Thomas P. Broughan
Question:7 Mr. Broughan asked the Minister for Health and Children the proposals, if any, he has to increase the number of consultant posts in public hospitals ; and if he will make a statement on the matter. [19849/97]
Ceisteanna — Questions. Priority Questions. - Consultant Posts.
The number of consultants in the health services in Ireland has increased steadily in recent years. Between 1984 and 1996, the total increased by 19 per cent and it can be expected that the numbers will continue to increase in light of new service developments, expansion of existing services, the introduction of new medical technologies, increased activity levels in individual specialities, the service requirements towards ensuring regional self sufficiency in medical and surgical specialities, and requirements regarding postgraduate medical training.
Towards ensuring that there is an appropriate framework in place to facilitate a medical manpower plan, the issue is being addressed and discussions are currently taking place with a range of appropriate organisations in the areas of training, education and regulation of the medical profession designed to match consultant numbers to service and training requirements.
I thank the Minister for his reply. Does he agree that it will be difficult to significantly improve the services provided by our health services unless the number of consultant posts, particularly in public hospitals, is increased? How many requests has the Minister received from health boards to increase the number of such posts?
I do not have the information requested in the latter part of the Deputy's supplementary question available to me but I will try to obtain it. The Department is currently conducting a medical manpower review designed to address the problems identified in the existing hospital and medical manpower structure by, among others, the Tierney report of 1993. We are also aiming at moving towards consultant provided services with a view to providing an improved quality of patient care, improved programmes of training for non-consultant hospital doctors and an improved career structure for hospital doctors.
To date the Department has met key participants in respect of medical manpower including the chief executive officers of the health boards and the Dublin acute hospitals, the Postgraduate Medical and Dental Board, Comhairle na nOspidéal and the Irish Committee for Higher Medical Training of the Royal College of Physicians in Ireland. When those consultations are completed, the Department will be able to evaluate the possible options involved. There is no doubt that we will be obliged to deal with the issue of medical manpower in our hospitals. When the consultations have been completed, I hope we will have gained a clearer picture of the situation.
The Minister will agree that the issue of career structures in hospitals has been on the table since before the publication of the Tierney report. Did the consultations to which the he referred take place recently? When are these expected to conclude and when does the Minister expect to be in a position to consider recommendations?
The consultations are current. The consultation process began before I entered office, I did not initiate it. I am not sure when the consultations will be completed.
Is it the kind of consultation period which never ends?
I do not believe so. Because of new regulations coming into place which will affect non-EU doctors in our hospitals, a situation will arise in future for which we must make plans. I assure the Deputy that this matter has arisen at management meetings in the Department, which I chair. We are commencing work to plan for the future. We need a better career structure for non-consultant hospital doctors. We also need to disabuse people of the idea that one has to gain consultancy experience abroad before one can obtain a consultant post at home. That was the trend in the past, the reason being that we did not have sufficient medical training programmes in place in our hospitals where non-consultant hospital doctors could get training and experience in the specialties in which they were interested and move on to registrar and consultant posts without there being a perception that experience elsewhere gives an advantage to prospective applicants. Many of our medical graduates are emigrating to obtain work. Given that there will be a reduction in the availability of non-EU medical doctors to work in hospitals, it is clear we must make them a more attractive workplace for our medical graduates. The problem is in its early stages, but it has been recognised.
Can I take it from the Minister's response that he would be open to proposals to create a junior consultant or entry type consultant grade within the hospitals?
I am open to change. I cannot commit myself to one or other option. I recognise that if the status quo is not addressed there will be a serious shortage of medical manpower in the years ahead and the first hospitals to suffer will be the smaller ones down the country which, from certain consultants' point of view, may be less attractive than larger hospitals where the specialties are based. It is an issue we have to work on, and I am committed to doing something about it.
Given the demographic data which indicate a large increase in births over the next ten years as the people born in the 1970s begin to have families of their own, what are the Department's plans to provide consultant obstetricians, gynaecological and other personnel, midwives, support staff, equipment and clinical services to the maternity hospitals to cater for the changes?
I have no specific plans. I recognise what the Deputy says regarding demographic trends. The same could be said of the increased number of elderly people who will require services from the health boards in the future. Comhairle na nOspidéal is the expert group that advises the Department on the need for the provision of consultant posts as trends emerge and there are pressures on services. The problems will be no different than in other specialties. The number of consultants has increased by 19 per cent in a relatively short time. We are committed to a consultant-oriented service to provide the optimum level of care, and the cost will have to be factored into health planning in the years ahead.