Dáil Éireann Debate, Thursday - 24 November 2022
3. Deputy John Brady asked the Minister for Defence the measures he and his Department are implementing or intending to implement to stem the exodus of doctors from the Defence Forces; and if he will make a statement on the matter. [58339/22]
View answer4. Deputy Cathal Berry asked the Minister for Defence the current number of medical officer vacancies; the extent to which this is impacting on Defence Force operations; and if he will make a statement on the matter. [58477/22]
View answerWill the Minister outline the measures he and his Department are implementing, or intend to implement, to stem the exodus of doctors from the Defence Forces, the current vacancy rate in that section and the extent of the impact on Defence Forces operations?
I propose to take Questions Nos. 3 and 4 together.
I am informed that, contrary to what has been suggested, there is no exodus of doctors from the Defence Forces. Medical officers are recruited into the Defence Forces via two streams, direct entry and the military medicine training scheme, which is a five-year training programme leading to dual specialisation in both military medicine and general practice. The establishment figure for medical officers is 28, which includes the position of psychiatrist and for which a civilian consultant psychiatrist is employed. I am informed the current strength of Defence Forces medical officers is 22, of whom three are undertaking the military medicine training scheme. Medical officers participating in this scheme rotate every six months between Defence Forces and civilian general practice placement and, as such, they are considered as 0.5 whole-time equivalents, giving an effective Defence Forces medical officer strength of 20.5, plus one civilian psychiatrist. There are currently 6.5 vacancies.
I am informed, however, that recruitment for medical officers remains ongoing and that four applicants have been successful via a recent direct-entry competition. One of these was recently commissioned and a further three are in the process of being security-cleared. In addition, the first two doctors are due to graduate from the military medicine training scheme during 2023 and will become full-time medical officers in the Defence Forces.
The Defence Forces acknowledge the key enabling role medical officers play in respect of operations to ensure a layered level of medical cover for all operations undertaken.
Specifically with regard to overseas, medical services provided to Defence Forces personnel are dependent upon the size of the troop deployment and the overall medical services provided as part of the mission. On larger missions, for example, the Defence Forces medical corps provides routine primary healthcare, specialised first aid, interim emergency surgery treatment, resuscitation, stabilisation of casualties and short-term holding of casualties until they can be returned to duty or evacuated. On smaller missions, these services may be provided by medical corps personnel from other forces participating in the mission. The recruitment and retention of trained medical personnel, as with other specialist areas within the Defence Forces, continues to be a major priority.
Listening to what the Minister said and reading what has been reported, I have the impression that there are two very different experiences of this issue. What has been reported is deeply concerning and would reflect the wider retention of experienced personnel in the Defence Forces.
To follow up on what the Minister said, the established number of medical officers is 28. He said 22 officers are currently in place. How many of those 22 officers are available in the here and now? This includes those on any form of absence, in service in any other jurisdiction, on illness or maternity leave or anything else along those lines. It has been reported that just nine medical officers are available. This is vastly different from what the Minister said. If one version is correct and the other incorrect, that needs to be reflected. It was reported in the media that nine were available.
All I can do is-----
I am sorry; I will take Deputy Berry first and come back to the Minister.
I hope I can shed some light on the issue Deputy Clarke raised with the Minister. I completely accept that the Minister can only use the information he is given. Having been a medical officer, I probably have slightly more accurate information that may be able to shed some light on proceedings. First, there should be approximately 32 medical officers in the Defence Forces. I am not sure where the figure of 28 came from. Without splitting hairs, however, approximately one third or 30% of medical officer posts are vacant at the moment. In the HSE, approximately 20% of consultant posts are vacant and that is causing mayhem. The Minister can imagine, therefore, the carnage in the medical corps as a result of its even higher proportion of vacancies.
I am particularly concerned about news from Syria over the past few weeks where, during a window of five or six weeks, there was no medical corps officer available. This is unprecedented in Irish peacekeeping history. The question is how we solve the retention problem because there is an exodus. Retention is primarily about pay from a medical officer point of view. I will give the Minister a quick example. The Irish Prison Service advertised for doctors earlier in the summer. It was offering €147,000 per year, plus a plethora of allowances, for doctors whereas medical corps doctors are paid half that amount. Will the Minister intervene with his Cabinet colleagues to ensure medical officers are paid at least on a par with other uniformed services in the public service?
