by Frank Schnittger
Tue Feb 24th, 2009 at 08:23:43 PM EST
Cross posted from the European Journalism Centre Think about it website
(Shameless self-promotion - please rate this post on the Think about it website above - its only one click away - and is part of a Euro blogging competition hosted by the European Journalism Centre)
In the midst of an economic and political melt-down with unemployment doubling in the past year the Minister for Health has found the time and resources to make Irish Hospital Consultants (senior specialist medical doctors) amongst the best paid in the world. Can anyone take Ireland seriously when there is such a scandalous reallocation of resources from the poor to the rich at the very moment when huge health service cutbacks are planned because of a 1.3 Billion Euro shortfall in the public health budget?
Harney agrees pay increase for consultants - The Irish Times - Tue, Feb 24, 2009
MINISTER FOR Health Mary Harney has given approval for the payment of significantly higher salaries for hospital consultants under the terms of a revised contract.
The Minister sanctioned, the new payments which will see consultants receive salaries of up to 240,000 per year in some cases, at the end of last week on foot of a verification process carried out by the Health Service Executive (HSE). The new increased salaries will be backdated to the beginning of January.
The introduction of the new contract, which the Government maintains will result in major work practice changes and greater benefits for public patients, will cost the exchequer about 140 million this year in gross terms and 72 million net after taxes and levies.
Under the new contract some consultants will see their salaries rise by between 50,000 and 60,000
It must be born in mind that many Hospital Consultants also earn more from their private patients than they do from their public work and that they frequently reallocate patients from their public to their private lists in order to maximise their income.
The mixed system of public and private medicine in Ireland has long been a public scandal. Hospital Consultants have a vested interest in maintaining long public waiting lists as this forces their more urgent public patients to go private to receive timely attention. Public patients with suspected cancer can wait many months to be seen...
Hospital consultants also control both public and private admissions into hospital with the result that private patients take up 30% of the beds in public hospitals even though only 20% of the beds are formally allocated to private patients.
Readers from outside Ireland may wonder what private beds are doing in publicly funded hospitals in the first place? The reality is that public and private patients use many of the same (publicly funded) facilities. The system of private heath insurance is essential a system of organised bribery to get you ahead in the queue for many of the same services and facilities.
Whereas previously, private healthcare insurance was the preserve of the well-off to guarantee a private room in a hospital, now it is a prerequisite for anyone who needs prompt medical attention for an urgent medical condition - with the result that c. 50% of the population now buy it. However the costs have sky-rocketed because there is no market discipline to keep medical prices down. Doctors can charge more or less what they want and the insurance company (Until very recently dominated by the state owned, ironically named Voluntary Health Insurance) just pays up. The result is sky rocketing medical inflation for no improvement in service.
Whenever waiting lists become a public issue the usual medical interest groups decry a lack of public funding resources. But the public health bill rose by 418% between 1990 and 2002 and is now above the EU average with no appreciable impact on waiting lists. Waiting lists are a necessary feature of the system to force patients to buy private health insurance which can then result in a doubling of consultant incomes. Consultants typically charge 200 for a 20 minute private consultation.
Mary Harney is a hold-over from the now defunct neo-liberal "Progressive Democrat" Party who famously opined that Ireland was closer to Boston than Berlin. When it comes to public healthcare she is certainly trying to achieve that goal. Greatly increased insurance and direct costs for patients, huge increases in public expenditure, huge cutbacks in services, and a medical elite who can become multi-millionaires within a short space of time.
In the meantime, health outcomes remain mediocre with Ireland coming 21st. on the OECD table of health care outcomes. Ireland scores particularly badly on male and female mortality from heart attacks (the highest in the OECD) and for potential years of life lost due to breast cancer. Having lost my wife due to breast cancer I have reason to feel betrayed by a medical profession which has arrogated the vast bulk of medical resources to its own enrichment. In her case we managed to arrange the best medical care possible but there are far too many unnecessary deaths in the Irish Health Care system.
Spending a further €140 Million p.a. on Medical Consultants who are already earning huge salaries at a time when there are already going to be €1.3 Billion cutbacks in services to public patients can only make this situation worse.