Sir, – Your proposed solution to the lack of provision of Non Consultant Hospital Doctors (NCHD), to further reduce consultant remuneration is regrettably flawed (Editorial, July 11th). Such an action would provide a significant disincentive to emigrating NCHDs from returning to Ireland.
Your proposal is perhaps based on a misconception that consultants receive remuneration in excess of their international colleagues. This is not the case. For example, in the UK a merit award system available to NHS consultants, can add up to €80,000 to their basic pensionable salary. One might interpret the UK system as having junior consultants who then receive financial incentives related to productivity and performance.
We can learn from this, in relation to the current medical staffing crisis. There is an argument to develop an alternative grade to the existing highly trained consultant grade, in order to meet the current service delivery problems. Such a medical doctor emerging from existing training programmes would be eligible for specialist registration and be competent to provide service at a senior level. Reimbursement would be based on the extent of experience at a level below that of the recently deployed consultants’ contract.
The title of this entry level position might be “junior consultant, or associate consultant”. Career progression would follow by securing a consultant appointment with the additional managerial, leadership and research responsibilities, as is currently the case.
Such an initiative would provide service in a cost-effective manner by removing the reliance on NCHDs. – Yours, etc,