Hospital registrar overtime bills hit €100m

OVERTIME paid to HSE registrars is still costing over €100 million a year, while 15 hospital doctors around the country earned more than €100,000 in overtime alone last year.

In the years since the recession hit — from 2009 to the first half of 2011 — €276.2m has been paid to registrars in overtime.

Compared to €219m for 2008 alone, considerable savings have been achieved, but the overtime bill is still topping €100m annually.

One registrar in the west earned €135,100 in overtime last year on top of a salary of at least €70,000. Other top overtime earners in 2010 were: a registrar in HSE South who got €130,098; one in the south who got €123,199 on top of pay; and a registrar in the north-east who received €120,106 in overtime.

Salary scales show that senior registrars can earn over €80,000 at the top end of their pay scale.

Of those who got more than €100,000 in overtime, eight were located in the HSE South area, which covers Cork, Kerry, Waterford, Wexford, Carlow, Kilkenny and south Tipperary. Two were located in the west, two in the south-east and two in the north-east.

Figures for the HSE’s top 50 overtime earners, which range from €80,000 to over €100,000, were provided to the Irish Examiner under the Freedom of Information Act.

The figures included a breakdown of payments by each hospital. In 2010, Cork University Hospital spent more than €14m on overtime, the highest pay-out.

A breakdown of top paying hospitals showed:

* UCHG: €12m in 2010; €6.2m January to June 2011.

* CUH: €14.2m in 2010; €5.9 January to June 2011.

* Limerick Regional Hospital: €8.1m in 2010; €4m January to June 2011.

* Waterford Regional: €6.3m in 2010; €3.3m January to June 2011.

According to the HSE, the ability to reduce high overtime earnings is limited, as anything beyond a core 39-hour working week is paid at overtime rates.

“The majority of these overtime earners are registrars working in smaller sites where they may be on call every second or third night and likewise every second or third weekend,” said a spokesperson.

“While the intensity of the activity at these sites may not be sufficiently high to warrant additional non-consultant hospital doctors (NCHDs) as services are currently configured, these hours are required to maintain full, 24-hour emergency services, seven days per week.”

According to the HSE, some overtime earners may be working rotas in teams of three or four in specialised services in tertiary centres, such as transplant teams.

“The nature of medical training and a requirement to be exposed to sufficient numbers of complex cases has previously restricted the HSE’s capacity to increase NCHD numbers in these specialities and reduce individual hours,” the HSE said.

“Management has continued to seek to reduce hours and meet legislative requirements of the European Working Time Directive through changes in work practices, including expansion of cross cover, reduction in tiers of call, changes in skill mix and other initiatives. This process is particularly challenging in the smaller sites where the numbers in individual teams do not allow for compliant rosters.”



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