Gerard Murphy
Ceist:13 Mr. Murphy asked the Minister for Health and Children his plans to address the shortage of radiographers across the State; and if he will make a statement on the matter. [10869/04]
Amharc ar fhreagraWednesday, 7 April 2004
Ceisteanna (15, 16, 17)
Freagraí scríofa
Intensive efforts have been successfully undertaken to improve staffing levels in radiography at local and national level. There had been an increase of 20% in whole time equivalent terms in the number of radiographers employed in the health service to the third quarter of 2003 compared with the end of 1999 — an increase from 757 to 908 radiographers. Recently, the number of radiography training places in the State has doubled from 30 in the 2000-01 academic year to 65 in the 2003-04 academic year.
Employment in the health services as a radiographer has been made more attractive through measures such as pay enhancements, developments in career structure and enhanced opportunities for professional development as a result of the continued implementation of the recommendations of the report of the expert group on radiography grades. In recent years, overseas recruitment by health agencies has also contributed significantly to meeting the human resource needs of the health services in radiography.
The introduction of a fast-track working visa scheme for health and social care professionals, including radiographers, and the streamlining of procedures for the validation of overseas qualifications are other initiatives that have been taken to help meet the human resource requirements for radiographers in the health service. Many radiographers with overseas qualifications have been validated as eligible to work in the Irish public health system for several years. Since the start of 2002, my Department has validated 407 radiographers as eligible to work here. Having recruited and developed many staff recently, it is a priority to retain them by offering a challenging and rewarding career path. In a human capital and skills intensive health sector, retention has been identified as a key issue in better people management. The implementation of the action plan for people management, which I launched in November 2002, is playing a crucial role in boosting the capacity of the health services to retain scarce skilled health and social care professionals, including radiographers.
Thomas P. Broughan
Ceist:14 Mr. Broughan asked the Minister for Health and Children the position regarding the application of the European Working Time Directive to non-consultant hospital doctors; the latest assessment of the implications for staffing levels in hospitals; and if he will make a statement on the matter. [10799/04]
Amharc ar fhreagra
Eamon Ryan
Ceist:64 Mr. Eamon Ryan asked the Minister for Health and Children when he hopes that Ireland will be able to comply with the European Working Time Directive for junior doctors; and if he will make a statement on the matter. [10821/04]
Amharc ar fhreagraI propose to take Questions Nos. 14 and 64 together.
Ireland will be legally obliged to begin applying the conditions stipulated in the European Working Time Directive to doctors in training from 1 August 2004. Every effort will be made to effect these employment rights from that date. As part of the early preparation for implementing the directive, a national joint steering group on the working hours of NCHDs was established in June 1999 and reported in January 2001. In order to reduce NCHD hours, it recommended that the following measures be progressed: reduction in the number of grades of doctor on-call at any one time; introduction of cross-cover arrangements; introduction of centralised rostering and shiftwork; and changes in skill-mix and practice for other grades of hospital staff. Following this work the national task force on medical staffing also recommended the introduction of a consultant-provided service, a significant increase in the number of consultants and the adoption of a team-based approach to consultant work. In line with this and with the role proposed for non-consultant hospital doctors, the task force report outlined that there should be a significant reduction in the number of NCHDs as the number of consultants increases. The objective must be to reverse the current ratio of more than two NCHDs for every one consultant.
The reasons for this approach are, first, even if it were desirable, it would not be possible to recruit sufficient extra NCHDs to cover existing rostering arrangements under the directive. This is particularly the case in smaller hospitals where there are already problems in maintaining the current numbers of NCHDs. Second, best practice requires that doctors should be recruited to accredited training posts in order to ensure the provision of quality patient care and appropriate clinical decision-making. Medical manpower managers appointed under the NCHD 2000 agreement are overseeing the reduction in NCHD working hours and are essential to the phased implementation of the Hanly report recommendations, especially where roster management is concerned. Latest returns indicate that well in excess of 60% of NCHDs will comply with the 58 hour requirement of the directive by 1 August next. However, difficulties arise when the details contained in the directive are applied, that is, rest breaks and compensatory rest. These issues are being considered and will be continuously advanced.
Negotiations between health service management and the Irish Medical Organisation about the reduction of NCHD hours have sporadically taken place in the Labour Relations Commission over the past 18 months. Progress has been slow and several key issues have yet to be agreed. The Hanly report outlines the need to establish a working group in each hospital to implement the required measures and to monitor progress in the reduction in NCHD hours. A national implementation group is also urgently required to co-ordinate the work being undertaken at local level and to monitor progress. These groups should include appropriate hospital managers, consultants, NCHDs, nurses and other relevant health care professionals.
The urgent need to establish these groups at national and local level has been discussed with the Irish Medical Organisation at the meetings in the Labour Relations Commission but the IMO has refused to agree to their establishment. It has lobbied for many years to achieve a significant reduction in NCHD working hours. That aim could be progressed by full participation in the national and local implementation groups. Chief executive officers of health boards and voluntary hospitals, and hospital managers, together with senior officials from the Department and the Health Service Employers Agency are in regular contact about progress to reduce NCHD working hours and are identifying the various steps at national and local level required to implement the directive by 1 August. In addition, a national co-ordinator and support team have been seconded to oversee the implementation process in the health agencies, and to provide direction and guidance on specific issues. Work is also progressing on the development of IT software to record NCHD working hours.
In February 2002, the medical education and training project group of the national task force on medical staffing was established to prepare an implementation plan, for medical education and training arising from the requirements of the directive and the proposal for a consultant-provided service. The group continues this task and I expect to have interim recommendations on meeting the training requirements within the directive soon. The chief executive officer of each individual health board and each voluntary hospital has responsibility for management of the workforce, including the appropriate staffing mix and the precise grades of staff employed within that agency, in line with service plan priorities, subject to overall employment levels remaining within the authorised ceiling. Hence, the recruitment of health service staff in 2004 and beyond will take place in the context of the implementation of each agency's service plan, taking into account new policy initiatives such as those necessitated by the implementation of the directive for doctors in training.
On 27 January last, I announced the composition of a group to prepare a national plan for acute hospital services. The group is chaired by Mr. David Hanly and contains a wide range of expertise from the areas of medicine, nursing, health and social care professions and management. It also includes an expert in spatial planning and representation of the public interest. The group has been asked to prepare a plan for the interim health service executive for the reorganisation of acute hospital services, taking account of the recommendations of the national task force on medical staffing including spatial, demographic and geographic factors. Rapid progress depends on all parties commencing this urgent work and preparing the plan for acute hospital services which will further help to implement changes in the reduction of working time for doctors in training.
The existence of significant difficulties and the relatively short timeframe available do not alleviate our legal obligations arising from the directive and only serve to emphasise the urgency of making rapid progress on implementation. Excessive working hours are unsafe for the doctor and his or her patients. The need to deliver appropriate training to our doctors while maintaining necessary levels of service provision will present a range of challenges. It also presents a unique opportunity to improve training, services and the working lifestyles of all NCHDs.