Vol. 814 No. 4
1. Deputy Billy Kelleher asked the Minister for Health the consultation his Department has undertaken with general practitioners in relation to the proposed introduction of free general practitioner care for under fives; and if he will make a statement on the matter. [40236/13]
The Government is committed to introducing, on a phased basis, a universal general practitioner, GP, service without fees within its term of office, as set out in the programme for Government and the future health strategy framework. It is a matter for the Government to determine policy in this area. There has been no Government decision at this stage on the details of the roll-out of a universal GP service, such as a proposal for a specific age cohort. When the Government has taken a policy decision in this area, I will engage with all relevant stakeholders, as appropriate, on the implementation and administrative arrangements.
The introduction of a universal GP service constitutes a fundamental element in the Government's health reform programme. The current Government is the first in the history of the State to have committed itself to implementing a universal GP service for the entire population. A well functioning health system should provide equal access to health care for its patients on the basis of health needs, rather than ability to pay. The principles of universality and equity of access mean that all residents in Ireland should be entitled to access a GP service that is free at the point of use. Universal access to GP care will facilitate the early identification of medical conditions, reducing the burden of illness, greater collaboration in the provision of primary care services, improved management of chronic diseases and will improve the delivery of essential health promotion and protection measures.
It has become clear that the legal and administrative framework required to provide a robust basis for eligibility for a GP service based on having a particular medical condition, as outlined initially in the programme for Government, is likely to be overly complex and bureaucratic. Relatively complex primary legislation and detailed regulations would be required to provide a GP service to persons on the basis of their having a particular illness. In my view, this would entail putting in place a cumbersome legal and administrative infrastructure to deal with what is only a temporary first phase on the way to universal GP service to the entire population.
The Government is firmly committed to introducing a universal GP service within its term of office. The Cabinet committee on health has discussed the issues relating to the roll-out of the universal GP service and has agreed that a number of alternative options should be set out with regard to the phased implementation of a universal GP service without fees.
Additional information not given on the floor of the House
As part of this work, consideration is being given to the approaches, timing and financial implications of the phased implementation of this universal primary care health service. A range of options is under consideration with a view to bringing developed proposals to the Government shortly.
We have received no further information as to what is happening with regard to the roll-out of universal GP care. We were given a commitment that an announcement would be made at some stage after the summer regarding what would replace the original commitments in respect of long-term illness in the roll-out of GP care. What I find amazing is that it is two years into the Government's term of office and we are still waiting for a formal policy decision on how it will implement GP care and the pathway to universality by March 2016, which is when the Government's term ends. Even though the Government has not yet made a decision on how it expects to implement this proposal, it should be discussing how the roll-out would work with the GPs. The programme for Government states that there will be universality by the end of the Government's term of office. In that context, it is incredible that there have not been discussions with the GPs. I believe it is a delaying tactic, so the Government can say that it must now enter into discussions with GPs, which will take a protracted period of time as well. The Government could be doing this already in advance.
I assure Deputy Kelleher there is no question of a delaying tactic in this regard. In fact, I discussed this matter with the Minister for Health as recently as this afternoon. We are actively considering this question in terms of the approaches, the timing and the financial implications of the phased implementation of the universal primary care health service. As I said previously, it must be seen in the context of the broader reform programme, including the roll-out and implementation of universal health insurance. The two go hand in hand. A range of options is under consideration with a view to bringing developed proposals to the Government shortly. We indicated before the summer that we would make announcements after the summer, as Deputy Kelleher said. At the risk of being facetious, it is still after the summer. We are working very actively on this question.
With regard to the Deputy's question about the GPs, we will discuss this matter with them. However, the Government will make the decisions. All Governments must operate on that basis. The policy decisions are made by the Government but the implementation and the roll-out will, of course, be the subject of discussions.
Governments make decisions but the problem is that this Government has not made a decision. The only decision it has made is one of prevarication. It is now two and a half years down the road in respect of a major plank in this Government's commitment to universality of primary care by the end of the Government's term of office.
Will the Deputy support us on it?
We would certainly like to see the proposals at some stage. In the broader context, it is incredible that the Minister has not sat down and discussed how the roll-out would work.
Even if the policy decision relates to long-term illness or if the cohort involved is based on age, the reality is that the people who will be responsible for implementing the actual policy will be GPs. What will happen is that the Government will hopefully make a decision at some stage and it will then enter into major discussions with GPs during the following six to 12 months in the interests of having that decision implemented. We are aware of one fact, namely, that the Government is committed to introducing free GP care for everybody by 2016. In the meantime, the Minister of State should be discussing this issue with GPs and putting in place the necessary supports to allow them to deliver on whatever decision is made.
