Oh dear some awful income inequality

February 4th, 2012 at 10:23 am by David Farrar

Martin Johnston at NZ Herald reports:

Some Auckland surgeons are being paid more than $6000 for a day’s work at a public hospital.

My God. They are part of the 1% scum.

The Waitemata District Board scheme has divided doctors over concerns that the surgeons involved can earn nearly four times as much as general physicians and psychiatrists on their collective agreement’s top step.

alert. This is evil and must be stopped.

The Waitakere “pilot” project pays orthopaedic surgeons a contract rate of $2200 for each total hip or knee replacement package of care. This comprises $1320 for the operation plus $880 for daily patient review, any call-backs during the hospital stay, availability for six weeks after surgery and a six-week visit.

A fixed cost per operation. We can’t have that.

On the union-negotiated multi-employer collective agreement, specialists of all kinds on the highest step earn an annual base salary of $206,000, or $99 an hour, but this increases to around $170 an hour when leave, KiwiSaver and allowances are factored in. Some specialists are paid above the collective’s rates.

Good God, they get paid even more than stevedores.

Senior doctors’ union executive director Ian Powell said the split rates undermined the team-work that was critical to the safety of patients in a complex public hospital.

Oh yes, because one doctor is paid more than another, they will compromise patient safety. I have to say I don’t know any doctors like that.

So why is the DHB doing this nasty income inequality with its doctors?

DHB chairman Lester Levy said the pilot had worked very well.

The rates paid to orthopaedic surgeons were around 60 per cent of private-sector rates. The scheme had led to a number of surgeons opting to do less private-sector work in favour of doing most of their work on public patients.

Productivity was up by a third. Costs shrank 12 per cent for hips and 16 per cent for knees because of a 40 per cent reduction in patients’ average length of stay in hospital, less time in theatre and fewer staff being involved in treatment.

Bringing previously out-sourced surgery in-house saved the DHB $3 million in the last financial year. Patient satisfaction was high and the transfer rate to North Shore Hospital was low.

So paying some staff more has saved the DHB money, improved productivity, reduced lengths of stays in hospitals, increased patient satisfaction and reduced the transfer rate.

But despite this, the union is against this because not all staff are paid more, only some.

Labour should be welcoming what Lester Levy is doing. Rather than contract their operations out to the private sector, the is now doing them in-house.

Tags: , , ,

39 Responses to “Oh dear some awful income inequality”

  1. bhudson (4,720 comments) says:

    I think the story can be summarised somewhat:

    “Some people are upset that some other people, who can do things that they can’t, get paid more.”

    Vote: Thumb up 0 Thumb down 0 You need to be logged in to vote
  2. Scott Chris (5,687 comments) says:

    David Farrar says:- “My God. They are part of the 1% scum.”

    Now I could misrepresent what you are saying here by alleging that you are in favour of crony capitalism, just as you are misrepresenting Martin Johnston’s article which actually focuses on how divided doctors are over concerns that the surgeons involved can earn nearly four times as much as general physicians and psychiatrists on their collective agreement’s top step.

    Shoddy post.

    [DPF: You miss (as usual) my point. I don't really give a fuck if surgeons are earning four times more than physicians, if it means more sick people are getting operations done quicker]

    Vote: Thumb up 0 Thumb down 0 You need to be logged in to vote
  3. Put it away (2,888 comments) says:

    Actually everyone involved in this is a “1% er” by income.

    Vote: Thumb up 0 Thumb down 0 You need to be logged in to vote
  4. tristanb (1,133 comments) says:

    I understand how a union can argue for increased wage for its workers, but how is it any of their business what anyone else is paid?

    Vote: Thumb up 0 Thumb down 0 You need to be logged in to vote
  5. Dean Papa (623 comments) says:

    whatever point Mr Farrar might have been attempting to make is lost amidst his overblown sarcasm

    Vote: Thumb up 0 Thumb down 0 You need to be logged in to vote
  6. grumpyoldhori (2,410 comments) says:

    Is that all those surgeons are making, fuck ,some of those eye surgeons coin over a million bucks a year in the private secto.

