Labour Court Database __________________________________________________________________________________ File Number: CD90538 Case Number: LCR13147 Section / Act: S67 Parties: PUBLIC VOLUNTARY HOSPITALS - and - IRISH MEDICAL ORGANISATION |
Claim by the Union for a 40% increase in the basic pay of Non- Consultant Hospital Doctors (N.C.H.D's).
Recommendation:
5. The Court finds that the parties, with equal conviction, have
put forward details and statistics to support their respective
views regarding the claim. It is the view of the Court that there
is merit in the case of the I.M.O. for a pay increase for
N.C.H.D.'s but not for an increase of the magnitude claimed. The
Court has taken account of all relevant information and details
supplied and is of the view that N.C.H.D.'s merit a pay increase
of 15% at all points of the scale.
Having decided an increase was merited the Court proceeded to
consider how the award should be implemented in the context of the
Programme for National Recovery. In this context the Court took
account of all of the views, oral and written, expressed by the
parties.
In all of the circumstances the Court considers that the
implementation of the award in accordance with Clauses 3.3 or 3.5
would not be sustainable.
Accordingly it is the view of the Court that it is appropriate for
the award to be implemented in accordance with Clause 3.4 of the
Elaboration of Clause 3 of the Agreement on Pay in the Public
Service i.e.
40% may be paid with effect from 1st May, 1991
30% may be paid with effect from 1st March, 1992
30% may be paid with effect from 1st September, 1992.
The Court notes that Management and the I.M.O. have accepted the
following proposals in respect of Medical Defence Subscriptions:-
"Management should agree to refund to N.C.H.D.'s 90% of the
net cost of Medical Defence Subscriptions.
Management should also agree to implement this agreement from
the Medical Subscription year commencing 1st July, 1990."
Division: MrMcGrath Mr Brennan Mr Rorke
Text of Document__________________________________________________________________
CD90538 RECOMMENDATION NO. LCR13147
INDUSTRIAL RELATIONS ACTS, 1946 TO 1976
SECTION 67
PARTIES: PUBLIC VOLUNTARY HOSPITALS
(REPRESENTED BY THE FEDERATION OF IRISH EMPLOYERS)
and
IRISH MEDICAL ORGANISATION
SUBJECT:
1. Claim by the Union for a 40% increase in the basic pay of Non-
Consultant Hospital Doctors (N.C.H.D's).
BACKGROUND:
2. In November, 1989, the Union lodged a claim for a 40% increase
in the basic pay of Non Consultant Hospital Doctors (N.C.H.D.'s).
The claim was discussed at local level on 26th April, 1990, and
was referred to the Conciliation Service of the Labour Court on
30th April, 1990. A conciliation conference took place on 9th
July, 1990, during which the Union claimed that because no special
pay awards were made to N.C.H.D.'s since 1981, their rates of pay
were considerably out of line with those of other grades of public
service workers. Management rejected the Union's claim
maintaining that N.C.H.D.'s received regular cost of living
increases since 1981, and that they had also received wide-ranging
improvements in their conditions of employment since that time.
As Management were not prepared to consider the claim the Union
requested a full Labour Court hearing. Management representatives
agreed to the Court hearing on 28th August, 1990 and the Court
investigated the dispute on 5th November, 1990. The investigation
was adjourned until 11th December, 1990, when a resumed hearing
took place.
UNION'S ARGUMENTS:
3. 1. There are approximately 2,000 N.C.H.D.'s employed by the
Public Voluntary Hospitals. Their staff structure comprises
three grades and attracts salary scales as follows - Intern
#10,767, Senior House Officer #12,220 - #17,608 and Registrar
#16,198 - #19,494. In 1981, N.C.H.D.'s received a special
increase in basic pay (L.C.R. 6711). The increase was similar
to that awarded to most other grades in the health service
generally. Since 1981, the majority of health service grades
have received up to three special pay awards, amounting to 40%
in total in some cases. An increase in basic salary in the
order of 40% is now required to restore the pay relationship
which pertained with comparable grades of workers when the
Labour Court recommended a special pay increase in 1981.
2. Salary increases paid to other health service workers in
the period 1st September, 1981 to 1st January, 1990 clearly
demonstrate that a 40% increase is justified and necessary if
the 1981 relationship in basic pay is to be maintained. While
Interns, House Officers and Registrars received salary
increases in the region of 50% in that period staff nurse
grades received increases ranging from 67% to 84%. Other
health service workers such as radiographers,
physiotherapists, dentists (clinical) and medical laboratory
technicians received increases in the region of 69%, 67%, 93%
and 72% respectively. A special pay award of 10% has now been
granted to staff nurse grades, radiographers, physiotherapists
and medical laboratory technicians and is due for
implementation. This increase further worsens the pay
position of N.C.H.D.'s and highlights the need to increase
their level of salary by 40% so as to maintain agreed
relativities.
3. The registrar grade of non-consultant hospital doctor has
had a clear salary differential with that of consultant
doctors. The differential was established by the Arbitrator
of the Local Authority and Health Services Conciliation and
Arbitration Scheme in Report No. 019. It was maintained until
broken by a recent salary increase granted to consultants by
the Review Body on Higher Remuneration in the Public Sector
(findings issued in Report No. 32 dated 15th June, 1990).