I got the statistics I cited directly from the Defence Forces. Let us be clear on that. As it happens, I have my monthly recruitment and retention meeting with the general staff today. Every month now, I have a scheduled meeting on recruitment and retention with key leaders in the Defence Forces. We will keep having those meetings until we turn the tide on recruitment and retention challenges. There is pressure with regard to medical staff, just as there is with many other specialties in the Defence Forces and across the rest of the public sector. I listened earlier to a discussion on "Morning Ireland" about psychiatric nurses and so on. We have many pressures across the public sector. The Deputy might look at the recruitment campaign for An Garda Síochána this year. When a country is at full employment, skill sets are in demand across the private sector and people are being headhunted out of the Defence Forces and offered alternative careers, we face a challenge. The numbers I outlined are from the Defence Forces.
The United Nations Disengagement Observer Force, UNDOF, is an issue I have asked about. I am informed that a medical officer was deployed to UNDOF on 12 November. The UNDOF medical section now comprises one medical officer, one paramedic and two combat medical technicians, which is full strength. It is important to put that on the record. I have heard all sorts of social media commentary and so on with regard to a lack of medical support on the UNDOF mission. That is the factual position. If there was delay in getting medical staff on to that mission, I will certainly look at why that happened. There have been challenges with the pace of recruitment and getting medicals done, particularly with the Reserve Defence Force recruitment campaign over the summer. That is a source of some frustration. We need to look at outsourcing some medicals as part of recruitment and induction campaigns. I thank the Deputies for their insight.
I genuinely believe the Minister read out the figures as they have been presented to him. There is no question about that. At the monthly meeting this afternoon, to which he referred at a meeting of the joint committee, I respectfully suggest that he clarify whether four doctors left in the six weeks in the run-up to the beginning of November. What is the current financial outlay on the use of locums? This information will enable us to get to the bottom of this because the figures in the public domain are vastly different and there is a real need at this point to establish the facts in this case. I am in no way insinuating that the Minister has not given us the facts as presented to him. Questions need to be answered here, however. If there is an issue with doctors leaving the Defence Forces to go to the Prison Service or any other issues, a specific plan of action needs to be put in place. It is unfair to new recruits to the Defence Forces and those who currently serve in terms of the continuity of care.
I want to double up on Deputy Clarke's comments by fully accepting the Minister's bona fides with regard to the figures. He mentioned that there are two pathways into the medical corps, direct entry and the military medicine training scheme. There is a third lesser known pathway. It is the one through which I joined the medical corps and one of the current medical officers is in a similar situation. He is a GP who came back from Syria where he had been for the past six months. He joined the artillery corps 20 years ago and took a career break. He funded himself through medical school, did his internship and GP training and then rejoined the Defence Forces. Perhaps at the meeting this evening, the Minister could discuss whether we could further explore and expand this third pathway. We know the Defence Forces send officers to college to study engineering, electronics, languages and commerce. Medicine is not included in the list of eligible courses, however. Will the Minister consider including medicine on the list of university courses in order that we can make maximum use of the homegrown talent that already resides in the Defence Forces?
I expect the figures I outlined to be true, regardless of what is being said on social media platforms or in other media outlets. If they are not correct, there is obviously an issue. I expect the numbers I outlined are factually correct, however.
We need to get an awful lot better at recruitment and retention in the Defence Forces in terms of how we manage people. That is why we have approval now to move ahead with the recruitment of a head of transformation and head of HR in the Defence Forces. Both of those positions are likely to be civilians who will bring outside expertise to work with the Chief of Staff, general staff and others within the Defence Forces to look at improving our recruitment and retention rates. We are planning for that.
To be fair, the Defence Forces have done a huge amount of work in planning for a dramatic increase in numbers for the years ahead as regards inductions, training programmes and so on. Let us not forget, we are seeking to add an extra 3,000 people to the Permanent Defence Force over the next six years, which means a net gain each year of 500 people. This year, we will probably have a net loss of a couple of hundred people in the Defence Forces. We need to turn the tide. There is a huge focus in the Defence Forces and Department of Defence on doing that across all specialties and ranks and among enlisted personnel.
The straight answer to the Deputy's question is that I am, of course, open to new ways of adding to the medical staff in the Defence Forces beyond direct entry and the normal induction and recruitment campaigns which we have.
