Dáil Éireann Debate, Tuesday - 1 April 2014
98. Deputy Tom Fleming asked the Minister for Health the number of hospital consultants' posts currently vacant; how widely medical consultant positions are advertised throughout the world by the Health Service Executive; the reason the salary scales applicable are not specifically included in advertising; and if he will make a statement on the matter. [15156/14]
Amharc ar fhreagraHow many hospital consultants' posts are vacant? How widely are medical consultant positions advertised across the world by the HSE? Why are the applicable salary scales not included in advertising?
I thank the Deputy for his question. It is Government policy to move to a consultant-delivered service. I am pleased to inform the House that, since the establishment of the HSE, there has been a significant increase in the number of whole-time equivalent, WTE, consultants by 723 from 1,947 in January 2005 to 2,670 in December 2013. However, there are some specialties in which there is an international shortage and that have been traditionally difficult to fill regardless of the salary scales. There are also some hospitals to which it has historically been difficult to attract applicants, in particular smaller hospitals that have onerous rosters due to a limited number of consultants. The establishment of hospital groups will help to address this issue, as they will allow doctors to be appointed as group resources instead of to just single hospitals.
The Public Appointments Service recruits permanent consultants on behalf of the HSE. All of these posts are advertised on www.publicjobs.ie, in the national newspapers, in medical journals and also on occasion through professional social networks. The terms and conditions are included in the information that accompanies these advertisements. Clearly, these include pay. They specify the types of contract being offered, for example, type A or type B, the applicable new entrant salary scale and the condition that serving permanent clinical consultants in the Irish public service are to retain the salary scales to which they were subject before these appointments.
Notwithstanding the need to reduce the numbers employed across the public service in order to meet fiscal and budgetary targets, the HSE has the capacity to recruit consultants. Arrangements are in place in the HSE to allow the recruitment of front-line staff where there is an established service need.
The HSE has advised that 34 hospital consultant posts are vacant. A further 219 consultant posts are filled by temporary or locum appointees. It should be noted that consultant posts take a number of months to fill, as applicants may be finishing training programmes or working abroad gaining additional experience at the time of their applications and, of course, are duty-bound to finish out their contracts.
Additional information not given on the floor of the House
The ability of the public service to attract and retain high-quality consultants shapes the extent to which the HSE can maintain and develop the range of health services required. As such, I set up a group under the chairmanship of Professor Brian McCraith last July to carry out a strategic review of medical training and career structures. The group submitted an interim report focused on training to me in December and is now progressing examination of the career structure to apply on completion of specialist training with a view to reporting to me shortly. Broader issues relating to recruitment and retention of non-consultant hospital doctors, NCHDs, and consultants will be given further consideration on receipt of this report.
I thank the Minister for his reply. To put this issue in context, Kerry General Hospital has advertised numerous times for consultant radiographers.
Radiologists.
There are two vacant posts and the hospital recently received one application. For years, this service has been provided by private contract at an increased cost of approximately 40% compared with filling the posts within the hospital. This is a time of scarce resources when we must get value for money. Will the Minister streamline the advertising process? Are we reaching out universally to recruit suitable and qualified applicants?
Just for clarity, and I am not in any way trying to be difficult, but the Deputy mentioned radiographers. They are the people who take the pictures and are not consultants per se. Radiologists are the consultants who read the pictures.
I will conclude my answer. The ability of the public service to attract and retain high-quality consultants shapes the extent to which the HSE can maintain and develop the range of health services required. As such, I set up a group under the chairmanship of Professor Brian McCraith last July to carry out a strategic review of medical training and career structures. The group submitted an interim report focused on training to me in December and is now progressing examination of the career structure to apply on completion of specialist training with a view to reporting to me shortly. Broader issues relating to recruitment and retention of non-consultant hospital doctors, NCHDs, and consultants will be given further consideration on receipt of this report.
I do not profess to be familiar with the specific problem in Kerry, so I apologise. Sometimes, hospitals that are geographically isolated experience difficulty in attracting consultants and NCHDs.
The group hospital scenario helps to address that, as they can be part of a group and move around through the hospitals, thus making themselves available to the broadest range of individuals within the service.
A recent report stated that less than one third of consultant posts advertised since 2012 have been filled. This is alarming, to put it mildly. The figures show that just 36 of 104 consultant posts have been taken up at this stage. The Public Appointments Service has confirmed that it received no applications for some consultant posts and it has re-advertised a number of times. A recent "Prime Time" programme on RTE provided the information that one locum in a certain hospital was paid up to €300,000 for services in a 12 month period. We must move with more urgency towards getting the overall situation back to normality.
The number of consultants has been increasing year on year, and that has been the case for the past number of years. In 2011, there were 2,470; in 2010 there were 2,410; in 2012 there was a further increase to 2,510 and last year the figure increased to 2,560. Year on year we are not only replacing those who are leaving but also adding to the total number. However, I must return to the point that there are certain areas and certain specialties that pose difficulties and we are examining innovative ways of trying to address that. The McCraith report will help in that regard.
The new salary scale, which starts at anywhere between €116,000 and €122,000 is a considerable sum of money and compares extremely favourably with the UK, where the starting salary is £80,000 or €100,000. People are wont to compare immediately with America, Canada and the wealthier nations, but that salary is for somebody who is just finished their training to be a consultant. I do not expect a consultant who has worked abroad as an associate professor of cardiology or whatever for ten years to come back here and start on that salary rate. That would not be appropriate. In all walks of life, people get paid a certain amount more for the additional experience they have.
