Dáil Éireann debate -
Thursday, 8 Oct 1998

Vol. 494 No. 6

Written Answers. - Consultant Appointments.

Eamon Gilmore

Question:

10 Mr. Gilmore asked the Minister for Health and Children the plans if any, the Government has to increase the number of consultant medical posts; the numbers appointed to date in 1998; the impact, if any, of the fall-off in the number of non-EU doctors; and if he will make a statement on the matter. [18839/98]

Brendan Howlin

Question:

73 Mr. Howlin asked the Minister for Health and Children the number of hospital consultant posts in the hospital service; his views on the adequacy of these numbers; the extent to which the ratio of consultants to population compares with ratios in other EU states; and if he will make a statement on the matter. [18890/98]

Minister for Health and Children (Mr. Cowen)

I propose to take Questions Nos. 10 and 73 together.

There are approximately 1,300 hospital consultants in the public sector. The question of appointing more hospital consultants is linked to the bigger issue of medical manpower in the hospital system The number of new hospital consultant posts approved in 1998 is 52. The number of consultant posts has increased by approximately 20 per cent in the last ten years. There is a need for a more fundamental review of the medical staffing in public hospitals. That is why I have established a major new initiative on medical manpower.

The focus of the medical manpower initiative in the general hospital sector concerns addressing the imbalance between career posts and training posts, the need to improve postgraduate medical training to keep more Irish medical graduates in this country and the need to provide the highest quality of medical care for those who require the services of hospitals.

A fundamental review of medical manpower is now required. At present there are approximately two junior doctors for every consultant employed. Non-consultant hospital doctors regard career prospects as poor and a large number emigrate. Young doctors tend to leave at the point where they have just acquired the skills and expertise and are ready to make a real contribution to Irish hospitals.

Women doctors also leave the system and we need to examine the reasons that this is happening so that solutions can be found to facilitate the optimum use of their skills and develop training structures to accommodate their needs.

Other areas which require attention are the different needs of larger and smaller hospitals, combining other disciplines with medical staffing, for example, general practitioners and nurses and coping with the demographic changes which have occurred in society.

I have, therefore, established a forum on medical manpower which in association with the various medical interests will address longer term contracts for non-consultant hospital doctors, a system of structured rotations that include training in the larger teaching hospitals as well as small general hospitals, revised arrangements for medical training and the need to take into account the requirements of women, institutional structural reform to allocate clear responsibility for ensuring the quality of training in Irish hospitals, centralising responsibility for medical manpower to include responsibility for all medical manpower, the need for another career grade of doctor who would have additional responsibility for delivering a quality hospital service and the need to place more fully trained doctors in our hospitals.

The forum which has met three times is examining areas such as the adequacy of medical cover in the hospital system and the ratio of doctors in Ireland compared with other EU states and I do not want to pre-empt the deliberations of the forum by commenting on these specific issues at this time. I am hopeful however that what emerges beings to resolve the medical manpower problems in the Irish context and will take into account the special needs of our public hospital system.