Dáil Éireann debate -
Thursday, 8 Jul 1993

Vol. 433 No. 7

Ceisteanna — Questions. Oral Answers. - Acute Hospital Staffing.

Liz McManus

Question:

5 Ms McManus asked the Minister for Health if he will give details of his response to the recent report on medical manpower in acute hospitals; if he will ensure that any increase in consultant numbers is not at the expense of the overall number of medical positions in view of the implications that this would have for the hospital service; if he will introduce a new contract for consultants to ensure equality of treatment for both public and private patients; and if he will make a statement on the matter.

Mr. Howlin

The report to which the Deputy refers was presented to me by a collaborative study group representative of my Department, Comhairle na nOspidéal and the Postgraduate Medical and Dental Board. The main purpose of the report is to stimulate discussion and debate with a view to gaining concensus on an equitable mix and distribution of medical manpower in acute hospitals throughout the country.

I have, therefore, circulated the report to all those with an interest in the subject and sought their comments by the end of October. When these are received, I will have them considered in my Department before deciding on any particular course of action. However, the overall objective will be to maintain and improve patient care and to provide a satisfactory working environment and career prospects for hospital doctors.

Ms McManus

I note that this discussion document has been with the Minister since March. Will he indicate his views on the proposed reduction in overall hospital manpower? While everybody welcomes the principle of a higher ratio of consultants to junior hospital doctors — it is recognised that this should improve hospital services — the proposal contained in the report would have major implications for hospital care. Would the Minister not be concerned about an overall reduction of 500 in medical personnel? Recent media reports indicate that a saving of £10 million would be made if the recommendations of the report were implemented whereas, as far as I am aware, it is clearly stated in the report that there would be a cost to the Exchequer in implementing its recommendations. Will the Minister clarify that?

Will the Minister, who has stated clearly he is in favour of equality in the health services, make a statement about the greatest inequity in our hospital service: public patients are treated so differently from private patients that it has a direct impact on their health. This would no longer be the case if his predecessor, Erskine Childers, who introduced equity into the general medical services had succeeded in doing so in the whole service.

Mr. Howlin

The Deputy has posed a range of questions. I stated my opinion the last time we had questions and again when we discussed the Estimates for my Department. This report is important to stimulate discussion and I circulated it to virtually every non-consultant hospital doctor, and to every consultant, to every acute hospital, voluntary hospital and every health board. I hope I will receive a broad range of reaction to it by October.

A number of issues arises from the report which I obviously would like to address. I have already voiced opinions on them. I believe there are too few consultants and that the training process, in other words the number of years that somebody serves as a junior hospital doctor, is inappropriate. The average age of newly appointed consultants is 38, and that is too old. I am also concerned about the gender balance in appointments. The report points out that although 50 per cent of medical graduates are women only 16 per cent of consultants are women. That is a cause of concern and needs to be addressed. A number of issues will be addressed consequent on the report.

There will be a cost to the Department of Health in implementing the recommendations of this report. I am glad to have the opportunity to comment on newspaper headlines because last Sunday the headline for all to see was "Department of Health to cut 800 jobs: 800 doctors to go in hospitals". This is a report from a review group and is for discussion in relation to a rebalancing of consultant and non-consultant hospital doctors. It was a totally inaccurate headline.

On the issue of equality of treatment, it is my objective that every citizen, regardless of medical cover or financial position, will be treated on the basis of medical need and not on any financial supports they might have.

Ms McManus

Will the Minister include the question of a new common contract for consultants when it comes to the end of the consultation process? Is the Minister saying that he will propose this as the only way to ensure patients will be treated equally?

Mr. Howlin

I said no such thing. I said I issued a discussion document and I am awaiting responses from all sectors on whom the report impinges and when I see the responses I will formulate a view.