In 2014 Consultant Psychiatrist Dr Nick Carrigan from Clara, County Kilkenny moved to Australia with his wife, Dr Allison Newman, also a Consultant Psychiatrist and from Tyrrellspass, County Westmeath, with their three young children.
The reasons were numerous. The financial crisis and recession of 2008 and the implementation of the Universal Social Charge (USC) in 2010 had a major impact on Carrigan’s take-home pay.
“We had a nice house, which meant we had some kind of stupid mortgage. Interest rates skyrocketed for a while and it also wiped out our savings because our mortgage payments doubled for a short period.”
He took a second job working for the Mental Health Commission after hours.
“Very often after work I would get in my car and drive to Portlaoise, Mullingar or Clonmel to check on patients for the commission. So I was doing extra guard duty and also had a second job. I was lucky to have had the option, but it still really reduced the time off and rest.”
The reduction in take-home pay, while a factor, was far from the only reason they felt as a family they could no longer stay in Ireland. Carrigan said other doctors had “begun to vote with their feet,” making it more difficult to recruit colleagues and increasing the workload for permanent staff.
“It started with younger colleagues leaving, as they are generally more mobile and have fewer responsibilities. So the junior doctor standard was more mixed. Working with an underperforming junior doctor actually increases your workload as you have to double check everything. It is better in terms of workload not to have anyone.”
His on-call shifts increased at St. Senan’s Hospital in Enniscorthy, even though he received no extra pay. While substitute physicians were hired to fill gaps in the roster, Carrigan said consultant substitutes were not typically on call lists.
“Somebody who’s a backup can say ‘Look, I don’t want to be on call,’ so they can come in from nine to five and leave and probably get double what they pay you and not do anything on call. to call.
“As a substantive consultant, you may have to supervise two young people, which means an hour-long meeting with the supervisee at least once a week. Administering education sessions, making lists, leading committees, participating in interdepartmental or regional work, serving as head of department, chairing policy groups, administering specialist clinics (ECT or Clozapine in psychiatry), etc., etc., should all be done by permanent consulting staff, so we also doubled and tripled in these roles.”
The consultants were ultimately responsible if something went wrong. “The service did not have a lot of money… so if something goes wrong, they cut off a service and there is an adverse result, the consultant is sued because we have compensation. He was pretty ruthless.”
While the work might be rewarding in Ireland, it was also a bit overwhelming, Carrigan said. A particular hospital where she used to work gives her a knot in her stomach every time she thinks about her time there.
His working life, he said, was made much more difficult by the medical administration.
“There seems to be some kind of hatred towards doctors on the part of the medical administration. It’s weird. I don’t get it.
At a job Carrigan worked in Ireland, he and a senior house officer (SHO) saw 40 patients in a morning clinic from 9 a.m. to 1:30 p.m., so they worked through their lunch hour. The manager of a hospital in St Senan said that because his lunch hour was not paid for, he would have to stay an hour at night..
“I used to work during my lunch hour anyway. That was nonsense. And all the rest of the day staff had gone home. I couldn’t see any patient without support staff. So I was supposed to sit in my office for an hour?
“It’s a shame. There are a lot of very well trained people, but there seems to be an attitude problem with HSE in general. [Health Service Executive] management.” The HSE was sought for comment but did not respond.
Even with the pay cuts and increased workload, Carrigan said her family could have. But during the recession, she said, a lot of negativity began to be generated in the media towards medical consultants. She said attitudes changed and people with stable, well-paying government jobs became “a focus of resentment and especially consultants, it seems.”
These attitudes affected how people in Carrigan’s personal life interacted with him and ultimately contributed to him and his family leaving Ireland.
“As well-paid public servants, we were kind of in the line of fire. There was a lot of ‘fat cat’ consultant stuff. It was relentless. Everyone was suffering financially and anyone who was seen to be doing well financially resented it. Those were terrible times in Ireland.
“I would go to family gatherings and have friends and some extended family members parrot these anti-consulting things to me. I’m thinking, I’m working twice as hard, I’m working in the public system, I’m trying to make up for lack of funds and failures and then in my social life I’m getting beaten up by people. .
“It was difficult when the people closest to you had absorbed the anti-consulting narrative. It was probably the straw that broke the camel’s back in my decision to emigrate”.
Carrigan disagrees with the “fat cat” consultant description that was prevalent at the time.
“I don’t think greed is unique to the medical profession or as prevalent as it is described in that profession. Doctors don’t look after themselves well enough, so they put up with the horrible working conditions that prevail in Ireland and the UK.”
Carrigan said at the time that he certainly saw abuse by consultants doing a mix of public and private work. However, he said that the misbehavior of a “small percentage of the profession” was being used as a club to beat up the rest of the consultants who at the time were “being flogged at work trying to keep the health system brittle with health cuts.” services and outgoing colleagues”.
He argues that if someone fulfills their contractual commitment to HSE, then “why shouldn’t they be allowed to do extra work outside of that commitment? Should teachers be banned from grinding?
“Public systems are always going to be less efficient than private ones, motivated by profit. That’s human nature.”
There is no comparison between the work-life balance in Ireland before immigrating and in Western Australia now.
“In Australia, at half past four, I’m cycling or kayaking after work,” he said. He is less stressed, has more time for hobbies, family, exercise and has lost around 10kg since he arrived eight years ago.
An Australian consultant, who was on the Australian Medical Association committee negotiating consultancy contracts with WA [Western Australia] government every three years, told Carrigan at a conference once that they don’t allow Irish consultants “to come anywhere near negotiations” as Irish doctors in WA were “too happy” and “wouldn’t negotiate hard enough”.
The Australian health system and those who work in medical administration take better care of staff, Carrigan said. She is accruing long-service leave and is due three months off, with pay, in 2024 for 10 years of continuous service. He keeps up to date with developments around new medical consultant contracts in Ireland. “There is very little trust, I wouldn’t be surprised if they fell apart once they had enough people at home.”
“I’m a bit obsessive about these things, I’m always looking and it really bothers me that I have to move, but it had to happen.
“There are a lot of angry doctors on Twitter, but we are only talking to ourselves, no one is listening. I’m never going back. There is nothing that will make me go back at this time.”