So why wouldn't you just go to the USA today if it's such a better deal, sounds like you are going to go? Seems like it would not be possible to incentivise it more...
It could be 5 years in public hospital or 10 years working in the state (public or private), each year worked in Ireland takes 10% or 20% off the balance.
I wouldn't single out medical students per se, but anyone whose training has cost the state > €100,000 and there is a shortage of qualified people in that area should have some sort of clawback.
Just looking at energy costs …
My electric usage is low but when standing charges, levies and taxes are added it makes a considerable difference.
For instance, on one bill the charge for usage was €49.66, when the above are added it became €99.71 or an additional 50%.
In another bill the charge for usage was €15.11, which became €63.11 or an additional 76% after add-ons.
Well it seems contradictory to environmental principles that the less energy one uses, the greater the percentage of additional charges.
the green lobby don't care as long as it means more for them. Sorry to be so cynical but the greens are a new movement, that fact that they are so encrusted with special interests is depressing.
Not too hot on the maths there.
According to your link the reasons they were contemplating emigrating were "career opportunities (85%), working conditions (83%), and lifestyle (80%)."If you don't believe the unions, have a read of a recent paper from Irish medical schools: https://human-resources-health.biomedcentral.com/articles/10.1186/s12960-015-0003-9
Doctors emigrate because they are paid better abroad, have better working conditions, and are treated better. The same for nurses. If you ask them to pay back fees, you will just be encouraging them go to Aus or NZ or USA or Canada where they will finish their training more quickly and be better paid at the end of it.
According to your link the reasons they were contemplating emigrating were "career opportunities (85%), working conditions (83%), and lifestyle (80%)."
GP's in the UK earn between £55,000 and £80,000. That's according to the NHS website.
According to the Competition Authority "fourth training years in GP practices, trainees' salaries are pegged to hospital registrar pay rates and continue to be paid by the HSE. With allowances, these pay rates can vary from €71,900 to €82,400."
According to the same report "The Competition Authority report also shows that GPs in Ireland earn an average of €220,000 a year from treating medical card patients." [broken link removed]
The reality is that Doctors and Nurses and other health service employees, be they "professionals" or just mere mortals, are as much part of the problem as anyone else. Instead of trying to fix the dysfunctional system they just look for more money to work in it.
Now if they can just stop telling lies about what they get paid and also get the Consultants who spent a decade and a half obstructing reforms which would improve patient care and earn hundreds of thousands a year crying crocodile tears about waiting lists and a lack of resources.
Okay, so 4th year trainee GP's are getting over €60,000 a year.The numbers you quoted are from 2009. There have been several changes in the payscale since. The current pay for GP registrars is: €61,404 - €65,920, including allowances. It was even lower until this year. So in fact trainees have taken a €10,000 - €20,000 pay cut, which undermines your argument completely.
Are you seriously suggesting that someone who has been a qualified surgeon for 10 years is earning €68,000 or €8000 a year more than a trainee GP? Will ya go on out'a that!Is paying a surgeon with 10 years experience a salary of €68,000 exorbitant? What job do you think would deserve that money?
This thread is about fees. My point is that doctors are very highly paid. You said that they are emigrating due to low pay. I pointed out that those who are thinking about emigrating are not doing so due to pay.According to your quote from my source above, you can see that doctors are actually looking for better career opportunities, better working conditions, and better lifestyles... which betrays your argument about money?
No, the average payment per consultation for GMS patients is higher than the average payment for private patients when all of the hidden payments that GMS dostors get are taken into account. The figure of €220,000 I quoted is for GMS payments only. Income from private patients is in addition to that.You quoted UK GP earnings previously, but those are salaried GPs who are bottom of the scale, they are not GP partners who are on around £100,000. In Ireland, GPs are not HSE employees, they are effectively private contractors with small guaranteed income, relying on private patients for the rest.
Okay, so 4th year trainee GP's are getting over €60,000 a year.
Are you seriously suggesting that someone who has been a qualified surgeon for 10 years is earning €68,000 or €8000 a year more than a trainee GP? Will ya go on out'a that!
I know a GP working in Ireland with no GMS list who gets paid more from the HSE than here sister who is a NHS GP in Wales.
Irish doctors are very well paid relative to their UK counterparts. The system they work within is dysfunctional. I would suggest that resources should be put into fixing the system rather than paying people more to work in the current one.
This thread is about fees. My point is that doctors are very highly paid. You said that they are emigrating due to low pay. I pointed out that those who are thinking about emigrating are not doing so due to pay.
No, the average payment per consultation for GMS patients is higher than the average payment for private patients when all of the hidden payments that GMS dostors get are taken into account.
GP's don't even do out of hours house calls any more; if you call a GP to come to your house at 8pm because your elderly mother has a throat infection you could wait for 2 or three hours only to get a proctologist to your door.
