Pádraig MacLochlainn
Question:218. Deputy Pádraig Mac Lochlainn asked the Minister for Health if he will confirm that the European working time directive is being fully implemented in Letterkenny General Hospital. [6011/14]
View answerThursday, 6 February 2014
Questions (218, 220, 226, 227, 228, 229)
Pádraig MacLochlainn
Question:220. Deputy Pádraig Mac Lochlainn asked the Minister for Health his plans to ensure that Letterkenny General Hospital has the necessary numbers of medical registrars in line with the European working time directive. [6013/14]
View answerPádraig MacLochlainn
Question:226. Deputy Pádraig Mac Lochlainn asked the Minister for Health his views that there is a crisis in the recruitment of NCHDs in our public hospitals. [6019/14]
View answerPádraig MacLochlainn
Question:227. Deputy Pádraig Mac Lochlainn asked the Minister for Health his views that there is a crisis in the recruitment of consultants in our public hospitals [6020/14]
View answerPádraig MacLochlainn
Question:228. Deputy Pádraig Mac Lochlainn asked the Minister for Health the percentage of consultant posts advertised by the Health Service Executive in 2013 that remain unfilled due to a lack of applicants [6021/14]
View answerPádraig MacLochlainn
Question:229. Deputy Pádraig Mac Lochlainn asked the Minister for Health the likely impact on hospital services of a simultaneous crisis in the recruitment of both NCHDS and consultants [6022/14]
View answerWritten answers
I propose to take Questions Nos. 218, 220, and 226 to 229, inclusive, together.
As they relate to service issues, I have asked the HSE to reply directly to the Deputy on his questions concerning implementation of EWTD and, related to this, the number of Registrars employed at Letterkenny Hospital. I have also asked the HSE to reply directly in relation to the data sought on consultant posts advertised in 2013.
I do not accept that there is a crisis in the recruitment of consultants or in the recruitment of NCHDs. There has been a significant increase in the number of consultants (Whole Time Equivalents) over the past 5 years. The number increased from 2,260 in December 2008 to 2,555 in December 2013. The great majority of almost 5,000 NCHD posts in the system are filled at present and were last year. I recognise, however, that recruitment of consultants and NCHDS is a significant challenge at the present time and needs to be facilitated.
It is appreciated that the 30% reduction decided in September 2012 for future ‘new entrant’ appointments represented a substantial reduction in the rate of pay for consultants. However, it was a necessary measure, given the challenging economic circumstances. If the health services are to continue to provide consultant-level opportunities for doctors to replace consultants who retire and eventually to expand overall capacity, this can only happen on the basis of a lower-cost model. I have asked the HSE and my Department to examine the application of the 30% reduction to serving consultants who move posts and to highly qualified consultants with considerable experience in Ireland or elsewhere taking up new posts.
I have emphasised on a number of occasions that there are a number of factors that need to be addressed to support NCHD recruitment and more importantly retention. NCHDs must be respected, be treated with dignity and have a clear training and career path. Given the need to address NCHDs working conditions, intensive work is underway in all hospitals, involving hospital management and the IMO, to pursue compliance with the European Working Time Directive on junior doctors’ working-hours.
In July last 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 received the interim report of the Group in December which dealt primarily with training issues. The Group is now focusing on career structures and pathways following training and is due to report by the end of March on these issues. The final report of the Group is to be submitted to me by end June 2014. I am confident that this strategic review will, in future years, support the retention of sufficient numbers of doctors trained in Ireland within the system.
It should be noted that there are some specialties, at consultant and NCHD level, in which there are international shortages and which have been traditionally difficult to fill. Filling these posts represents a significant challenge given that there is a competitive market. There are also some hospitals to which it has historically been difficult to attract applicants, in particular smaller hospitals that have onerous rosters. The planned establishment of hospital groups should help to address this issue, as this will allow doctors to be appointed as group resources - instead of to just one hospital. Where posts are vacant and suitable candidates cannot be sourced, locums are retained or alternative arrangements are made to ensure service delivery.