I was listening to an item on the news about a new report from the Comptroller and Auditor General. This report is about hospital [tag]consultants[/tag], or more particularly about whether we’re getting value for money from them. A very topical matter indeed in this country.

I googled it and and found the report, entitled Medical Consultants Contract.

Here’s an extract:

General Finding

The failure to evolve and implement a model that integrates responsibility for resources, activities and outcomes was a factor that contributed to the failure to activate the key terms of the 1997 contract in regard to monitoring commitments and clinical audit.

Overall, any new contractual arrangements need to specify the administrative and governance changes that are required to achieve effective implementation and be underpinned by a change management drive. Moreover, it would be desirable that the arrangements provide for a verification process to ensure that the agreed change envisaged is delivered in accordance with action plans tailored to the circumstances of individual hospitals.



The really depressing thing is that the report probably contains a lot of valuable information, and I’ll have to wade through this kind of lazy shit writing to find out what it says.



Tribunal Lawyers’ Fees (and Hospital Consultants)

So the lawyers aren’t going to suffer a crippling reduction in fees after all. What a relief.

It looked for a while as if they were going to be forced to manage on a measly €1,000, but no.  Common sense prevails and their fees remain at a richly-deserved €2,500 per day.

Now, I know that some begrudgers are saying uncharitable things about the fine fellows who struggle by on this pittance.

Bah! say I. Year after year, at the Planning Tribunal, these splendid intellects have toiled away for a paltry  €650,000 a year in the service of the Nation – as fine an act of patriotism as you will ever see. Foresaking the thrill of going out and competing for work, they have instead chosen the dull and unglamorous drudgery of the Tribunal, with the dreary boring sound of its week-by-week cheque for €12,500 flopping onto the carpet. Oh Jesus, you can hear old Tribunal lawyers groan, Not another fucking €12,500 cheque for me to lodge.”

I feel their pain.

Quite properly, they point out that they gave up the chance of earning far higher fees to work at the Tribunals. True. I had the same experience. By taking a day-job, I gave up the chance of becoming a Texan oil-billionaire.

Now, don’t get me wrong. I wish the lawyers the very best, and I certainly wouldn’t want to seem churlish, but there’s one thing I can’t help wondering: as the Tribunals are not courts of law, why do they need to be run by lawyers? If they’re looking for people with a high level of professional training and administrative skill, why not consider other professions? Can accountants not read and speak? Or geologists? Or physicists? What about union negotiators? Architects? Doctors?

Oh. Now don’t get me started on that.

All right, then. Go on.

Hospital consultants. Now there’s another crowd of fine individuals, for sure and certain.

These are a bunch of guys who want to have a contract to work as public employees, including a guaranteed salary, pension and all the rest, which is fair enough. But they also want to be able to run a private practice, and why not? I can see how there would be no conflict of interest at all there. That’s why, here in Ireland, you can just walk into any hospital and say I’m sick – fix me, and they’ll ask you if you’re a private patient or a public patient, but it won’t matter. You’ll receive instant attention either way, isn’t that right? Not like in that parallel Ireland invented by the media where you walk into a hospital and they ask you if you can pay, and you say no, and they tell you to come back when you’re dead. That was all made up by commies in the media, wasn’t it? And consultants won’t put you to the top of the list just because you can pay them. Of course not. And they don’t have the use of facilities already paid for by you in your taxes – do they? Oh Jesus no. They pay for the whole lot. Of course they do.

It’s just like when you walk into your local Council, and you meet the planner and you say

I want planning permission for my bungalow.

And the planner says Fuck off!!

But I can pay, you protest.

And the planner takes you by the elbow. Why didn’t you say so? Come in here to my consulting rooms paid for by the public, and I’ll draw up your plans on the computer bought out of your taxes and it’ll all be sorted out by the morning for you and don’t worry one bit. Would you like a coffee while you’re waiting?

That’s right. Nobody would mind that, would they? Of course not. And that’s why we allow hospital consultants to do the same thing.


The Top Man in His Field

Did you ever hear people saying that?

Oh, yes. Indeed. You see, I had a little twinge. Nothing really, but it’s best to be on the safe side, so I went to see Mr Fachtna  Ó Féileacháin. I believe he’s the top man in his field. Oh yes.

Is he now? The top man? The very best?

Ok. I see. So there’s a load of fuckers not as good as Fachtna “ Fucking Féileacháin, but you’ll pay them just as much. I never heard anyone say, I had a bunion and I went to Conrad Plingebattery. I believe he’s the second-best in the whole country for bunions. Did you ever hear anyone saying something like that? Of course not. What a load of fucking shite. Either you can cure stuff or you can’t. The end. Did you go to college? Did the tax-payer pay for it? Did you learn what they taught you there? No? then fuck off – you shouldn’t be a doctor. Are you making a huge pile of dosh? Right. Then fix my fucking bunion.

I also never heard anyone saying I had a terrible effluxion and I went to Tarquin Windsor-Murphy. He’s the bottom man in his field, you know.