Consultants received their last special pay increase in 1981.
The Review Body having taken account of general movements in
the basic pay of a wide range of employments in the private
and public sector determined that consultants should have
increases in basic pay of between 45% and 50%. The
registrar/consultant differential must be restored and
maintained. All non-consultant hospital doctors are in the
exact same position as consultants in that no special pay
increases have applied since 1981. An increase in basic pay
similar to that awarded to consultants is totally justified.
4. Community Medicine Doctors are other salaried medical
grades in the health service. Three grades of doctors operate
in this area i.e. Director of Community Care, Senior Area
Medical Officer and Area Medical Officer. During the period
1981 - 1990 these grades were awarded salary increases of
110%, 109% and 108% respectively. The awards again clearly
indicate that an increase of at least 40% is warranted in the
case of N.C.H.D.'s.
5. Until recently N.C.H.D.'s in Ireland enjoyed considerably
higher salaries than their counterparts in the United Kingdom.
In 1981 the differential in favour of Irish doctors was 32%
for Interns, 46% for House Officers (max) and 32% for
Registrars (max). Currently a comparison differential in
favour of doctors in Ireland is, Interns - 2%, House Officers
1% and Registrars 3%. In the past number of years the number
of Irish graduate doctors who have emigrated has risen to
alarming levels. While more senior doctors have always
emigrated for training purposes, the trend now is for more
Irish non-consultant hospital doctors to emigrate in the first
two years after graduation. The primary reason for the
increasing trend towards emigration is the far more generous
conditions of service available in the United Kingdom and in
other countries. As well as improved salaries there are other
very important conditions available in the United Kingdom,
such as removal expenses, leave and expenses for attendance at
courses, post-graduate education fees, exam fees including
repeats, together with standards of accommodation. Doctors in
Ireland are expected to meet the costs of these requirements
from their own resources. An increase in their basic pay to
redress the imbalance that has occurred with British
counterparts is essential.
6. Because of the nature of their work N.C.H.D.'s are
required to remain on duty for an approximate 65 hour week.
In surgical specialities doctors work up to 100 hours per
week. This compares to other health service/public service
employees who work an average 39 hour week. Even though
N.C.H.D.'s basic working week is 40 hours, less than 5% of
them are rostered for just 40 hours. Overtime payments (set
by L.C.R. 11840) do not compensate adequately as regular
overtime payments are calculated differently to those of all
other workers. Management have compared N.C.H.D.'s earnings
with salaries of other public service workers but if those
public service workers were to be rostered for duty for 70
hours per week their earnings would be substantially greater
than the earnings of N.C.H.D.'s.
7. Management contend that the award arising from Labour
Court Recommendation 11840 is covered by Clause 3.2 of the
Elaboration of the Agreement on Pay in the Public Service and
that the current claim comes within scope of Clause 3.5 of
that Elaboration. This is not so as the new system adopted
for revised hourly overtime payments (arising from L.C.R.
11840) increased overtime payments only. No increases were
applied to the basic pay of N.C.H.D.'s at that time or since
1981. Clause 3.2 of the Elaboration of the Agreement on Pay
in the Public Service covers increases in basic pay and any
adjustments to bring overtime rates or other conditions of
employment of N.C.H.D.'s into line with normal working
conditions cannot be regarded as coming within scope of the
Elaboration.
PUBLIC VOLUNTARY HOSPITALS ARGUMENTS:
4. 1. There are 2,036 N.C.H.D.'s employed in the Health Board
and voluntary hospitals of Ireland. Of these 335 are Interns,
1069 are House Officers and 632 are Registrars. The current
salary scales attaching to the posts are - Intern #10,767,
House Officer #12,220 - #17,608 and Registrar to #16,198 -
#19,494.
In addition, other allowances are payable. Where an N.C.H.D.
holds a particular recognised qualification he qualifies for
an allowance of #1,122 (higher degree) and #384 (diploma) per
annum. N.C.H.D.'s receive fees from the Department of Social
Welfare in respect of certificates issued to claimants.
Registrars receive fees for delivering lectures to nurses
(#9.86 per lecture). If a particular hospital authority is
not in a position to provide adequate accommodation, a living-
out allowance of #22.53 per week is paid to each doctor.
Where an N.C.H.D. who is obliged to be on call is living
outside of the hospital the cost of telephone installation and
rental is borne by that hospital authority.
2. In 1979, a payment system was introduced whereby payment
for 40 hours reflected basic salary and a payment was
established for all hours in excess of 40. These changes
resulted in an increase in remuneration of approximately 30%.
