This issue is about pandemic safety, so I’ll try to explain..
https://twitter.com/imo_irl/status/1321924720888074241
....in Ireland, when you finish medical school, you can go on and do specialty training. It takes years and there are lots of awful exams, but you get there in the end and you qualify as a consultant. And then the @HSE_HR give you a consultant contract. Except for public health..
....Decades ago, someone in the dept of health decided that public health doctors were so useless as to require unique treatment and an individual contract. This was called a “specialist” contract, and was generally just a crappy version of a consultant contract. It meant you...
...didn’t get a team to help you. You got less study leave, you got less study allowance, you weren’t allowed do research and you didn’t have the authority or the autonomy that a consultant had. You also got paid less. This contract was thought to be acceptable because PH was a..
...mostly female workforce. Don’t give the women too much authority, and sure they’re just topping up their husbands’ paycheques anyway. By the 90s, outbreak control had become quite sophisticated and people were asking why public health doctors were treated differently....
...Nobody quite knew why at that stage. Or rather, they weren’t willing to admit why. Clue...👩👩🦰👩🦳 So governments did what governments do. They commissioned reports into the issue. Each report said the same thing ie every other English speaking country in the world gives their..
..public health doctors consultant status, and these guys are doing the same job as those guys in other countries. So get it sorted. Of course, these reports always took so long that the ministry would invariably change hands by the time they were published. So we’d meet with....
...the next minister and the cycle of reports and investigations would continue. It’s been like this for 17 years. All the while, my colleagues just got on with it, dealing with exactly the same stuff as PH consultants in the UK, Oz or NZ. Just without the appropriate tools....
...While consultants like me in Oz manage outbreaks of all sorts of infectious diseases in prisons and homeless shelters and schools with big teams and the authority to just get on with it, the guys in Ireland frequently manage them alone, or with maybe a solitary nurse....
...Just before covid they were promised it would get sorted. But it didn’t. They’re sound, so they said “that’s fine, we appreciate there’s a pandemic and the dept of health has other priorities so we’ll give you a few more months to get your ducks in a row”. And, as always...
...they got stuck in. Their “specialist” contract doesn’t oblige them to do even half the stuff they’ve been doing during this outbreak. So when you see PH doctors describing their awful experiences on twitter, let’s be very clear...it’s not accurate to say “that’s their job”....
....So @roinnslainte keeps meeting with them because @DonnellyStephen has been saying that sorting this “is a priority”. It is not a priority. Each time they meet, the lads in suits just say “sorry, were not doing it”. Simple as that. They say @mmcgrathtd won’t sign off on it...
...Each time that happens, my wonderful colleagues keep going back to work and flogging themselves half to death. I hate industrial hyperbole, but this isn’t it. Some of them are going off sick with exhaustion. Others are close to it. They’re being denied the autonomy to get on..
...with the job. They don’t have the authority to properly advocate for their patients. They’re not allowed enough study leave to keep up with the ever-changing science and they’re not allowed to generate their own research interests on HSE time. They don’t get a team....
....They also get paid less than their consultant colleagues. They’re only human and being singled out for less pay than your colleagues would irk any of us. But money isn’t the big issue here. It’s the whole package. If your cardiologist or neurologist or paediatrician tried...
...to run their department without consultant status, they couldn’t do it. It’s doubly demoralising when the politicians refer to them as “heroes” on the airwaves. They’re not looking for special treatment and they’re not taking advantage of a pandemic for personal gain...
...The pandemic is the REASON this needs to happen urgently. They cannot cope. It’s too late to train new specialists quickly. So they need help from overseas. But nobody will leave a consultant contract overseas to come to Ireland for a non consultant contract. Simple as that...
...So if this all kicks off, and we all hope it won’t, please think about the reasons why anyone in PH would take industrial action during a pandemic. These are good guys. They really are. They’re being forced into a corner and they need your help to fight their way out.
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