When decisions were made a decade ago in respect of the over 70s, I do not believe the Government of the day consulted GPs as to whether it should make the relevant policy choice.
I am referring to the implementation of the policy.
No Government would consult on such a policy choice. GPs and all other relevant practitioners are entitled to be involved in the discussions and, where appropriate, negotiations relating to the roll-out of any policy decision which affects them. However, policy decisions are a matter for Government and the Deputy can expect the relevant decisions to be brought forward in early course. I look forward to the support of Fianna Fáil in respect of universal access to GP care, particularly as I have never previously heard of that party advocating such care.
2. Deputy Caoimhghín Ó Caoláin asked the Minister for Health the progress he has made towards providing justice and truth for the victims of symphysiotomy and, if he has had discussions with the Department of Justice and Equality, to now progress to enactment the Statute of Limitations (Amendment) Bill 2013; and if he will make a statement on the matter. [40227/13]
I met the support groups representing the women who have been affected and afflicted by symphysiotomy on 1 August 2013 and informed them that a decision has not yet been made by Government on how to achieve closure on the issue. I proposed at that meeting that I would appoint a judge to engage with the women affected by symphysiotomy in order to explore all relevant issues. At the conclusion of that process, the judge will advise me on how the matter may be progressed. I will then be in a position to bring detailed proposals to Government. It is, of course, open to any woman not wishing to involve herself in that process to bring a claim through the courts. Any proposals brought to Government will also take into account the findings of the independent research report commissioned by my Department in respect of the practice of symphysiotomy in Ireland. The research process comprised two stages. The first of these involved an independent draft academic research report, which was based on an analysis of published medical reports and research. The second stage involved consultation on the draft report with patient groups, health professionals and, in particular, the women who have experienced symphysiotomy.
As the Deputy is aware, the Private Members' Bill concerning the Statute of Limitations has been referred to the Select Committee on Justice, Defence and Equality. A date has yet to be scheduled for the taking of Committee Stage of the Bill. My officials will provide any necessary supports required from my Department in order to progress the legislation through Committee Stage.
My first priority is to ensure that the women who have had this procedure have their health needs comprehensively and professionally met. In this regard, the HSE provides a range of services to women who continue to suffer the effects of having had this procedure. These services include the provision of medical cards, the availability of independent clinical advice, the organisation of individual pathways of care and the arrangement of appropriate follow-up.
I welcome the fact that the Minister met representatives from the various groups campaigning on this issue on 1 August last. However, no real progress has been made in the intervening period. I welcome the Minister's statement to the effect that it is open to women to pursue the matter through the courts and that he is not seeking to corral them into accepting whatever formula he and the Government might wish to present in terms of redress. Nevertheless, the Bill relating to this matter, which I introduced in the House and in respect of Second Stage of which there was unanimous agreement on the evening of 17 April last, has not been progressed. I am greatly concerned with regard to what appear to be delaying tactics designed to prevent the legislation being addressed further in the House. On 16 April, during the debate on the Private Members' Bill in question, the Minister stated, "The Government is also committed to dealing with this issue with all the sensitivity which is undoubtedly required".
Legal firms representing 167 of the survivors wrote to the Minister on 14 March last seeking a response within a reasonable period of weeks. Some considerable time later, the Minister's private secretary issued a response indicating "Unfortunately, due to a very busy schedule of Government and Department business, the Minister regrets he will not be in a position to accede to your request". The purpose of the original letter was to initiate the Minister's engagement-----
The Deputy is over time and I ask him to conclude.
-----towards an agreed settlement. Why will the Minister not meet the representatives of the survivors and seek to reach such a settlement with them?
I hope the Leas-Cheann Comhairle will afford to me a similar amount of additional time as that which he afforded to the Deputy. I wish to make it absolutely clear that we want to bring closure in respect of this issue for the women concerned who suffered as a consequence of the procedure involved. Long after the use of this procedure had been discontinued elsewhere, it continued to be employed in this country and, inexplicably, it was sometimes performed after a baby was born. There are huge issues for the women in question and we had a very good meeting with their representatives at which these were discussed. The women were very forthright in expressing their feelings and describing what they have been obliged to endure. One woman explained how harrowing it had been for her to go through the courts. Even though she felt she had an absolutely open-and-shut case, she found herself faced with the prospect of losing her home if she lost the appeal on a point of law. I do not want these women to have to go through that.
