Sunday 19 November 2017

Even Norway's medical elite can only dream of our docs' whopping wages

This week's revelations of golden handshakes worth over €400,000 and six-figure pensions did nothing to thwart consultants defiantly battling changes to their work rosters aimed at slashing waiting lists and giving patients greater access to out-of-hours care.

These lucrative lump sums and pensions were paid to 35 retiring consultants last year, costing the Health Service Executive approximately €10m on top of their annual salaries, which can be in excess of €200,000.

Despite the huge burden on the health service, consultants claim any slashing of such benefits and stellar salaries could spark an exodus of senior doctors abroad, even though the excessive earnings of our hospital elite are the envy of many other healthcare systems.

The Government has proposed a 30pc reduction to the salary of newly recruited consultants, which will see their pay fall to the far-from-paltry sum of €116,000-€121,000. Under the proposals, those already walking the wards will maintain their basic annual wage of between €147,000 to €200,000.

Not surprisingly, such whopping wages come as something of a shock to many of their continental counterparts, including consultants working in Norway's sleek Scandinavian healthcare system, considered by many as a role model for the rest of the world.

"I think most consultants in Norway could only dream of making that type of money," says Ivar Skjåk Nordrum, senior consultant in surgical pathology at St Olavs Hospital. "I don't think any in Norway would be on such a substantial salary. It would be considered very high. The basic salary here for senior consultants is equal to around €100,000."

However, when it comes to the take-home pay of many Irish consultants, the apparent 'pay ceiling' of €200,000 is just the tip of the iceberg. Consultants here also receive on-call, call-out and continuing medical education payments, while clinical directors are handed an extra €46,000 in allowances.

The result is that over 500 consultants are earning in excess of the €200,000 pay cap. And this is before they jump on board the private-practice gravy train.

Things are dramatically different in Norway, a country with a similar population size to Ireland.

"While some senior consultants can earn up to 1 million NOK (€135,000) when on-call time and extras are included, the beginner's salary is closer to 500,000 NOK (€67,500)," says Steinar Westin, professor of social medicine at the Norwegian University of Science and Technology.

Although Norway's consultants can boost their pay by double-jobbing in private hospitals, this practice is nowhere near as lucrative as in Ireland.

Norway's private hospital sector only provides around 1pc of hospital beds, according to the OECD, compared to 38pc in Ireland.

But despite their comparatively modest earning potential, consultants in Norway are rarely on a collision course with their government when it comes to pay. "Consultant salaries are no major question in Norway these days," says Professor Westin. "Frustrations are about hospital leadership, merging of hospitals, growth of bureaucracy, clash of cultures, locations and issues like that, but not salaries."

And while the difference in pay between consultants in Ireland and Norway is significant, the gulf balloons when a comparison with what the average worker earns is taken into account.

The OECD's Health At A Glance 2011 report, which compared a consultant's pay to the average wage, found that in Ireland the ratio was a whopping 4.5 compared to Norway's more meagre 1.8.

In fact, almost no one beats the Irish when it came to state-salaried consultants. Only in Mexico was there a bigger gap between the average wage and the earnings of the highly-paid hospital professionals. Out of the 23 countries, only self-employed consultants working in the private sector in Germany, Canada and the Netherlands did better.

Such statistics means the healthcare system in Ireland is a highly attractive proposition for international consultants, especially if their Irish counterparts were to decide to seek their fortunes elsewhere.

'Trained consultants who speak languages are more than willing to move to other countries, and are seeking the opportunities to move," said the owner and manager of Doctors Abroad, which offers Hungarian healthcare professionals employment opportunities in foreign countries. "An estimated 1,000 of our doctors leave every year. In fact, we have placed 62 in Ireland in the first half of 2012."

So while Irish consultants argue that new working conditions and salaries will force the best and the brightest abroad, the medical recruitment sector isn't exactly expecting an avalanche of enquiries.

"We had given up a long time ago pushing to recruit Irish consultants for placement abroad," says Ann Griffin of Professional Connections, a specialist medical recruitment agency. "It was just a waste of time because their salaries in Ireland are just so astronomical.

"When we are placing professionals in foreign healthcare systems, they are looking for the crème de la crème and we always pay to get the best. So when it came to Irish consultants, it just wasn't worth our while. And I honestly don't think any new pay cut is going to greatly affect that."

Indo Review

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