Madam, - Your Editorial of January 31st, "Harney's medicine for the consultants", states: "When that issue [new arrangements for clinical indemnity] was resolved, talks broke down over the freedom of consultants to engage in private practice". Your assertion teeters precariously on the fine line between artistic licence and downright inaccuracy.
The negotiations of February 2006 broke down because the opening gambit of the HSE in those talks was to abolish one of the contracts the talks were supposed to renegotiate. Is there any other group of workers in the State that would have reacted differently to the consultants in the face of such a provocative approach? So predictably destructive has been this action that one wonders whether the intention ab initiowas to provoke consultants to walk away from negotiations, thereby allowing the simultaneous imposition of a new contract and the discrediting of existing consultants.
Ms Harney could then dangle a dripping, but expensively groomed, scalp in front of the electorate as belated evidence of her success as Minister for Health and Children.
Simon P. Kelly (January 31st) seems to want the Minister to impose a new contract so that he can get a consultant post in Ireland. He supplies a few paragraphs of interview rehearsal for good measure. Will his missionary zeal dissipate when he starts his consultant post, shiny new contract in one hand, briefcase in the other, only to be told: "Sorry doctor, no support staff, no junior doctors, no office, no clerical support, no theatre space and one only OPD session a month"? Even now, this is frequently the introduction of new appointees to consultant life.
At least crucial issues such as these, and other conditions important to those taking a job lasting 30 years or more, can be thrashed out in the context of negotiations. They can be ignored in an imposed solution. In the latter case, Mr Kelly's only consolation may be that his inevitable frustration won't be compounded by the "pressures and distractions of private practice".
Roderick Tyrrell claims that "all evidence points to the consultants' common contract being the root cause of the health service problem". Whatever the root cause, surely there can be no greater symptom of the dysfunction in the health service than patients not getting the service they need, when they need it. This is clearly illustrated in the recently reported cancellation of operations at St James's Hospital because of a lack of beds. Does anyone seriously believe that even one extra consultant on a new contract (never mind 1,500) would alter that situation, when existing consultants on their existing contract can't do their job because of bed shortages? Blaming consultants for the ills of the health service is easy and fashionable; and it might even garner a few votes. The real danger is that it allows other fundamental problems to fester, unchecked, in the background, to the ultimate detriment of patients.
Finally, Simon McGuinness decries "wealthy, educated doctors". He fairly spits those two adjectives. Could I suggest to him that, should he find himself consulting a poor, uneducated doctor, he might be wise to seek a second opinion?
- Yours, etc,
GARETH QUIN, Consultant in Emergency Medicine, Mid-Western Regional Hospital, Limerick.