Ms Susan Clyne:

Before I answer that question, I wish to refer back. We have seen the implementation report thus far but it is not really dealing with the big issues around working hours. Our point is very much that we can set up all the working groups we like to look at these things but unless we actively do something about it, nothing will change.

On the pay of doctors, there is no centralised system to pay doctors. Every time a doctor moves hospital, he or she is a new employee in that hospital going into the system. The hours then have to be submitted. There are clock-in arrangements in some hospitals but mainly it is a paper-based system. Doctors’ hours have to be filled in and have to be signed off by the consultant and are then sent in. Hospitals will often choose what hours they will or will not pay for. They may say that the doctor should not have been there between 7 o’clock and 8 o’clock and no one should have rostered the doctor to come in before 8 o’clock and therefore, the hospital will not pay for that hour between 7 o’clock and 8 o’clock. There are issues about being on the right pay scale, about doctors getting the right number of hours for overtime and about getting those overtime hours at the right rates. There are issues about getting their night rate, their premium pay and compensatory rest.

There is no standard pay system for doctors, which is something that was in the 2022 agreement. It was recognised by the HSE. It is a problem for the HSE in that it now has to pull information from all over the place to find out the data around the payment of doctors. It commissioned a report from an independent consultancy firm but we have yet to see a copy of that report. Movement was supposed to be made during 2024, but now it will be 2025 at the earliest before there are any guarantees in this regard.

It is very late in paying. For example, the public sector pay agreement is about staged payments and some of them go back to January. If I have a NCHD contract, I could have moved employer and I am relying on my previous employer. My current employer would give me the pay increase but I would have to wait for my previous employer to send me details of the arrears I am due from 1 January. It is unbelievably chaotic. The NCHDs get tired and exhausted as a result of having to go up all the time querying. It is not the fault of any individual; it is because there is not a proper system and it is part of the whole IT problem in the health services.