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What is happening with hospital consultants?

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12 minutes ago, The Lurker said:

In fairness and in the interest of balance I should add that by employing locums we don’t have to pay them super-an or a pension on retirement so there is a saving there. 

But I’d say across the board for the senior roles all changing the pension scheme has done is put up direct employment costs by 25% or more which is a big reason for why they’re so much over budget constantly. They’re having to pay people under shorter term contracts to make up for the fact that few in their right mind want a full time job linked to a shit pension. Even less I’d say would want to take the risk of transferring their NHS benefits over to a scheme that’s pretty much screwed either. It’s not like you’re recruiting ill-educated people who won’t have looked at the integrity of everything before they accepted the job or demanded more money and a change to contract terms where they see stuff they don’t like. They don’t have to work here so we almost have to bribe them to come now. 

Edited by thesultanofsheight
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Does anybody else keep getting appointment cancellations and new appointment times sent to them? I may have enough to start a bonfire at this rate.

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I can remember nobles on westmorland road, a small site,  now the nobles site / estate / town / in Braddan is now the size of small town / city, what has changed for to become so big, and expensive to run and  maintain ?

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23 minutes ago, LightBulb said:

I can remember nobles on westmorland road, a small site,  now the nobles site / estate / town / in Braddan is now the size of small town / city, what has changed for to become so big, and expensive to run and  maintain ?

Ego's.

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We stupidly let too many old people come here to retire, to avoid inheritance tax, and having never paid a penny into the Isle of Man but they are now eligible for free health care for life and as they get older the cost skyrockets.

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1 minute ago, Howard said:

We stupidly let too many old people come here to retire, to avoid inheritance tax, and having never paid a penny into the Isle of Man but they are now eligible for free health care for life and as they get older the cost skyrockets.

Is there a Euthanasia unit at nobles ( probably splet wrong ), where we could reduce the manx liability  ?

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22 minutes ago, LightBulb said:

Is there a Euthanasia unit at nobles ( probably splet wrong ), where we could reduce the manx liability  ?

the whole place is one big euthanasia clinic with unwilling subjects.

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Few points to make on this topic. As all are aware I am a Noble’s consultant, but I’m not in the top 10 this thread refers to. 

Firstly, the consultant pay scale here is the same as the UK, broadly, except we have additional automatic progression through 20 points whereas in the UK the higher points have to be applied for based on other roles, the so called merit award system. This automatic progression is used as a selling point to attract applicants here, and in my view it’s not a bad thing. In the UK the people who get the awards are usually the ones who are never at the hospital because they’re on national committees etc. Here at least we’re paid for loyalty/longevity of tenure. 

The second point is job planning. Each consultant has a job plan which details how many sessions per week they work. The basic is 10 for full time, notionally 40 hours per week including some hours for continuing professional development. Most consultants here work more than 10, because we generally have fewer consultants than the colleges recommend. In my specialty, based on our population we should have 5 or 6 consultants. There are 4 of us. Paying 4 people to do the work of 5 or 6 makes sense for the employer as there are reduced superannuation contributions and in the future fewer pensions to pay. And pensions are based on the basic 10 sessions. This is one reason our salaries are higher than the UK where generally NHS trusts have pared things to the bone with everyone on 10. 

We’re also not comparing like with like. In the NHS consultants will do extra NHS work in the private sector, using the ‘choose and book’ facility the GPs there have. This salary will not be included in the NHS figures we’re comparing with. There are other things too which make the figures incomparable. In our top ten numbers, additional bank work is counted - this is when a colleague goes on leave and instead of paying for an external agency locum the work is kept in-house for additional pay.  Agency locums do cost a fortune, certainly in shortage specialties, but I don’t think Max’s 500K example is right. 

It does cost a lot to employ a consultant. I don’t know how much is right, but if we’re made public enemy number 1 and get accused of fleecing the NHS then I can guarantee recruitment, hard enough as it is, will get worse, and this will only increase the wage bill as more agency staff are used to plug gaps. As others have pointed out, market forces apply, and where people might like to think of the medical profession as Dr Kildare types doing it for the love of humanity, the reality is that the pressures and risks associated with the job are increasing and unless we’re paid well people won’t do it. 

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7 minutes ago, wrighty said:

Few points to make on this topic. As all are aware I am a Noble’s consultant, but I’m not in the top 10 this thread refers to. 

Firstly, the consultant pay scale here is the same as the UK, broadly, except we have additional automatic progression through 20 points whereas in the UK the higher points have to be applied for based on other roles, the so called merit award system. This automatic progression is used as a selling point to attract applicants here, and in my view it’s not a bad thing. In the UK the people who get the awards are usually the ones who are never at the hospital because they’re on national committees etc. Here at least we’re paid for loyalty/longevity of tenure. 

The second point is job planning. Each consultant has a job plan which details how many sessions per week they work. The basic is 10 for full time, notionally 40 hours per week including some hours for continuing professional development. Most consultants here work more than 10, because we generally have fewer consultants than the colleges recommend. In my specialty, based on our population we should have 5 or 6 consultants. There are 4 of us. Paying 4 people to do the work of 5 or 6 makes sense for the employer as there are reduced superannuation contributions and in the future fewer pensions to pay. And pensions are based on the basic 10 sessions. This is one reason our salaries are higher than the UK where generally NHS trusts have pared things to the bone with everyone on 10. 

We’re also not comparing like with like. In the NHS consultants will do extra NHS work in the private sector, using the ‘choose and book’ facility the GPs there have. This salary will not be included in the NHS figures we’re comparing with. There are other things too which make the figures incomparable. In our top ten numbers, additional bank work is counted - this is when a colleague goes on leave and instead of paying for an external agency locum the work is kept in-house for additional pay.  Agency locums do cost a fortune, certainly in shortage specialties, but I don’t think Max’s 500K example is right. 

It does cost a lot to employ a consultant. I don’t know how much is right, but if we’re made public enemy number 1 and get accused of fleecing the NHS then I can guarantee recruitment, hard enough as it is, will get worse, and this will only increase the wage bill as more agency staff are used to plug gaps. As others have pointed out, market forces apply, and where people might like to think of the medical profession as Dr Kildare types doing it for the love of humanity, the reality is that the pressures and risks associated with the job are increasing and unless we’re paid well people won’t do it. 

What is the difference between a surgeon, and a surgeon who is a consultant ?

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2 hours ago, LightBulb said:

What is the difference between a surgeon, and a surgeon who is a consultant ?

Surgeon = doctor who carries out operations. 

Consultant = doctor who has reached the highest level of qualification/registration by way of examinations and experience. 

There are surgeons, some of whom are the best in the business , who are not consultants. There are consultants who are not surgeons. 

Does this answer the question?

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On 9/21/2018 at 3:49 PM, Howard said:

Does anybody else keep getting appointment cancellations and new appointment times sent to them? I may have enough to start a bonfire at this rate.

The mental health people do that I guess, I don't think they are telling you to burn everyone though.

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43 minutes ago, wrighty said:

 

Does this answer the question?

He’s only rated at 5W, so not very bright - draw your own conclusion...

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25 minutes ago, Kipper99 said:

He’s only rated at 5W, so not very bright - draw your own conclusion...

5w led's are super bright :D

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@wrighty

Please stop bringing facts to these threads. The logged-in-to-Facebook public has had enough of listening to expert and / or informed opinion.

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Want to save money and lots of it?....easy.....kill all the old people.....Everyone over 70 gets killed....this would save hundreds of millions a year....probably.

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