    If those who call themselves doctor instead of mister want to make more they only need to go and train to become surgeons and buy a barber’s pole.
    Boils down to supply and demand people, the surgeons are more in demand so earn more.
    Now I am waiting for nurses to whine that because they now have degrees like doctors, their pay should reflect the fact they have a degree.

    Vote: Thumb up 0 Thumb down 0 You need to be logged in to vote
  7. Scott Chris (5,687 comments) says:

    David Farrar says:- “You miss (as usual) my point.”

    “My God. They are part of the 1% scum” and “Good God they get paid more than stevedores” sets the rhetorical tone for any subsequent points you happen to make.

    Vote: Thumb up 0 Thumb down 0 You need to be logged in to vote
  8. nasska (9,559 comments) says:

    Sheer bloody madness! We live in a country where a parasite CEO of a lacklustre local body can con the simpletons elected to council into paying him over half a million a year. Then some arseholes grudge paying a well qualified orthopaedic surgeon about 60% of what he’s worth.

    Vote: Thumb up 0 Thumb down 0 You need to be logged in to vote
  9. UpandComer (496 comments) says:

    It’s actually a very good system. Pychiatrists blatantly don’t deserve as much money as orthopaedic surgeons. I know this because a lot of my friends are medical students, dentists and doctors. Surgeons are being paid only a percentage of what they are worth. As the stats show, the system is working brilliantly. For fucks sake people need to sort their shit out. Scott Chris who gives a fuck if they are getting paid more, when the upside is a massively more efficient service for the patients?

    Vote: Thumb up 0 Thumb down 0 You need to be logged in to vote
  10. Johnboy (13,439 comments) says:

    “The Waitemata District Health Board scheme has divided doctors over concerns that the surgeons involved can earn nearly four times as much as general physicians and psychiatrists on their collective agreement’s top step.”

    Being a rampant right winger and huge supporter of charge what the market can afford I feel slightly uncomfortable with the fact that erstwhile professionals are on a quote, “collective agreement”.

    This malaise seems to permeate the so called “teachers profession” and also, though I am not wishing to stir any shit, ( :) )
    Lord Birkenheads mob.

    Vote: Thumb up 0 Thumb down 0 You need to be logged in to vote
  11. Scott Chris (5,687 comments) says:

    UpandComer

    You miss my point. I don’t have a problem with people being paid what they’re worth, what I object to is the way in which anyone who seeks to rationalize market worth is immediately attacked as being a fucking commie.

    With regard to psychiatrists, I disagree with you completely. In the UK for instance, psychiatrists must hold a medical degree. Following this, the individual will work as a Foundation House Officer for two additional years to achieve registration as a basic medical practitioner. Following this, training in psychiatry can begin and it is taken in two parts. Basic Specialist Training is the first three years and trainees take the MRCPsych exam. The second stage of training is Higher Specialist Training. Candidates with MRCPsych degree and complete basic training must reinterview for higher specialist training. At this stage, the development of speciality interests such as forensic, child/adolescent take place. At the end of 3 years of higher specialist training, candidates are awarded a CCT.

    At this stage, the psychiatrist can register as a specialist.

    Vote: Thumb up 0 Thumb down 0 You need to be logged in to vote
  12. UpandComer (496 comments) says:

    Im not saying that psychiatry isn’t a laborious specialisation, but the aim of the game is still surgery. There is endless demand for surgery, and more successful surgeries can be completed then ongoing psychotherapy treatments. Psychiatrists are dedicated, extremely learned professionals but I still think surgeons deserve more money for what they do. I don’t just consider the length of training, I also consider the relative patient turnover each can achieve and the life outcomes for those patients. It is more competitive as far as I know to become a surgeon in New Zealand then a psychiatrist.

    Vote: Thumb up 0 Thumb down 0 You need to be logged in to vote
  13. Johnboy (13,439 comments) says:

    Why do people, who obviously rank in the upper intelligence bracket of the population, ie: doctors deem it appropriate to become union members and join a “collective agreement”?