In 1981, N.C.H.D.'s received a special 8% increase in basic
salary and in excess hours rates. In 1982, holiday pay
calculated on the basis of 10 notional hours per day was
introduced. Travelling expenses for attendance at interviews
were also introduced. In 1983, annual leave entitlements were
increased. The living-out allowance, diploma and higher
degree were also increased to take account of all special
increases granted since 1976. In 1986, updated conditions of
service brought many improvements such as the abolition of 1:2
rotas and the provision of locums. Between 1981 and 1988 a
dual payment system applied for all hours worked in excess of
40 per week. In 1988, the hourly rates depending on grade
were #2.10, #3.06 and #3.85 for hours worked between 40 and 70
per week and #2.88, #3.62 and #4.27 for 70 plus hours per
week. Arising from Labour Court Recommendation 10674 a
standard rate of #2.88, #3.62 and #4.27 per hour was
introduced for all hours in excess of 40. This resulted in an
increase to N.C.H.D.'s of between 11% and 37% in the on-call
rate and between 3% and 9% in their overall payments. Labour
Court Recommendation 11840 introduced a maximum rostered week
of 65 hours. It also introduced premium payments for on-call.
This resulted in an increase of between 14% and 49% in on-call
rates and between 4% and 12% in overall payments. Since their
last special pay increase in 1981, N.C.H.D.'s direct
remuneration based on a 65-hour rostered week has increased
(at 1st January, 1990), as follows - Intern 79%, House Officer
83% - 81% and Registrar 78% - 77%.
3. The Union claim that a relationship exists between the pay
of medical consultants and N.C.H.D.'s. Management strongly
contend that N.C.H.D.'s salaries have never been determined by
reference to the consultant salary position. The Union claim
is based on findings of the Arbitration Board (Report No. 019
March, 1978). This Report did not establish a pay
relationship between N.C.H.D.'s and consultants. It merely
stated that the medical consultant should enjoy a differential
over N.C.H.D.'s. Even if a relationship did exist the reasons
for such a condition have changed fundamentally. In 1981, the
common contract for consultants completely altered terms,
conditions and the method of consultant remuneration. Labour
Court Recommendation 6711 accepted Management's position as -
"The Arbitrator's Report No. 019 created a differential
which the Arbitrator can only have regarded as a minimum
and not necessarily as a maximum. The relationship
established then has, in any event, ceased to have any
validity because of the introduction of the new common
contract."
Similarly, the increases recently awarded to hospital
consultants by the Review Body on Higher Remuneration in the
Public Sector do not carry any knock-on effects for N.C.H.D.'s
as the increased rates are contingent on the introduction of a
revised contract for consultants.
4. N.C.H.D.'s have fared very well in relation to pay
movements, when compared to movements in both the Civil and
Public Service. The introduction of a 65-hour rostered week
has significantly increased their direct remuneration. In the
period 1st June, 1981 - 1st January, 1990, Interns, House
Officers and Registrars have received salary increases of 79%,
81% and 77% respectively. Civil Service Executive Officers,
Higher Executive Officers, Assistant Principals and Principals
have received salary increases of 75%, 76%, 72% and 74%.
During the same period teachers (with honours degree and
honours h/diploma) received an increase of 68%, while
qualified nurses, physiotherapists (basic grade) and gardai
all received salary increases of 73%.
5. Because of the increases already awarded by Labour Court
Recommendation 11840, under Clause 3.2 of the Elaboration of
the Agreement on Pay in the Public Service the current claim
falls within the terms of Clause 3.5 of the Elaboration.
Under Clause 3.5 the agreed position is that such claims may
not be processed to finality until after 31 March, 1991.
Concession of the claim, based on a 40% increase in overall
payments to N.C.H.D.'s, will cost #20m annually. One
essential element of the Programme for National Recovery is
that various measures to control and curtail public
expenditure should succeed. Public service pay forms a
significant proportion of such expenditure and, accordingly,
cost-increasing claims must be subjected to most careful
scrutiny. The improvement in public finances should not be
put at risk by a build up of cost-increasing awards on pay and
conditions.
RECOMMENDATION:
5. The Court finds that the parties, with equal conviction, have
put forward details and statistics to support their respective
views regarding the claim. It is the view of the Court that there
is merit in the case of the I.M.O. for a pay increase for
N.C.H.D.'s but not for an increase of the magnitude claimed. The
Court has taken account of all relevant information and details
supplied and is of the view that N.C.H.D.'s merit a pay increase
of 15% at all points of the scale.
Having decided an increase was merited the Court proceeded to
consider how the award should be implemented in the context of the
Programme for National Recovery. In this context the Court took
account of all of the views, oral and written, expressed by the
parties.
In all of the circumstances the Court considers that the
implementation of the award in accordance with Clauses 3.3 or 3.5
would not be sustainable.
Accordingly it is the view of the Court that it is appropriate for
the award to be implemented in accordance with Clause 3.4 of the
Elaboration of Clause 3 of the Agreement on Pay in the Public
Service i.e.
40% may be paid with effect from 1st May, 1991
30% may be paid with effect from 1st March, 1992
30% may be paid with effect from 1st September, 1992.
The Court notes that Management and the I.M.O. have accepted the
following proposals in respect of Medical Defence Subscriptions:-
"Management should agree to refund to N.C.H.D.'s 90% of the
net cost of Medical Defence Subscriptions.
Management should also agree to implement this agreement from
the Medical Subscription year commencing 1st July, 1990."
~
Signed on behalf of the Labour Court
Tom McGrath
_________________________
14th January, 1991 Deputy Chairman.
A.McG/J.C.