The Reilly File

Consultants pay has been highlighted in the Indo. The phony shock horror is laughable. Is it not obvious for decades that this is the case? I do not think that the top lawyers are worth more than many of the top medics. This used to be about relativities. Most of these doctors are internationally tradeable. Some of the people here are among the best in the world.

However in an era of national existential crisis, across the board leadership must be given.

Prior to his election to the Seanad, I asked Professor John Crown on Newstalk Radio to nominate a suitable annual income for a consultant oncologist in a western country like Ireland. After minutes of sophistry, he ducked and dived and avoided the bullet. Mark Coleman let his escape.

I am vastly entertained by Minister James Reilly’s reported quotes. As President of the IMO, did he never hear of the figure paid by the VHI annually to the consultant body? He must have known that there were a max of about 1,600 consultants in the state at that time. He must have known that procedurists earned the vast bulk of the money and that cognitive specialists such as neurologists and psychiatrists earned much less.

As a GP, he must have known the usual band of fees charged by GPs to private patients and the reputed earnings of his colleagues and himself. Must be a few bob there to be backing entrepreneurship!

In summary – my view is that some doctors are appropriately highly paid. They are worth it. Others are not. The question is what is appropriate in the new national dispensation? Shock horror from most politicians is a sham. The political class in this country has been less than impressive. There are national bodies all over the place. Standards in cardiology are quantified and published. They stand the test of comparison but there must be a readjustment now.

On the Pat Kenny Radio show in 1987, I said that one three cardiologists on £150,000 each per annum was better value for the Irish people that one on £450,000. This placed me outside the Pale in Medicine. Plus ca change!

Consultant earned €1m in 2010 from VHI patients

By Eilish O’Regan Health Correspondent
Saturday July 09 2011
A hospital consultant earned €1m in fees for treating patients privately insured by the VHI last year, new figures revealed yesterday.
The doctor, who is in full-time private practice with no state salary, is not named, but the highest earners are in the area of cancer, cardiac and orthopaedic care.
The figures revealed that more then 200 consultants with salaries of between €173,000 and €184,000 for working in public hospitals topped up their earnings with another €200,000 from the VHI. Of these, 10 earned more than €600,000, with three getting between €750,000 and €800,000.
Health Minister James Reilly hit out at the scale of the earnings.
“I am not satisfied that any consultant should be paid €1m in a single year,” he said. “This level of remuneration is grossly out of step with most ordinary people’s expectations.
“I am also dissatisfied that a number of other consultants earned enormous sums from the VHI, and no doubt to a lesser extent from other insurers, in recent years,” he added.
He said the Government was committed to reviewing costs in the private health insurance market to identify where savings could be made.
The professional fees paid by the VHI to consultants are expected to cover the cost of the procedure or service plus the doctor’s rooms, professional indemnity insurance, practice nurse, secretary and sundry other practice expenses.
Slightly more than half (57.95pc) of both public post and private practice consultants were paid less than €50,000 by the VHI in 2010. The sums do not include earnings they received from insurers Quinn Healthcare and Aviva.
Consultants are obliged to confine their private practice work to between 20pc and 30pc of the workload, but several are still breaching this limit and in some cases are reaching 50pc.
The figures were released in a parliamentary reply to Labour TD Kevin Humphreys, who branded the figures shocking.
“This highlights the need for health service reform at the top,” he added.
The VHI drew fire this year when it increased its premiums for customers by up to 45pc.
A spokesperson for the company said yesterday: “We have reduced the average cost of procedures by 15pc since June 2009 and we estimate that in 2011 the payment will be €52m below that in 2009.
“The average payout to a consultant in 2010 was €98,000; 70pc of consultants were paid less than €100,000 and 6pc paid more than €300,000.”
– Eilish O’Regan Health Correspondent