    Vote: Thumb up 0 Thumb down 0 You need to be logged in to vote
  14. tristanb (1,133 comments) says:

    My understanding is that in NZ the psychiatry training scheme is among the shortest in duration.

    Also, it doesn’t matter what training they did – it’s about the value of the job they do. If I did a 10 year diploma in supermarket bag packing, I still can’t expect to be paid a ton for a job that most people can quickly learn the skills to do.

    There’s more money in surgery than psychiatry, it’s just the way it is. People prefer to pay for something to be done, people don’t like paying for talking and opinions (I’m sure many people begrudge paying a lawyer for every six minutes that they’re “just listening” for). It’s unfortunate really, because those opinions and access to knowledge can be very valuable, but it’s human nature to expect to get something tangible for their money.

    And it’s not as if it’s a secret the surgeons make more money, but there’s more to life than money and I’m sure many doctors became psychiatrists for the better hours and lifestyle – a bit unfair for them to demand to have the cake as well.

    Vote: Thumb up 0 Thumb down 0 You need to be logged in to vote
  15. Johnboy (13,439 comments) says:

    It seems fair enough, even to a dumb bugger like me, that it’s a bloody good idea to pay the fellow who is cutting the cancerous bit out of your guts a tad more than the strange fellow who want’s to warp your mind a bit.

    Course if you were a cancer free, bloody lunatic, (which apparently I’m not just yet, in case any of you were thinking that way) perhaps the Psychiatrist would seem to be worth a higher hourly rate.

    Vote: Thumb up 0 Thumb down 0 You need to be logged in to vote
  16. odysseus (22 comments) says:

    It’s not the first time that on medical matters that it is DPF who misses the point. Which is that by what ethical principle are we incentivising ELECTIVE non urgent surgery above acute life threatening medical care? Unless meeting an entirely political target has become an ethical principle.

    Vote: Thumb up 0 Thumb down 0 You need to be logged in to vote
  17. wat dabney (3,470 comments) says:

    Unless meeting an entirely political target has become an ethical principle.

    When the state is taxing you to not only buy but provide your healthcare services, what other outcome could there possibly be?

    It is literally inconceivable that things could be otherwise.

    Vote: Thumb up 0 Thumb down 0 You need to be logged in to vote
  18. odysseus (22 comments) says:

    Er, clinical need and ability to benefit comes to mind…and probably only state provision can ensure that.

    Vote: Thumb up 0 Thumb down 0 You need to be logged in to vote
  19. wat dabney (3,470 comments) says:

    Oh bless.

    Vote: Thumb up 0 Thumb down 0 You need to be logged in to vote
  20. Tautaioleua (266 comments) says:

    Good on the DHB, now why isn’t the Ministry of Education taking note?

    Give teachers more money and watch performance EXPLODE!!

    :P

    Vote: Thumb up 0 Thumb down 0 You need to be logged in to vote
  21. annie (533 comments) says:

    Doctors know what future earnings are likely to be when they choose their specialties, and most choices are made on the basis of the person’s interests.

    Geeks tend to go for medicine, the more straightforward types for surgery. And most of them don’t regret their choices. If you don’t understand or like medicine at all and don’t want to touch patients, you can do psychiatry. If you like statistics and don’t like to touch patients, you can do public health. If you don’t like dealing with live patients, there’s pathology. If you’re bright and like them unconscious you can do anaesthetics. If you’re a diagnosis junkie there’s general practice, though the pay is lousy. And so on.

    Vote: Thumb up 0 Thumb down 0 You need to be logged in to vote
  22. SPC (4,679 comments) says:

    I am just glad that the right wing can appreciate evidence based policy. About time, do it more often.

