Irish Medical Consultants

There’s an almighty row going on at the moment about the contracts being offered to new hospital consultants.

An incredible uproar.

And the reason? Well, the government is going to hire more consultants, but they’ll have to work exclusively in the public health service. They won’t be able to have private patients under the new contract but instead will have to devote their full attention to public work.

This won’t affect the conditions of employment enjoyed by the present consultants, nor will it reduce their income in any way, but they’re not a bit happy. They don’t want their money-making system changed, and they’re not used to being questioned.   You see, Irish consultants have a great set-up, whereby they get a salary from the government and can also treat private patients in public hospitals, using theatre facilities, laboratories and hospital beds provided by the taxpayer. Not to mention all the nurses and junior doctors, also paid for by the taxpayer. On top of all that, many of them behave like arrogant strutting demi-gods, as we saw for instance in the Neary scandal.

They like it that way, and who could blame them?

I had a look around and, as far as I can establish, these are the only group of public-service workers entitled to this kind of working arrangement. As far as I’ve been able to find out, all other professional groups within the civil service and in local councils are barred from doing private work. Lawyers, engineers, veterinarians, architects and a host of others are all explicitly barred from working privately in their own profession.

When you walk into an Irish hospital, you can choose to be a private patient or a public one, and it is a festering scandal in this country that, if you walk into a publicly-funded hospital and choose to go private, you will get faster treatment in the hospital and better attention from the consultant, because you can pay. This is true and it’s a disgrace.

Did you know that in Ireland, by law, there’s a universal entitlement to free healthcare, regardless of whether you have private health insurance or not? And yet, everybody entering an Irish hospital is asked if they have insurance, and if the answer is yes, they’re automatically routed into the private channel.

The Comptroller and Auditor General recently published a report into all of this. He concluded that, even though hospital consultants have, by agreement with the government, a right to use up to 20% of hospital beds for their private patients, they routinely take more. Likewise, they refuse to account for their hours of work though – depending on their category – they receive between €140,000 and €180,000 a year to attend work.   In addition, for their private work, they get all the back-up services available at the hospital, paid for by you and me, including staff to work for them.

Now, I know I made this comparison before, but just let me say it again. It’s the very same as if you walked into your local Council, and you said to the planner: I want to build a house.

The planner looks back at you and says, OK, but you’ll have to wait two years. I’m busy.

So you say, But I can pay!

And the planner takes a step backwards. Why didn’t you say so? Come into my Council office here and I’ll get a Council technician to draw up the plans for you. We’ll print them out on the Council’s printer and you’ll have permission tomorrow morning.

Seriously. Isn’t it exactly the same? And yet, any planner attempting such behaviour would be arrested.

There was an article in the Irish Times last Friday that I thought was very revealing of the sort of elitist condescending mindset at work among some of the medical profession in this country. An outraged sense of entitlement not unlike that of your average welfare scammer.

It was written by a guy called Ronan Cahill, described as a senior specialist registrar at Cork University Hospital.  He’s close to becoming a consultant himself, and no doubt he received all this training from my taxes and yours, but he’s not the slightest bit happy that the gravy train is about to come off the tracks. He thinks that the level of pay on offer won’t attract people to take up consultant posts in this country. Incidentally, the salary is in the order of €200,000 a year, and I heard one English-based consultant on the radio during the week saying it was better than the British rates, and better than many self-employed consultants in the USA could make.

But the real giveaway, I thought, was a nasty little comment embedded in the article where he remarked that the new contracts would prove attractive to clock-punching, detached, disengaged automatons whose ambition is levelled at achieving a reasonable monthly salary.

I had to read it twice to be sure I was right.

clock-punching, detached, disengaged automatons

Hold on. That’s me he’s talking about, isn’t it? And you. And nurses. And junior doctors. And technicians. And radiographers. And physiotherapists. And everyone else inside or outside the health service who holds down a paying job. The very people, in other words, whose taxes paid for Ronan’s training. This is a guy who regards just about the entire world with contempt and I have no doubt he’s a good example of his breed. No wonder he’s peeved: this man is clearly consultant material, in his condescending attitude if nothing else.

Ronan makes the point that exceptionally innovative, educated people – such as himself – won’t train to be consultants any more because the money won’t be good enough. All along, throughout his training, he expected to get the State salary and also have his own private income, and to be fair to him, you can see his point. There is a lot more money in the private work. He’s right.

Aha! I have it!!

Why doesn’t Ronan forget about the public work? Why doesn’t he just go off and work in a private clinic where the rewards are so much greater? That will solve his problem.

Oh! No, sorry, I was wrong. It won’t.

