By Gary Culliton.
Senior emergency medicine (EM) doctors have demanded partly private practice Type B consultant contracts before they will take up lower-salary new-entrant consultant posts or operate the Croke Park flexible work practice arrangements.
At a meeting on October 20, over 60 emergency medicine doctors who are on higher or basic training schemes overwhelmingly voted not to accept the mooted conditions for new consultant posts. “What is coming down the tracks over the next year is cataclysmic,” said Irish Association for Emergency Medicine (IAEM) Secretary Mr John McInerney. “The changes proposed by the employers are disproportionately antagonistic to the viability of emergency medicine as a career.”
The doctors have demanded equality of access to private practice, which would put them on a par with other specialties. “We will see mass resignations from the training schemes in early January and a drop-off in applications for the training schemes,” said Mr McInerney. “Some consultants will be enticed abroad. This is the death knell of our specialty, unless there is a volte-face by the Government.”
Emergency department (ED) closures after Easter now appear likely, he warned: “Large hospitals will not have enough specialist staff to run EDs 24/7.”
Distances have a huge impact on patient care and the consultant in emergency medicine at the Mater predicted the closure of a major ED in the West within the next six-to-12 months due to a lack of senior decision-makers. This, he suggested, could be at Galway, Sligo, Limerick or Letterkenny, with Waterford also vulnerable.
Currently, new Type B contracts are not allowed for emergency physicians, who are restricted to Type A public work-only contracts. The trainees in the specialty argue that a new emergency consultant taking the 30 per cent wage cut should also be able to do private work in their hospital and potentially “earn an extra €50,000 to €100,000 from this practice”.
The EM trainees have said they “will not accept contracts that are not equal in terms of working conditions” with other acute consultants, suggested the IAEM Secretary. Huge dismay over the prospects for emergency medicine and the looming “closures of large EDs” was expressed by 66 public contract consultants and more than 60 trainees at the meeting, which followed last weekend’s IAEM Annual Conference.