    Vote: Thumb up 0 Thumb down 0 You need to be logged in to vote
  23. pq (728 comments) says:

    demerit points 20 farrar
    arrogance and stupidity, NZ Nat party are thinking about you Farrra about to be replaced.
    hahahah

    Vote: Thumb up 0 Thumb down 0 You need to be logged in to vote
  24. pq (728 comments) says:

    think about it farrar,

    Vote: Thumb up 0 Thumb down 0 You need to be logged in to vote
  25. Manolo (12,643 comments) says:

    Long live inequality! Those who like everyone to be the same are invited to ship out to North Korea.

    Vote: Thumb up 0 Thumb down 0 You need to be logged in to vote
  26. Johnboy (13,439 comments) says:

    Where do cosmetic surgeons fit into your jigsaw annie?

    Hands on, the bits we don’t talk about and dealing with the psychiatry of the over or under endowed patients.

    Must be shattering for the new guys on the block till they check out their bank accounts. :)

    Vote: Thumb up 0 Thumb down 0 You need to be logged in to vote
  27. RightNow (6,350 comments) says:

    Isn’t this just piece work?

    Vote: Thumb up 0 Thumb down 0 You need to be logged in to vote
  28. Viking2 (10,747 comments) says:

    Johnboy (6,559) Says:
    February 4th, 2012 at 2:36 pm

    Course if you were a cancer free, bloody lunatic, (which apparently I’m not just yet, in case any of you were thinking that way) perhaps the Psychiatrist would seem to be worth a higher hourly rate.

    Well now Johnboy as with all things Medical yopu should get a second opinion. Here it is. Well all thunk you are anblanced, phycop[athic sheep hugging looney.

    You need help.
    :lol: :lol: :lol: 8) :mad:

    Vote: Thumb up 0 Thumb down 0 You need to be logged in to vote
  29. Johnboy (13,439 comments) says:

    “yopu should get a second opinion. Here it is. Well all thunk you are anblanced, phycop[athic sheep hugging looney.”

    Ipou thunks as an anbalanced phycop[athic sheep hugging looney I should take your advice onboard V2 and immediately jettison it out of the sanity porthole.

    No oceans were polluted in the making of my decision! :)

    Vote: Thumb up 0 Thumb down 0 You need to be logged in to vote
  30. Manolo (12,643 comments) says:

    Inebriety rules! :D

    Vote: Thumb up 0 Thumb down 0 You need to be logged in to vote
  31. Richard29 (377 comments) says:

    So basically the union doctors are upset because the DHB is hiring ‘scab’ doctors (no offence to any dermatologists) at more than 4 times their rate.

    Says something about the nature of this part of the labour market. Normally an employer would bring in contractors like this because they are trying to undercut the union wages and conditions (e.g. Ports of Auckland).

    This is a completely different because of the extreme shortage of specialists – it’s a cartel dynamic.

    Vote: Thumb up 0 Thumb down 0 You need to be logged in to vote
  32. Luc Hansen (4,573 comments) says:

    Having read the serious and informative article, which raises valid points both for and against the practice, I am amazed that DPF is so obsessed with a few stevedores that he seeks to drag them into this issue.

    It’s almost deranged.

    As deranged, in fact, as his obsession in completely misrepresenting teachers and their unions and, indeed, our entire education system and its notable achievements.

    We can see that DPF approves of unions and collective agreements when he feels himself part of that particular tribe (whether or not that tribe would see it the same way is a moot point) and against it when he does not have that same belonging feeling.

    Tribalism rules!

    Vote: Thumb up 0 Thumb down 0 You need to be logged in to vote
  33. ross (1,454 comments) says:

    Luc

    It’s easy to uunderstand DPF’s obsession with stevedores given his pathological hatred of unions. But it’s curious that while he attacks the pay of wharfies – who earn $27 per hour – he doesn’t ask for flexibility from doctors – earning $99 an hour. I wonder what colour the sky is in his world?

    Vote: Thumb up 0 Thumb down 0 You need to be logged in to vote
  34. ross (1,454 comments) says:

    “[I don't really give a fuck if surgeons are earning four times more than physicians, if it means more sick people are getting operations done quicker]”

    You miss the point of the article, summed up by Dr Julian Fuller:

    “Dr Julian Fuller, in an email to all specialists at the DHB and obtained by the Weekend Herald, said: ‘This DHB does not need to pay vastly inflated rates of pay to a limited few proceduralists, in order to achieve higher throughputs.’”