There. The average payment to GMS doctors per patient visit was €65. The report also cites the feminisation of GP services and the resulting increase in part time work; female GP's are far more likely to work short hours. Cuts in recent times may have reduced that gap slightly as GP's "just happen" to increase their fees for private patients in order to maintain their income.What is the source for that?
You don't even have to be a qualified GP to work as a GP! You do need to be qualified to get a GMS list. Any qualified doctor can work for an out of hours GP service.Is there any evidence for any of this? It sounds like opinion. You are claiming no GPs do out of hours - can you link to this?
I was quoting your source. It shows that over 80% of doctors who were thinking about leaving (lost think about it, very few do it) money wasn't an issue.No, your quote only shows that pay is not the only issue. It is part of the problem. Regardless of the reasons for doctors leaving, the fact is they are leaving and posts can't be filled, which then pushes up costs.
No, the GP's who do not have a GMS list still get a very large amount of their income from the HSE. In the case I know personally the income from the HSE for the Irish GP with no GMS list was higher than the total income of the UK based GP. I can't say that's universally true.Exactly, if they have no GMS list then they are fully private and not salaried, so why are you comparing 1 private GP in Ireland with 1 public GP in Wales?
You keep saying Irish doctors are very well paid, but what is that based on? There are 7,000 trainess in Ireland alone across 57 different specialties - do you think each one is well paid? I would like to see real data.
There. The average payment to GMS doctors per patient visit was €65. The report also cites the feminisation of GP services and the resulting increase in part time work; female GP's are far more likely to work short hours. Cuts in recent times may have reduced that gap slightly as GP's "just happen" to increase their fees for private patients in order to maintain their income.
You don't even have to be a qualified GP to work as a GP! You do need to be qualified to get a GMS list. Any qualified doctor can work for an out of hours GP service.
I was quoting your source. It shows that over 80% of doctors who were thinking about leaving (lost think about it, very few do it) money wasn't an issue.
The fact that they are leaving is not the reason posts can't be filled. Posts can't be filled because so many doctors can make a great living working part time so two GP's are doing one job and because of the dysfunctional system they helped to create and help to maintain.
No, the GP's who do not have a GMS list still get a very large amount of their income from the HSE. In the case I know personally the income from the HSE for the Irish GP with no GMS list was higher than the total income of the UK based GP. I can't say that's universally true.
Why not fix the problem instead of permanently treating the symptoms?
Are you suggesting that their income has dropped to a level at which they are now below the incomes of their UK counterparts? The FEMPI cuts to GP's were an average of 7.5% and yet the NAGP come out with "cuts up to 38%". At best that's a misrepresentation of the facts, or a lie as us plebs call it.That report is from 2010, and the data is 2008. Almost 10 years ago. Since then there have been FEMPI cuts (2009 onwards), including a significant decrease in GP and pharmacy fees, as well as decreased weighting for seeing patients over 70 (who tend to need more time and resources). So the figures you are quoting are out of date and out of context. There is also no detail there, just 1 mention of an average, no breakdown. Do you have anything up to date and relevant?
My point is that GP's, along with Hospital Consultants, want it both ways; lavish pay but outsource the heavy lifting to someone else.I don't know what point you are trying to make re: out of hours care. Again, have you any source that says qualified GPs are no longer doing out of hours cover? And how does that affect fees? Surely if any doctor can do it, it would decrease cost through competition?
Yes, but not a main factor. You do know the difference between thinking about something and actually doing it? I often think about losing weight, training to run 10k or taking up karate again. I don't do it though.Indeed you were quoting my source, that wasn't the problem, the issue is your misreading of it. If you read the full paper, 65% state that pay is a factor.
Yes, but they include the non-Irish doctors who trained here but never intended to stay here. I can't find figures on what percentage of students in TCD, RCSI, UCD etc are foreign but my experience 20 years ago was that in TCD the class was over one third foreign students who were never going to stay here. When the RCSI present the emigration figures without that caveat they are at best misrepresenting of the facts, or lying as us plebs call it.You say very few emigrate but the recent RCSI report highlights it as an issue and states that emigration is rising among doctors aged 25-34.
Because of the dysfunctional nature of the medical industry.You say that posts can't be filled because people are going part time. If it's a great and well paid job that everyone should want, why were they unable to recruit enough trainees to start the scheme this year?
Smear tests, Prenatal examinations, vaccines, postnatal examinations and all the other schemes that the HSE pays for which are delivered through GP's.How are they getting that income from the HSE? Can you give specifics?
There is no big answer; there are thousands of small answers. It would be great to see Doctors unions and Nurses unions (sorry, Professional bodies) offering solutions that don't center around their own pay or taking more money from the public to try to fill the bottomless pit..What is the solution?
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