I propose to take Questions Nos. 68, 77, 79, 88 and 278 together.
The Health Service Executive (HSE), which has responsibility for determining the composition of its staffing complement, is anticipating that there may be some difficulties in the filling of Non-Consultant Hospital Doctor (NCHD) posts in July when doctors begin their new training rotation. Initial reports from the HSE indicate reductions in applications for these posts, especially in emergency medicine, anaesthesia, general medicine and in smaller hospitals. A range of proposals to address the situation, if there is a significant number of unfilled posts, are currently being worked on by the HSE.
A number of factors determine the extent to which the HSE can fill the full cohort of NCHD posts:
the legal requirement under the Medical Practitioners Act — reflected in the NCHD Contract 2010 — to employ NCHDs in line with their training or non-training status and related medical registration status;
reductions in the levels of overtime available arising from the implementation of the European Working Time Directive;
and the ability of the HSE and HSE-funded agencies to compete in the international recruitment market for NCHDs.
I have asked the Executive to respond directly to the Deputy in relation to the number of unfilled Non-Consultant Hospital Doctor posts in hospitals. The HSE and the Government are determined that patients will continue to have hospital services that are accessible and responsive to their medical needs.
With regard to the impact of the European Working Time Directive on services, attainment of compliance is good for patient safety. It is agreed that it serves no good purpose to have over-stretched, over-tired junior doctors treating patients. The use of excessive levels of overtime is not in patients' best interests.
In relation to attracting doctors from outside the EEA, concerns have been expressed that the current visa and work permit obligations for non-EEA doctors may be hindering recruitment. Discussions are in train between my Department, the Department of Justice, Equality and Law Reform, the Department of Enterprise, Trade and Innovation and the HSE. The objective is to provide a framework that facilitates the entry of non-EEA doctors while ensuring effective and appropriate visa and work permit arrangements are in place. My Department has been advised that visas are now being issued for 12 months duration and they can be renewed annually at a local Garda Station.