I wish to place on record the fact that nobody will be coerced into any process. Those involved have a choice.
The Minister should conclude.
I beg the Leas-Cheann Comhairle's indulgence, particularly as he was kind enough to offer some extra time to my colleague opposite. I wish to ensure that we will bring closure for the women in respect of this matter while ensuring that they endure the least possible amount of additional pain. I have asked the Attorney General to approach a judge on the matter and discussions are in train in this regard. We want to find the right person with the best experience. We cannot really seek anyone from the High Court because some of the cases may be heard in that court. We are, therefore, limited in terms of the range of people of whose services we might seek to avail. Nonetheless, I hope we will get the right person and that she or he - I hope it is a she - will be able to progress this matter further in the context of what will work - from the women's point of view - in the interests of bringing closure.
I appreciate the Leas-Cheann Comhairle's indulgence. I wish to make a key final point and I will then conclude. I want the money to go to the women who suffered, not to legal firms.
The evidence I have put on the record in respect of the two legal firms representing 167 of the women shows that it is not a case of those firms seeking to line their pockets with money. They are quite willing - they are absolutely enthusiastic in this regard - to negotiate an agreed settlement. They put that fact on the record and the Minister rejected the opportunity that was offered in his response to them. That response issued on the same day on which the Minister placed on the record of the House the very comments I quoted at the start of this exchange.
I met a number of the women during the summer months. They are good and decent people and they do not have the open choice the Minister states they have available to them in terms of having the courts address their issues. They are dependent on the processing of the Statute of Limitations (Amendment) Bill in order to give them the choice to which the Minister refers. I urge him to accept what they have said to me in this regard. One woman asked me, "How many surviving victims must die before the Minister and his Department act?" The women in general have also asked me whether the policy is one of delay until they all die. Those are their words, not mine.
In response to the Deputy's final point, I can categorically state that this is not the Department's approach and it is certainly not my approach nor that of my Government colleagues. I want to bring closure in respect of this matter. This is one of a myriad of legacy issues left behind by previous Governments and by Ministers who presided over the Department over which I now preside. We will deal with those issues seriatim or one by one. I want to find the best way, from the point of view of the women, to proceed. In order to do so, there is a need for interaction with an individual, preferably a judge - we are seeking a judge and we are in discussions with one at present - in the context of identifying how we might proceed. The individual in question will also make recommendations to us in respect of how we might expedite the issue. I do not want there to be any delays and nor do I want anyone who has suffered and who is currently with us to be gone by the time this matter is settled. I want this to be dealt with as quickly as possible.
The clock is a new addition to the Dáil. The Minister has two minutes and there is one minute for each question and reply. Like every referee, I will probably be accused of being fair or unfair. No referee gets it right all the time but I will do my best. When I tell Deputies their time is up, they can check it by looking at the clock.
3. Deputy Finian McGrath asked the Minister for Health if he will provide an update on the crisis in disability services in St. Michael's House; and if he will make a statement on the matter. [40365/13]
St. Michael's House received more than €70 million in 2012 in funding from the HSE to provide a range of services to approximately 1,660 children and adults with an intellectual disability in more than 170 centres in the greater Dublin area and in Navan, County Meath.
The HSE and St. Michael's House work in close collaboration in regard to the funding and delivery of services to people with an intellectual disability. As a voluntary agency, St. Michael’s House is obliged to work within the resources available to it and in that regard has introduced significant efficiencies over recent years to remain within budget. The HSE has advised that these changes to date have not resulted in service contraction.
The Haddington Road agreement sets out measures relating to productivity, cost extraction and reform which together intend to achieve a required pay bill reduction of €150 million identified in the HSE Service Plan 2013. The agreement provides a framework and opportunities for managers within the health services, including agencies such as St. Michael's House, to reduce their costs associated with agency and overtime and a wide range of other pay costs, in particular through measures such as additional working hours and revised rates in respect of overtime.
The HSE has advised the Department of Health that the recent application of additional budget cuts under the Haddington Road agreement has presented a significant challenge to St. Michael's House. A process is now under way between the HSE and St. Michael's House to identify the impact of these budget reductions on services. In this respect, I understand that the following are under discussion: St. Michael's House proposal of Sunday closing and revised transport arrangements are under consideration in consultation with those families who may be in a position to accommodate this; the HSE is unaware of any issues concerning respite; appropriate staffing levels and skill mix are under consideration in line with the Haddington Road agreement; and patient charges are being reviewed by St. Michael's House in line with national regulations.