You see, then there would be no €200k from the State. No free beds. No free nurses. No free theatres. No free technicians. No free pathology. But worst of all, there would be nobody at the front desk to tell 20% of publicly-entitled patients that they have to go privately and pay Ronan a big pile of money. That’s what’s pissing him off, the miserable, grasping little prick.
And they accused the nurses of greed?


related article from The Bitter Pill

13 thoughts on “Irish Medical Consultants

  1. Greedy bastards………..then again, Mercs & Beemers don’t grow on trees you know.

    By the way, I’ve set up a Blog Consultancy. You’ll get to me at :

    1800 RAPE ME

  2. “clock-punching, detached, disengaged automatons” Yes that’s us and throw ignorant into the mix. Bock was it ever any different and we still haven’t got our act together. Still it’s nice to see (though I’m dead set against it as regards cheap labour) the open global market putting the squeeze on them: (demi) God’s more like.
    A decent days work for a decent day’s pay for white, black, yellow, aliens the lot. Decent minimum wages that you can live on for all. Y:-) Paddy

  3. Bock, I agree the consultants are being ridiculous. But the specialist reg is right about one thing. Right now with public + priv work these guys make serious money. For them 200k is a severe pay cut. Whether we feal it is a reasonable salary or not, why would they agree to a pay cut?

    You’ll be happy to know my latest article exponds on the greediness of consultants and their neglect of public duties.

  4. Bock, I love your pieces. Do you write professional, think it would make an amazing social commentary column in one of the papers.

  5. Derfen: Great plan. You should try and get a public contract for your new consultancy.

    Paddy: 220k is hardly cheap labour, no?

    Doctor Pill: It isn’t a severe pay cut for the eisting guys. They keep their present cotracts. And anyway, if public work is such an imposition, why don’t the disaffected guys simply restrict their practice exclusively to private work?

    Flirty: You found me out. Secretly, I’m a world-famous Pulitzer-prizewinning jopurnalist. I’m just pretending to be an obscure Irish blogger.

  6. Aparently 200k is mickey mouse money according to some consultants.So the taxes that we all pay without accountability is considered mikey mouse money.I for one would like to know that my taxes are getting a full days work from the consultants.

    Ireland has the best pay in the world for consultants apart from the USA where the consultants are self employed and do not have security of tenure and pension benefits comparable to our consultants. Romantic Ireland is truly fumbling in a greasy till.

  7. Excellent editorial Bock. My Father worked in the Mid-West health service in a professional role, (not a doctor), for over 30 years. He practically foams at the mouth, and has done so for years, when the subject of consultants comes up. His take is they ultimately ruined a decent medical system. Not so much by their greed but by their intransigence. They were utterly opposed to any changes.

  8. This is madness. I’m a Pulmonologist in Chicago in private practise. I earn around $250k per annum, but I do not make the kind of money your talking about (Euros as well)

    Where do I apply…


  9. Dear Bock,
    As a UCD Medical school graduate, a foreigner, who did in fact work in Dublin in the late 80’s, my move to the U.K changed my life. The awesome arrogance of some Irish consultants (most) was such a contrast to the supposedly arrogant Brits.

    As a graduate from St Vincent’s Hospital, I found the young Professors Niall O’Higgins and Mauris Fitzgerald 2 of the most inspiring people I have ever encountered. Moreover, I found all the medical school appointed professors in general the same ( appointed mind, not emeritus)

    Ireland is a country with marvellous people in it who deserve their reward and more. It also has the worst and many of them in high places. And , dare I say , many of the best leave. ( Ireland’s historical greatest tragedy) The medical profession has in it the very worst. I’ve mentioned 2 of the very best. I mention now 3 three of the very worst, most obnoxiously racist and despicable people I have ever met in my life (if I may – I absolutely don’t personally care if they sue me but I do fully appreciate that you operate under irish legal constrictions)! They are [names deleted — I don’t care if they sue you either, but I do care if they sue me].

    You know, the medical consultants overall deserve to be condemned for their greed. And yet, There are, I bet , an awful lot of good and decent people in their ranks still I’m sure times have changed in 20 years and booming Ireland is now gone greedy like the rest of the world.

    Scum, sadly, all too often in politics rises to the top. The greedy bastards are in control I guess. I do have bitter feelings but NOT towards the Irish people. The Irish tolerate too much and are abused for it.

    Solution. Tell the consultant authorities to fuck off, either politely or otherwise. Given their pay deal and conditions they will be replaced by better public service and private care providers from abroad in no time i.e their remuneration package is amazing to Brits, continental Europeans and even the yanks. They’ll flood in. Who looks the gift horse in the mouth? Sorted in months.

  10. PS
    I’m slightly confused by ‘Names deleted (understandable) and then ‘I don’t care if they sue you either, but I do care if they sue me.’ Correction. I don’t care if the three deleteds sue me. I’m living in a foreign country. I do appreciate that you are under the constriction of Irish law and I do respect that. I stand by what I said.

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