The revelation that mid-career senior hospital consultants are leaving the State at the rate of three a month due to deteriorating work conditions will come as a surprise to many. These doctors were appointed under a previous hospital contract with public service salaries of €166,000 per annum and so have not been directly affected by the 30 per cent cut in pay that applies to new consultants appointed since last October.
It has been known that many posts lay vacant in the last year; many failing to attract even a single applicant. The annual conference of the Irish Hospital Consultants Association (IHCA) was told at the weekend that for 52 posts for permanent and pensionable consultant jobs advertised there were just seven applicants. Denis Evoy, president of the IHCA, said the prestigious post of professor of surgery at the Mater Hospital in Dublin cannot be filled because a consultant working in the system who took the post would have to take a 30 per cent cut in salary and accept poorer working terms and conditions. The continued degradation of consultants' conditions and contracts was changing the medical landscape in Ireland and creating a system that cannot cater for patients, he added.
When added to the early exodus of junior hospital doctors because of poor training and working conditions, the most recent revelation suggests an unwanted “perfect storm” may be about to engulf our public health system. A failure to attract and appoint candidates for current vacancies, combined with a longer term shortage of doctors returning to the system and a steady exodus of experienced consultants represents a fundamental threat to the quality of healthcare in Ireland.
In the short term the decision by mid-career consultants to emigrate suggests their tolerance for current working conditions, system failures and compromises in patient care has reached a tipping point. It is a weather vane the Minister for Health would do well to take note of and respond to.