Hospital consultants who can earn up to €250,000 a year will have to be paid more if vacant positions are to be filled, according to Fianna Fáil’s finance spokesman Michael McGrath.
The Cork TD said the Government will need to “bite the bullet” and accept pay will have to increase for consultants.
A consultant who works full time in public hospitals with no fee-paying patients would see their salary increase from around €180,000 to €252,000, he suggests.
Consultants who are allowed treat private patients in their public hospital would get a salary rise from €170,000 to €225,000.
In an interview with the Irish Examiner, Mr McGrath said: “Some of the cuts in health may have been politically popular, like the extra cut to consultants pay in 2012, but it really appears not to have been a smart move.
“Like it or not, we are simply not attracting consultants, retaining them, and I think we are going to have to bite the bullet and pay what is required.
“There are similar issues in nursing.”
Mr McGrath’s comments come amid growing industrial unrest in the health sector, with the Irish Nurses and Midwife Organisation preparing to hold a number of one-day strike actions.
His comments also come as the HSE has been given a record budget of €17bn for 2019 and amid growing criticism from the Irish Fiscal Advisory Council (IFAC) about the year-on-year growth in the health budget.
Mr McGrath said the IFAC criticism is fair and needs to be heeded by Finance Minister Paschal Donohoe.
“Until you have a credible budget, until you have a credible plan, you will have this annual charade of a budget being agreed that everyone knows is not sufficient and then big supplementary budgets are needed,” said Mr McGrath.
“You do have to question where all the money is going.
“We have a vacuum at the top of the HSE, we are several months without a CEO at the top of the HSE. That will filter right down through the organisation.
“The criticisms from the fiscal council are fair and have to be accepted by the Government.
“Within-year expenditure growth has become a trend in the past couple of years and needs to be addressed properly.
“Within health, if overruns of €600m or €700m are happening without a credible reason as to why, then those issues need to be dealt with.
“Everyone else in opposition, meanwhile, wanted to go further and had the Government done that, the concerns and criticisms would have been greater.”
Mr McGrath also hit out at Mr Donohoe’s handling of the budget process in holding back the full figures from the Fianna Fáil team right up to the day it was announced.
“It makes it difficult for us to finalise our position on ‘our asks’ if they are keeping back,” he said.
“It can result in the overall package moving to a position beyond what is prudent. When it happens so late in the day, it is very difficult to turn the bus around.
“We get some things delivered in confidence and supply, but we are not behind the wheel.
“A lot of it is not tied down until very late in the day — health, housing, education.
“The process does actually go down to the wire.
“But it seems to come down to the last 24 or 48 hours, which is not a good way to do business.”
On a per capita basis, Ireland is among the countries with the lowest numbers of hospital consultants in the Organisation for Economic Co-operation and Development (OECD) area, but, according to the group, they are among the highest earners internationally.
Statistics from the OECD in 2015 show specialists earned an average of around €170,000.
This is twice the average in Britain and higher than in any other OECD country except New Zealand and Luxembourg. However, the Irish Hospital Consultants Association insists that some of the salary amounts included are gross, while others are net, and the pay in some countries is not directly comparable.
In Ireland, spending per head of population in 2016 was $5,600, similar to Germany and slightly ahead of Belgium. We have three hospital beds per thousand. The OECD average is 4.7.