Industrial dispute not just about pay, locum doctors say

Locum doctors who failed to report for duty this week after their salary was cut say their dispute is about much more than pay.

A lack of training and career progression opportunities for non-EU doctors was the most often mentioned grievance when The Irish Times met a group of those involved in the action.

Some said they had worked for years as Health Service Executive junior doctors without any chance of obtaining a training post before opting to work as self-employed staff providing services through locum agencies.

The doctors said many locums received only a few days’ notice of the cut in their hourly pay rate from €40 to €34 from September 1st. One said he was “only told last Friday” while another said he got an email “a week ago”.

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Up to 20 locum doctors did not report for work this week, according to the HSE, putting pressure on emergency departments in a number of hospitals. On Wednesday, the HSE said the dispute was causing “minimal” impact on service delivery.

The doctors denied they were on strike and said descriptions of their action as “wildcat” were insulting. “We are self-employed and we have always had the choice whether to accept or reject a job. We are not obliged to accept a post,” one pointed out.

The group declined to be identified or photographed and asked that the location of their meeting not be disclosed. All hail from developing countries and have been working in Ireland for periods ranging up to a decade.

Training posts

Many would be ineligible for training posts that lead to consultant positions because these go to doctors trained in the European Union.

“The pay cut was the final blow, but it’s about much more than that,” said one man, who said he chose to work as a locum because he had no chance of career progression as a salaried doctor.

“We are the backbone of the system, the ones doing the hard work,” said another man. He gave the example of being asked at 7pm one evening to work the following morning in a hospital two hours away from where he lived. “You just do it.”

Doctors were also angry that the biggest cuts were imposed on junior doctors, whose rates were reduced by 16 per cent. In contrast, they said, the rate for locum registrars dropped 10 per cent and those for locum consultants by 5 per cent.

As self-employed contractors, they have to pay for their own accommodation, fuel, etc. “In the UK, the hospital would provide me with a bed for minimal cost. Here I stay in a B&B which I pay for,” said one doctor.

Although the group welcomed the focus on their issues that followed this week’s action, they seem unsure what to do next and who to talk to. Many are also registered to work in the UK and may consider moving there.

This week’s action arose out of discussion on social media groups among locum doctors employed in Ireland.

While the impact of their action has been less than was feared at the start of the week, this may be due to the fact that many of the locums were on holidays due to Muslim religious festivities.