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 Post subject: Re: protected professions
PostPosted: Tue Jun 21, 2011 5:31 pm 
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initech2 wrote:
Ardillaun wrote:


Given the straitened circumstances the country finds itself in, I would suggest:

1. Defined contribution pension plans for all doctors.
2. A review of procedure rates – some of these should be put out to tender.
3. Training for specialists should take 5 years from graduation, maybe 6 for surgeons and 2 years for GPs. It’s not that complicated.
4. Reduce consultant pay and create more positions - make the structure more cylindrical.
5. Reduce job security. Consultants should be appointed for 5 years and then have to reapply for their jobs.


May I suggest 2 more

6. Graduate more doctors, which should have the benefit of increasing supply of the service and create price competition within it.

7. Relieve the IMO of the function of regulating the medical profession. Self regulation has not worked, either in relation to quality or cost.



There are plenty of doctors graduating. Unfortunately we are unable to hold on to them in hospital medicine due to better training, hours/conditions and long term prospects abroad.

The IMO is a medical trade union I think you are mixing this up with the Irish Medical Council (which incidentally has a lay majority)


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 Post subject: Re: protected professions
PostPosted: Tue Jun 21, 2011 5:59 pm 
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drochfhiach wrote:
initech2 wrote:
Ardillaun wrote:


Given the straitened circumstances the country finds itself in, I would suggest:

1. Defined contribution pension plans for all doctors.
2. A review of procedure rates – some of these should be put out to tender.
3. Training for specialists should take 5 years from graduation, maybe 6 for surgeons and 2 years for GPs. It’s not that complicated.
4. Reduce consultant pay and create more positions - make the structure more cylindrical.
5. Reduce job security. Consultants should be appointed for 5 years and then have to reapply for their jobs.


May I suggest 2 more

6. Graduate more doctors, which should have the benefit of increasing supply of the service and create price competition within it.

7. Relieve the IMO of the function of regulating the medical profession. Self regulation has not worked, either in relation to quality or cost.



There are plenty of doctors graduating. Unfortunately we are unable to hold on to them in hospital medicine due to better training, hours/conditions and long term prospects abroad.

The IMO is a medical trade union I think you are mixing this up with the Irish Medical Council (which incidentally has a lay majority)


At least some of those graduates leaving have paid for their own medical education via the Graduate Program ; hopefully they'll cotton on and apply appropriate fees across the board


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 Post subject: Re: protected professions
PostPosted: Tue Jun 21, 2011 6:15 pm 
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drochfhiach wrote:


There are plenty of doctors graduating. Unfortunately we are unable to hold on to them in hospital medicine due to better training, hours/conditions and long term prospects abroad.

The IMO is a medical trade union I think you are mixing this up with the Irish Medical Council (which incidentally has a lay majority)


I recognise the correction in relation to the IMO and IMC.

I also recognise that the IMC has a lay majority, 12 medical members versus 13 non-medical members, appointed by (list is not exhaustive); the Minister for Health and Children, Health and Social Care Professionals Council, Independent Hospitals Association of Ireland and the HSE. This has been the case since 2007 only. I would submit that the there is still defacto self regulation through regulatory capture of this agency [1].

If you are unable to hold onto a sufficient number of doctors, then there are not sufficient numbers graduating. The solution would be to graduate more doctors. The same retention rate from a suitably enlarged pool would have the effect of; retaining an adequate number within the hospital system, reducing the workload (improving the hours and conditions) on those who remain within the hospital system, increasing the number of doctors within Ireland to closer to European norms [2].

This would hopefully also have the effect of increasing competition within the GP system which, in theory, should provide for better access to service and better outcomes, which is what it is ultimately all about.

[1] http://www.irishtimes.com/newspaper/ireland/2011/0601/1224298207189.html

[2] Czech Republic: 3.5 per 1,000 people 2003
Austria: 3.4 per 1,000 people 2003
Germany: 3.4 per 1,000 people 2003
France: 3.37 per 1,000 people 2004
Portugal: 3.3 per 1,000 people 2003
Sweden: 3.3 per 1,000 people 2002
Ireland: 2.79 per 1,000 people 2004


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 Post subject: Re: protected professions
PostPosted: Tue Jun 21, 2011 9:25 pm 
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I get the impression that although the number of students in the irish medical schools has increased over the years, the ratio of overseas students to irish students has increased. Many of these overseas students will leave immediately after graduating.

As a number of people have posted above, the ratio of junior doctors to consultants is very high and as a result there just aren't enough irish doctors to fill all of the posts. In the past many of these junior doctor posts were filled by doctors graduating in India, Pakistan, Egypt Libya and the Sudan. Recent changes in allocation of work permit to extra EU doctors has made it difficult to recruit to many junior doctor positions.

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 Post subject: Re: protected professions
PostPosted: Wed Jun 22, 2011 12:40 am 
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Enoch Root wrote:
I get the impression that although the number of students in the irish medical schools has increased over the years, the ratio of overseas students to irish students has increased. Many of these overseas students will leave immediately after graduating.


