As this is a service matter, I have asked the HSE to revert to the Deputy with the information sought concerning agency costs.
The great majority of NCHD posts are filled at present. However there are a number of vacancies, mainly in smaller hospitals and in certain specialties, including Emergency Medicine and General Medicine at Registrar level. Filling these posts represents a significant challenge given that there are shortages internationally, there is a competitive market and it can be more difficult to attract doctors to smaller hospitals. Where sites, such as Waterford, continue to experience challenges in terms of vacancies, hospital management implement contingency plans. If necessary, hospitals make locum arrangements to ensure continued service delivery. While I would wish to see appointments made to fill these posts, the reality is that in many instances suitable candidates cannot be sourced and locums have to be used in order to ensure service delivery.
I am committed to improving the working-conditions of NCHDs, to ensuring that they can have a suitable career pathway within the Irish health system and to making all posts as attractive as possible. Intensive work is underway in all hospitals to pursue compliance with the European Working Time Directive on NCHDs’ working-hours. The immediate focus, involving the HSE, hospital management, the IMO and NCHDs, is on eliminating shifts in excess of 24 hours. In July this year, I set up a working group chaired by Professor Brian MacCraith, President of DCU, to carry out a strategic review of the medical training and career structure of NCHDs. I see this as a modernising initiative which is needed urgently and which will, in future years, support the retention of sufficient numbers of doctors trained in Ireland within the system. I have recently received the interim report of the Group, to be published shortly, and the final report is to be submitted to me by June 2014. System reform, in particular the implementation of the Report on Hospital Groups and the Framework for the Development of Smaller Hospitals will also assist, through achievement of a more focused and efficient deployment of NCHD staffing.