    I could see you arguing that Tonny Marryatt deserves to be paid more than $500K, all the while ignoring the fact that he’d be happy to do the job for $200K.

    Vote: Thumb up 0 Thumb down 0 You need to be logged in to vote
  35. ross (1,454 comments) says:

    Meanwhile, from today’s Herald on Sunday, we learn that the economy is in much better shape than previously thought:

    “Director-General of Health Kevin Woods, and Education Ministry chief executive Lesley Longstone are among senior public sector bosses recruited from offshore in the past two years.

    Woods, who already earns nearly $50,000 a month, will be reimbursed up to a further $50,000 after producing receipts for [his] relocation expenses. He started work here in early 2011 after running Scotland’s public health sector, the NHS, for more than five years.

    Longstone, who makes around $660,000 a year, was appointed in July last year on a five-year contract.

    The new head of Work and Income, American Janet Grossman, is in line for a similar relocation payment.

    Briton Gabriel Makhlouf was appointed head of Treasury last year. Two other Government departments, the Inland Revenue, and Economic Development Ministry, have longstanding chief executives from overseas.

    Labour state services spokesman Chris Hipkins said the amounts were worrying “when we should be able to fill these positions ourselves.”

    The Herald on Sunday requested a response from acting State Services Minister Tony Ryall. Present minister Jonathan Coleman was out of the country.

    Ryall’s office referred questions back to the State Services Commission, whose spokeswoman Marian Mortensen said: “He has not got the time to speak to you.”

    Interestingly, the States Services Commission refused to disclose this information for a year and was forced to hand over the info by the Ombudsmen’s Office. Maybe the SSC was a little embarrassed?

    Vote: Thumb up 0 Thumb down 0 You need to be logged in to vote
  36. Elaycee (4,089 comments) says:

    ross continues his distortions: “the pay of wharfies – who earn $27 per hour… ”

    Hang on a minute – not long ago you were expressing support for the militant unionists on the picket line – including the muppet who was holding a placard claiming he was on $13 per hour. And even when it was proven (by the Ports of Auckland themselves and even by auditors) that this claim was bollocks and that the wharfies really earned an average of $91,400 per annum for the 2011 year), you still continued the bullshit.

    You should form a group with Luc – he has also been proven to tell porkies. His motto (his own words): “…start with an untruth and build upon it with more lies and distortions, confusing the audience with the volume of misinformation.” Remarkably similar to this quote from Josef Goebbels: ““The most brilliant propagandist technique will yield no success unless one fundamental principle is borne in mind constantly – it must confine itself to a few points and repeat them over and over””

    ross – You and Luc have as much credibility as Penny Bright – and her level is around the same as a three dollar note with a picture of Winston on one side. Zero. Nada, Nil. Zip. SFA.

    Vote: Thumb up 0 Thumb down 0 You need to be logged in to vote
  37. burt (7,096 comments) says:

    You should form a group with Luc – he has also been proven to tell porkies.

    A rampant lefty who’s full of shit… who would have picked that….

    Vote: Thumb up 0 Thumb down 0 You need to be logged in to vote
  38. wreck1080 (3,533 comments) says:

    I’m with you on this one dpf.

    These surgeons train very hard and deserve their 6k per day.

    Having seen the US system at work (in a minor way), i’m pretty happy with our health system.

    Vote: Thumb up 0 Thumb down 0 You need to be logged in to vote
  39. gump (1,232 comments) says:

    It has always been a mystery to me why surgeons also need to be MDs before they can become surgeons.

    I’d like to see skilled technicians selected and trained to handle routine surgical procedures. But the cartel that controls such things will never let it happen.

    Vote: Thumb up 0 Thumb down 0 You need to be logged in to vote

Leave a Reply

You must be logged in to post a comment.