The HSE is working with St. Michael's House and other service providers to fully address the needs of school leavers in 2013 by reconfiguring existing resources. The Department of Health has received assurances from the HSE that both organisations are committed to working within the terms of the Haddington Road agreement to ensure that services are impacted upon only as a measure of last resort.
I thank the Minister of State for his response. I am glad he accepts St. Michael's House is experiencing major challenges in the current economic climate. There is a huge crisis in regard to the services in St. Michael's House. All summer families came to my clinics and they have contacted me about day care services, transport issues and respite. They even contacted me from the constituency of the Minister, Deputy Reilly, because of the lack of services. The reality is that €12 million has been taken out of St. Michael's House services over the past two and a half years.
St. Michael's House has 1,663 service users and 454 residential places and those people are frightened. The parents of adults with severe physical and intellectual disabilities are worried about the transport issue in that they will not be able to get to their centres in the morning. Some parents have told me they might have to give up their jobs to try to facilitate their children.
The Minister of State spoke about productivity and efficiency. St. Michael's House has taken major cuts and has carried out reforms and has cut administrative costs by 34%. Absenteeism is down to 3.5%. It delivers an efficient service and yet the Minister has withdrawn money from it and now the services are in crisis.
I cannot disagree with the Deputy. There are real challenges here. Everybody understands that and, as public representatives, we are all aware of the incredible work St. Michael's House does. In circumstances where costs are being reduced, no one can deny but there is an impact. As I said, the HSE is trying to ensure services are impacted only as a very last resort. A concerted effort is being made by all concerned, including St. Michael's House, to ensure we minimise the impact on services.
I accept the interest the Deputy has expressed in this regard. There are real challenges but they are being addressed in a sensitive way which ensures the undoubted reduction in finance has the least possible impact on services.
When dealing with adults with an intellectual disability, stability and routine are very important. When one disrupts that stability and routine in terms of services, it causes a huge crisis which is what the families have told me. I am disappointed the Minister of State, Deputy Kathleen Lynch, is not in the Chamber because disability is her specific reasonability.
The Minister of State mentioned the challenges, including the Sunday closing, which is a disgraceful cut. He also mentioned transport. Parents have been told to transport their children with physical and intellectual disabilities to the centres themselves which some cannot do.
We are coming up to the budget and I urge the Minister of State, Deputy White, the Minister, Deputy Reilly, and the Minister of State, Deputy Kathleen Lynch, to ensure disability services are top of the agenda. They promised they would protect the vulnerable and now is their opportunity to do so. I urge the Minister to listen to the parents and to look at the savings which have already been made by St. Michael's.
I will take note of what the Deputy said in his rejoinder. The Minister of State, Deputy Kathleen Lynch, is genuinely indisposed on this occasion and no offence should be taken by the Deputy.
Okay.
4. Deputy Billy Kelleher asked the Minister for Health if he will examine the possibility of introducing paediatric care packages for children with life-limiting conditions; and if he will make a statement on the matter. [40237/13]
The issue of the provision of home care packages for children with life-limiting conditions is complex, encompassing those requiring short to medium-term care, those with a disability requiring long-term care and also sick children for whom sadly there is no reasonable hope of a cure.
Palliative Care for Children with Life-limiting Conditions in Ireland – a National Policy, published in 2010, provides the foundation and clear direction for the development of an integrated palliative care service for children and their families across all care settings. Following its publication the national development committee for children's palliative care, NDC, was established by the HSE to oversee the implementation of the national policy. Membership includes statutory, professional, parent and voluntary representatives, including the IHF, LauraLynn and The Jack and Jill Foundation. The NDC has commenced working in partnership with these providers to develop a model for the provision of hospice at home care.
In 2012 the HSE spent approximately €8.58 million on home nursing for children with life-limiting conditions. It is widely acknowledged that this does not capture all relevant expenditure, which is significantly higher. Children with life-limiting conditions, in particular palliative care needs, are prioritised by the HSE. Every effort is made to provide care to the maximum extent possible, including home care for them and their families.
The HSE is committed to proper governance, that care provided is clinically sound and that those providing care are adequately trained. A suitable national programme of continuing professional education has been established in partnership with the HSE, IHF and Crumlin children's hospital. A working group has been established in HSE Dublin mid-Leinster to restructure the financial system so that relevant expenditure is effectively accounted for. This will be replicated across all regions.