Thirty years ago, there would have been about ten foreign nationals out of a class of 150 in UCD. That must have increased at least 6-10 times.


Quote:
As a number of people have posted above, the ratio of junior doctors to consultants is very high and as a result there just aren't enough irish doctors to fill all of the posts. In the past many of these junior doctor posts were filled by doctors graduating in India, Pakistan, Egypt Libya and the Sudan. Recent changes in allocation of work permit to extra EU doctors has made it difficult to recruit to many junior doctor positions.


I believe that reducing the training time and increasing the number of permanent posts might encourage more grads to stay but it's hardly the easiest time to tinker with the system.


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 Post subject: Re: protected professions
PostPosted: Wed Jun 22, 2011 11:53 am 
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Coming late to this thread but I sincerely hope OPTICIANS and PHARMACISTS are listed as protected professions.

As regards the latter.........you hand in your prescription and you pay whatever you're told. So much for price display, shopping around, consumer choice XX

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 Post subject: Re: protected professions
PostPosted: Wed Jun 22, 2011 1:34 pm 
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Prescription drug prices are set by the Government.


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 Post subject: Re: protected professions
PostPosted: Wed Jun 22, 2011 1:36 pm 
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Tyler wrote:
Prescription drug prices are set by the Government.

:roll:


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 Post subject: Re: protected professions
PostPosted: Wed Jun 22, 2011 1:42 pm 
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Who do you think buys the vast majority of medicines in Ireland - it ain't private prescription patients.


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 Post subject: Re: protected professions
PostPosted: Wed Jun 22, 2011 2:33 pm 
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Tyler wrote:
Who do you think buys the vast majority of medicines in Ireland - it ain't private prescription patients.



I hate to quote the Irish Times Letters page but there was a good example of an auld wan who kept getting refills of her prescription though there was plenty left in the tube of ointment ; the 50c charge (or whatever it was) meant that she copped herself on. NOw they're getting rid of this modest charge though the vast majority of people can afford it...


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 Post subject: Re: protected professions
PostPosted: Wed Jun 22, 2011 4:51 pm 
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slasher wrote:
Tyler wrote:
Who do you think buys the vast majority of medicines in Ireland - it ain't private prescription patients.



I hate to quote the Irish Times Letters page but there was a good example of an auld wan who kept getting refills of her prescription though there was plenty left in the tube of ointment ; the 50c charge (or whatever it was) meant that she copped herself on. NOw they're getting rid of this modest charge though the vast majority of people can afford it...



anything available for free to a person is treated by that person as having no cost/value

this even comes down to SW payments/Rent Allowance where certain lifestyle SW recipients cannot link they can only be paid these payments if people work and pay taxes and it isn't the Government giving them free money but fellow citizens taxes that allow it


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 Post subject: Re: protected professions
PostPosted: Wed Jun 22, 2011 5:05 pm 
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Government to ease restrictions on extra EU doctors to moderate the junior doctor shortage.

http://www.irishexaminer.com/ireland/dail-to-rush-law-on-junior-doctors-158599.html

Gerry Adams is concerned for patient safety. :roll:

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 Post subject: Re: protected professions
PostPosted: Wed Jun 22, 2011 6:12 pm 
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the Plank gave O'Reilly 40 minutes of media blowjob ( an easy ride if ever I saw one ) on Monday night to talk through that shite.

O'Reilly has wrecked the only working bit of the health service ( the NTPF ) because it's an IMO shibboleth to do so.

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 Post subject: Re: protected professions
PostPosted: Wed Jun 22, 2011 6:43 pm 
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initech2 wrote:

[2] Czech Republic: 3.5 per 1,000 people 2003
Austria: 3.4 per 1,000 people 2003
Germany: 3.4 per 1,000 people 2003
France: 3.37 per 1,000 people 2004
Portugal: 3.3 per 1,000 people 2003
Sweden: 3.3 per 1,000 people 2002
Ireland: 2.79 per 1,000 people 2004


Interesting data. It would be more interesting to look at numbers of doctors graduating relative to the population. We export an awful lot of doctors.

Watch the recent frontline episode. It is a problem retaining hospital doctors not producing them. 75% of the 5,000 current non consultant hospital doctors will leave Ireland due to a lack of long term prospects. This has been going on for years.


Ardillaun wrote:
I believe that reducing the training time and increasing the number of permanent posts might encourage more grads to stay


Spot on.


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 Post subject: Re: protected professions
PostPosted: Wed Jun 22, 2011 10:41 pm 
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Problem is not at junior level. Problem is at consultant level.
Simple maths-salary of one consultant is inversely proportional to no of consultants any health system can hire. We give almost double what they get in UK means we can afford almost half no of consultants that makes very few opportunities for junior doctors.
So, they leave the system and move on. Includes both Irish and overseas doctors.


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