Seán Ó Fearghaíl
Question:1. Deputy Seán Ó Fearghaíl asked the Minister for Defence if the Defence Forces have succeeded in recruiting the required number of doctors; and if he will make a statement on the matter. [1391/15]
View answerWednesday, 14 January 2015
Questions (1)
Oral answers (6 contributions)
I welcome staff and colleagues back to the House and wish them a happy new year. My question reflects the difficulties experienced by the Defence Forces in recent years in recruiting the full complement of doctors to provide services to members of the forces. I am seeking to ascertain what progress has been made in this regard.
I join Deputy Ó Fearghaíl in wishing colleagues and staff a happy new year and welcoming them back for what we expect to be a busy term in the Dáil.
I am advised by the military authorities that as of 9 January 2015, there are 20 doctors employed as medical officers in the Permanent Defence Force. The current establishment figure for medical officers qualified as doctors in the Permanent Defence Force is 28. There is an ongoing recruitment effort to appoint doctors to fill vacancies for medical officers in the Defence Forces. To this end, a competition for the appointment of doctors remains open, with applications being accepted on an ongoing basis. Unfortunately, there has been and remains a limited response to this competition. As suitably qualified applicants are identified, they are interviewed with regard to their suitability for service in the Defence Forces. In 2014, three doctors were appointed as medical officers, and a further two applicants are currently progressing through the selection process.
Due to the difficulty experienced in recruiting doctors to the Defence Forces, it has been necessary to identify alternative options for the provision of medical services, including consideration of the outsourcing of Defence Forces domestic medical services. In this connection, a joint civilian-military standing committee was set up with a view to advancing the development of a sustainable integrated medical service and addressing the appropriate means of delivery of key medical capabilities for the Defence Forces. An integrated model for provision of the required medical services, involving both the medical corps and outsourced service provision, is currently being progressed.
I take this opportunity to assure the House that Defence Forces personnel requiring medical treatment are getting the care they need. I am committed to providing a sustainable medical service to meet the needs of the Defence Forces both at home and abroad.
I welcome the Minister's statement to the effect that Defence Forces personnel are receiving the medical care they need. That is an issue of paramount importance to all of us. My interest in the area of medical services dates back to the decision of the Minister's predecessor, Deputy Shatter, to close the Curragh families clinic. When I previously raised this matter with him, Deputy Shatter advised the House that the establishment figure for medics within the Defence Forces was 32. The Minister has just stated that this figure now stands at 28. Much more significantly, figures provided by the then Minister, Deputy Shatter, indicated that 45 private GP practices provided services to the Defence Forces in 2012 and that these accommodated 36,000 visits during that year. The cost to the Exchequer in this regard was €1.4 million. In 2011, 51 GP practices accommodated 39,000 visits at a cost of €1.5 million to the Exchequer. The figures for these visits seem inordinately high and it is extraordinary that this number of GP practices are providing services in addition to those provided by Defence Forces medics. The current position with regard to the general population is that 141 medical professionals provide services to every 100,000 members of the population. This would equate to 14.1 doctors for every 10,000 personnel within the Defence Forces.
The Deputy quoted a number of figures. Defence Forces personnel are not like everyone else in society. They are constantly checked in terms of their mental and physical fitness, they are driven hard in the context of the training they must undergo and they are benchmarked with regard to the standards etc., which they need to set. As the Deputy knows, medical assessment of Defence Forces personnel forms part of the training regime. Defence Forces personnel, who are fit, strong, healthy young men and women, are still obliged to see GPs in order to ensure that they meet the standards expected of them. There is a difference between medical care for these personnel and the need to outsource the carrying out of assessments relating to fitness levels and so on.
In the context of the alternative arrangements that are in place to provide medical cover to military personnel, a total of 36 medical practices, including those involving nine retired military medical officers, provide general practitioner medical services, as required, for military personnel on a contract for services basis at various military installations. We are examining practical ways to ensure that Defence Forces personnel will have access to the medical facilities required in order that they can be looked after adequately in the context of their health demands. Obviously, however, an establishment figure of 28 trained doctors within the Defence Forces is something we would like to achieve. We will continue to consider ways to ensure that we host more successful recruitment campaigns.
I take the Minister's point. However, it seems extraordinary that in 2011 and 2012 - this also appears to have been the case in 2013 and 2014 - it was necessary to make contractual or other arrangements with anything between 45 and 51 general practices in order to meet the needs of what should be - and is - the healthiest cohort of people in the country. Some 39,000 and 36,000 visits were accommodated by such practices in the years 2011 and 2012, respectively. The numbers of such visits appear to be inordinately high.
The management of the medical services by the Department of Defence is, at best, questionable, and serious attention needs to be paid to how they are managed and ordered, and to the cost arising in respect of them, namely, €3 million over the two years. This cost excludes consultancy services because I notice that in each of the two years, there were six consultants in addition to the general practitioners on a retainer of some sort in the Department. In addition, out-of-hours services were provided.
The Deputy is trying to make a big issue out of something that I admit is an issue in terms of our capacity to recruit the required number of doctors suited to be in the Defence Forces. Recruiting them is a problem. We have 20 but need 28. We need to find ways of attracting medical practitioners into the Defence Forces more successfully. However, I take issue with the Deputy's suggestion that because there are as many visits to general practitioners by members of the Defence Forces as he has quoted, there is some kind of health problem. The role of doctors and medical advisers to the Defence Forces is very different from that of medical personnel among the normal population. To be fair, the Deputy accepts that. The figure for medical practitioners is actually 36.
On recruitment, it is true to say that in 2011 there were no additional doctors in the Defence Forces. In 2012, there was one extra, in 2013 there was another one, and last year there were three. There are two currently under consideration for the start of the year. We are making some progress here but this is certainly an area that I am very aware needs constant attention. It is receiving attention. There is a committee examining this matter to ensure we proceed in a cost-effective way and, most important, in a way that is appropriate for a modern defence force.