Vol. 243 No. 3
asked the Minister for Health the vacancies in each category of assistant psychiatrist and senior psychiatrist at present in the psychiatric service; the longest duration of any such appointment; and what steps he has taken, or proposes to take, to deal with the problem of attracting satisfactory personnel in sufficent numbers to the service.
2.
asked the Minister for Health what action has been taken by him to implement paragraph 190 of the Report of the Commission of Inquiry on Mental Illness dealing with the need for appointing a psychiatrist in overall control with doctors of consultant status having full clinical responsibility for their patients and the title senior assistant medical officer which is considered to be undesirable, implying its substitution with the term consultant.
With your permission, a Cheann Comhairle, I propose to take questions Nos. 1 and 2 together. It is presumed that the Deputy refers to vacancies for permanent posts of psychiatrist and senior psychiatrist. There are at present 47 vacancies for permanent psychiatrists and 12 for permanent senior psychiatrists in the psychiatric service. The vacancy of longest duration is in the grade of psychiatrist, formerly known as assistant medical officer. This vacancy arose in February, 1963.
Following discussions which were held by my Department with managers of mental health authorities and resident medical superintendents, a circular letter was issued in August, 1968, to each authority indicating that the Minister for Health was very concerned regarding the number and quality of applicants for medical posts in the psychiatric services and outlining a number of steps which could be taken to improve the position regarding recruitment. Among the matters dealt with were:
(i) a recommendation that the titles of medical officers in district mental hospitals could, with advantage, be altered as they did not suitably describe the nature of the posts and including in particular a suggestion that the title of senior assistant medical officer should be changed to senior psychiatrist;
(ii) the grant to senior psychiatrists, at the discretion of managers of the right to limited consultant practice and to medical superintendents and senior psychiatrists of the right to limited private beds;
(iii) provision for special incremental credit to medical staff for experience in psychiatry;
(iv) provision for the payment of an allowance of £175 to persons possessing higher medical qualifications;
(v) the grant of increments to married women holding temporary appointments;
(vi) provision for the employment on a sessional basis of psychiatrists not in the local authority service and of other medical practitioners;
(vii) provision for the participation of officers from provincial mental hospitals in a training scheme involving practical experience in psychiatry needed to complement university lectures.
The circular letter also indicated that the Minister was conscious of the critical position in some mental hospitals in regard to medical staffing and that sympathetic consideration would be given to proposals from individual hospitals not covered specifically by the measures mentioned above. In addition to the steps already outlined a committee was appointed in August last to consider the recruitment, training and utilisation of psychiatric medical staff. When I have received and examined the report of this committee I will consider what further measures need to be taken. The extent to which senior psychiatrists employed by mental health authorities are given clinical responsibility for their patients is a matter for the medical superintendent or the medical officer in charge.
3.
asked the Minister for Health whether temporary medical officers in the psychiatric service are on an incremental salary scale; and, if not, if he is prepared to give such an incremental scale on appointment.
Incremental salary scales normally apply only to permanent appointments. Health authorities have been authorised to apply the appropriate salary scales to married women who, because of the shortage of permanent staff and because married women are ineligible for permanent appointments, are employed as medical officers in the psychiatric service on a temporary basis. In view of the number of openings for permanent appointments of medical staff in the psychiatric service, there is no apparent need to apply salary scales to temporary appointments generally.
4.
asked the Minister for Health what investigations have been carried out by him into the reasons for the delay in appointing a doctor of forensic psychiatry; if he is aware that the question of according years of service and superannuation rights under the National Health Scheme in Britain is at issue; and if this concession will be made without delay in view of the urgent need to have the services of an eminent psychiatrist to assist in dealing with the very urgent problem of adolescent crime and criminology generally as the person in question is a specialist practitioner in penology and criminology.
I understand that the Dublin Health Authority has not so far made an order requiring the person recommended by the Local Appointments Commission in July last for this appointment to take up duty within a specified time under pain of forfeiting the appointment. The health authority apparently does not yet consider that in the circumstances of this appointment the person recommended has taken too long to decide to take up duty. I understand that the health authority is in touch with him in order to clarify the salary and superannuation conditions of the appointment. He has not indicated to the health authority on what, if any, of these conditions his decision depends. The appointment must be made on the he conditions provided for under the Local Government Acts and the local government superannuation code. The superannuation conditions which the Deputy suggests should apply to this appointment are not provided for in that code.
