Vol. 443 No. 3
6 Mr. Flanagan asked the Minister for Health the total number of community doctors currently working for the health boards; the number who have been awarded permanent status; the number still in temporary or acting positions; and if he will make a statement on the matter.
33 Mrs. T. Ahearn asked the Minister for Health if the current industrial dispute affecting community doctors will in any way impede the delivery of community health services; and if he will make a statement on the matter.
I propose to take Questions Nos. 6 and 33 together.
My Department is monitoring the situation in health boards on a daily basis to ensure that every effort is being made to minimise the possibility of disruption of services due to the public health doctors' dispute. Arrangements are in place to deal with emergencies and these arrangements are working satisfactorily.
There are currently 247 public health doctors working with the health boards. The following tabular statement gives a breakdown of their permanent or temporary status by grade.
|
Permanent |
Temp-Acting |
|
|
Directors of Community Care |
7 |
26 |
|
Senior Area Medical Officers |
20 |
16 |
|
Area Medical Officers |
97 |
71 |
|
124 |
113 |
|
|
Grand Total |
237 |
There are, in addition, ten training posts.
What action does the Minister intend to take to resolve the problem where there are so many acting rather than permanently employed doctors? Surely it would be to the betterment of the services, would improve confidence in the services and boost job satisfaction for the people concerned if they were given permanent appointments.
An integral part of the strategy I published for the health services was the creation of departments of public health medicine. The reason no permanent position was filled in recent times is that it was agreed by everybody that public health medicine needed to be restructured. We have broad agreement with the representative bodies of the doctors involved in public health medicine. The one outstanding matter is the level of pay. There is a considerable gap between the current rates of remuneration for directors of community care and senior area medical officers and the rates for the new positions as directors of public health medicine and specialists in public health medicine. The expectations of those who would possible fill the new positions are greater than the capacity of the Department of Health or of the taxpayer to pay.
I was interested to hear how fast the Minister spoke when reading out those figures. I am sure he will agree that the proportion of permanent as against acting appointments is incredible. Is the Minister aware that this has a serious effect on the service, with large numbers of people filling in posts for a considerable time? It leads to uncertainty and insecurity and has led to a serious dispute with the Department. Will the Minister agree that as the role of director of community care is an important one, it is unacceptable that this dispute has developed? I recently received a letter from the director of community care in my area stating that she simply cannot deal with all the cases I bring to her attention. That position has arisen due to failure by the Department to plan and make decisions. Will the Minister ensure that people are permanently appointed to these positions so that they can get on with their very important work?
The reverse is the case; the reason for the dispute is probably that we planned so well. For the first time an infrastructure of public health medicine is clearly laid out and the Government has approved of its putting in place. There is no lack of planning. There is broad agreement on the structure. For years people have talked about departments of public health medicine and I hope I will get the full co-operation of all involved to put them in place as speedily as possible. There is only one outstanding matter, that is the issue of money. I am not in a position to meet the demands of the IMO on the salary structures for the new directors of public health medicine and to pay them at the level of senior consultant, up to £65,000 a year, which is virtually a doubling of their existing salaries.