Eight children's outreach nurses are in place throughout the country to facilitate a co-ordinated support structure for children and families. They will identify the needs of each child and link families to appropriate local services. The first consultant paediatrician with a special interest in paediatric palliative medicine has been appointed to Crumlin hospital and is available to provide an advisory service to other paediatric and maternity hospitals.
I thank the Minister of State for his reply. Approximately 1,400 children have life-limiting illnesses in this country and approximately 340 die each year. Not enough is being done. If one was to be harsh and look at it from an accounting point of view, one would see it is a cost saving exercise. Providing palliative care and supports for children with life-limiting illnesses at home is a cost saving rather than having them in acute hospital setting. More important, allowing people to care for their loved ones at home in their own surroundings, with which they are most comfortable, is the right thing to do rather than have parents and siblings traipsing in and out of hospitals on a continual basis.
We have the expertise and competence. LauraLynn and The Jack and Jill Children's Foundation, to which the Minister of State referred, are two excellent organisations which provide wonderful supports for people at home. We have the competence but what we need are the resources to establish a proper paediatric home care package.
I urge the Minister of State to look on this matter from a human point of view and also as a solution to the budgetary position.
When cost savings are required, they do not happen in disregard of the real needs of the people involved. That is particularly true in the case we are talking about. Of course resources are always a challenge. We all know the reasons they are a particular challenge at this time. The strategy that has been outlined is being brought forward. The appointment of the consultant in Crumlin is an important development. I think everybody has a commitment to this area. Everybody can see this is an area we need to attend to. I think the Deputy will accept on the basis of the initial reply that it is regarded by the HSE as an important area of work.
I welcome the Minister of State's reply. The difficulty is there is often a disconnect between what is said here and what actually happens on the ground. The current position is that medical cards are being withdrawn from some of the sickest children in this country. Deputies on all sides of the House are raising this on a continual basis. The Minister of State has said there is a strategy in place for providing paediatric home care packages and supports to children with life-limiting illnesses, but the reality is that is not happening. Organisations like LauraLynn and The Jack and Jill Children's Foundation are being put to the pin of their collars as they try to raise funds, provide support and give people palliative care at home. The strategy sounds good, but we need the resourcing to fund 24 hour palliative care for children with life-limiting illnesses. This is necessary to allow them to live at home with their families in dignity. As I have said, it is a cost-saving exercise. It costs up to €150,000 a year to keep a child in an acute hospital setting. Palliative care at home can be provided to children for €16,000, with the rest of the cost being met with the support of LauraLynn and the Jack and Jill Children's Foundation.
I do not know whether I can add too much to what I have already said. The initial question related to the introduction of paediatric care packages for children. The national policy is in place and is being implemented. This is undoubtedly an important issue. No one can disagree with the general thrust of what Deputy Kelleher has said. We are always trying to identify more resources as best we can. We understand the issue here. I think it is dealt with well and sensitively.
5. Deputy Caoimhghín Ó Caoláin asked the Minister for Health the action he will take to ensure immediate progress in reform of hospital medical staffing and in our medical training and recruitment system to ensure compliance with the European working time directive for non-consultant hospital doctors, to recruit and deploy doctors in sufficient numbers and appropriate grades, including new grades as required, and provide a proper career path to guarantee safe practice, better working conditions and improved care for patients; and if he will make a statement on the matter. [40228/13]
Ireland must have sustainable arrangements to train and develop the medical workforce we need to provide safe and effective services to our population. For that reason, I am committed to retaining in our health service doctors who are educated and trained in Ireland. I intend to do this by providing them with clear career pathways and appropriate working conditions. I think the lack of such requirements is one of the main reasons many of our young doctors are leaving. The Government is committed to achieving compliance with the European working time directive in relation to non-consultant hospital doctors by the end of 2014. At my request, the HSE established a national group earlier this year to bring an urgent focus to the implementation of the working time directive. This group has been working closely with hospitals. There has been progress on a number of interim targets relating to the number of doctors working more than 24 hours in a single shift and instances of doctors working more than 68 hours a week. I am confident that progress will continue to be made towards the objective of full compliance.
I welcome this week's decision by the Irish Medical Organisation to suspend its threat of industrial action by non-consultant hospital doctors. This followed last week's discussions under the auspices of the Labour Relations Commission. A further meeting of the parties is taking place today. I hope it will be possible to resolve the issues of concern in a way which does not involve disruption of services to the public. In July of this year, I set up a working group chaired by Professor Brian MacCraith, who is the president of Dublin City University, to carry out a strategic review of the medical training and career structure of non-consultant hospital doctors with a view to improving the retention of graduates in the public health system. In particular, I want the group to set out a clear pathway for training at every level from intern to specialist and to examine the potential for reducing the length of specialist training. I see this as a modernising initiative which is needed urgently. I have asked Professor MacCraith to provide an interim report to me by the end of November 2013 and a final report by the end of June 2014.
