Irish Medical Organisation

Spending Review on Consultant Pay and Skills Mix 2012 – 2017

The key facts missing from the Spending Review Paper published today are:


  • There are over 500 vacant consultant posts in Ireland that are vacant or filled on a temporary basis
  • Almost half of consultant posts advertised by the HSE in 2018 received few suitably qualified applicants, or none at all      
  • We have the lowest number of consultants per head of population in the EU  
  • Our doctors continue to emigrate to health systems that pay substantially more and offer better supports and working environments
  • The consequences are that there are over 560,000 on outpatient waiting list and a further 200,000 patients waiting for in patient or day case procedure


The crisis in consultant recruitment is directly linked to the decision to slash pay for consultants employed after 2012, creating a   two-tier system of consultant pay here for the first time and which convinced a generation of doctors that there was no future for them here.  Doctors emigrated, job vacancies were ignored and waiting lists grew longer.  The disparity in pay between consultants can be up to €50,000 pa which is simply not fair or sustainable.

The Review published today acknowledges that there is a differential in salary of pre and post 2012 consultant appointments of 32%.  The paper also acknowledges that average salaries for consultants in Canada in 2017 were 27% above those in Ireland at that time and for the US, the figure was even higher with average salaries some 48% ahead of Ireland at that time.

Both the Taoiseach and the Minister for Health have stopped pretending that the two-tier pay system is not a direct factor in the waiting list crisis however neither has shown any willingness to resolve the issue despite their respective roles.

This latest analysis is nothing more than an attempt to undermine the crisis we have in our health services and distract from the very simple fact that we cannot recruit enough consultants to treat patients in a timely manner and that leads to negative outcomes for those patients.

The IMO is determined to end this crisis once and for and if Government don’t start to engage that will inevitably mean doctors are forced to take industrial action.

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