I am very keen for this matter to be resolved. I want to send a message to the young men and women who study hard to achieve high points in the leaving certificate, and who study so hard for a further five years at college to become doctors, that there is a future here for them. We need them and we value them. We should respect them. I certainly do, even if others have not in the past.
They certainly have my respect. We all welcome the fact that the strike action that was due to take place yesterday has been suspended or deferred. It is important that there has been engagement between the Irish Medical Organisation and the HSE. In his response, the Minister referred to "compliance ... by the end of 2014". Can he confirm that the HSE has agreed to a timetable for the implementation of the European working time directive, with compliance beginning from early January 2014? That date, which is a short number of months from now, is just after the start of the next rotation of junior doctors. Has the Department of Public Expenditure and Reform given a commitment to provide whatever resources are needed? We appreciate that resources will be needed in this situation. The Minister will certainly be very mindful of that in terms of the responsibility of his Department. Have commitments been made with regard to resources to ensure implementation of the directive?
In the past, everybody always looked to quantums of money and numbers of people. A change in the way we work is what is really required as we reform our health service. It should not be a question of asking people who are already working hard to work harder. It should be a question of asking them to work differently. I asked the HSE today why some model 4 hospitals - the big hospitals - have nine nurses for every health care assistant, while other hospitals of model 4 size have 2.8 nurses for every health care assistant. Non-consultant hospital doctors are being asked to do a great deal of work which they should not be doing and which could be done by others. The hospital groups will help in this regard. I want to put it on the record of the House that we have made considerable process in relation to this. No non-consultant hospital doctor now works more than 68 hours. That was our initial focus. I am not sure we are 100% there yet, but we are working towards that and on ensuring no shifts exceed 24 hours.
I welcome the Minister's acknowledgement that we need to address some of the core issues here, including career path issues. Does the Minister accept that the virtual crisis situation with junior doctors has continued year after year? Does he agree that fundamental reform along the lines of what he indicated at the outset of his reply is long overdue? The elements of reform are well known and were set out in my question. Can the Minister tell us whether he is making progress with the new grades that are required, or with the necessary increase in the number of consultant posts? He referred to those who achieve the highest performance rates in the leaving certificate. What is he doing to open medical training to more of our young people and not just those from privileged backgrounds - I do not suggest that all medical students come from such backgrounds - or those who attain 600 points in the leaving certificate? I have seen the great disappointment of young people who have done exceptionally well in the leaving certificate but have been excluded from these requirements even though they have the necessary attributes to prove to be among the most caring and dedicated of doctors in the future.
Of course education is a matter for the Minister for Education and Skills. While no system is perfect, the leaving certificate is about the most transparent and fair system we have. I have already placed on the record my distaste for the health professions admission test. Its introduction has led to the development of a new industry that involves educating people in how to pass the test. It has been proven that people who have failed the test have subsequently passed it after going away and doing a course. It is not really doing what it is supposed to do in terms of testing aptitude in a genuine fashion.
I want to give the House some positive news. There are an extra 200 non-consultant hospital doctors since this Government took office. The Deputy asked about consultants. There are another couple of hundred of them as well. Overall medical manpower has increased by approximately 420. According to a 2009 survey, non-consultant hospital doctors worked an average of 60 hours a week. HSE data from 2012 indicate that non-consultant hospital doctors work an average of 54 hours a week. There will be exceptions because these are average figures. Data for the first six months of 2013 show that there has been a further reduction to 52.4 hours per week. The percentage of non-consultant hospital doctors working shifts in excess of 24 hours decreased from 58% in March 2013 to 24% in August.
Further progress needs to be made. We are very pleased to be co-operating with the IMO and NCHDs in this regard. I want to address the other issues that affect them in terms of the lack of a career path.
Would the Minister create a new grade to help their career path structure?
No, I did not say that. I want to shorten their training. I do not see why one can become a fully trained specialist in Australia in six years and yet it takes, on average, 12 years here. That is not acceptable and is not fair on people. It strikes me that we have many people who are very experienced at a lower grade doing an awful lot of the work when they should already be in that specialist grade and out there as specialists. That is what I want to see.
