The ratio of consultants per head of population in Ireland is lower than in other jurisdictions. However, it is Government policy to move to a consultant delivered service and there has been a significant increase in the number of consultants (Whole Time Equivalents) over the past decade. Under section 57 of the Health Act 2004, the procedure for the approval of consultant posts in the public system and the determination of the number and type of appointments, are matters for the HSE. Since the establishment of the HSE, the number increased 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 which have been traditionally difficult to fill, regardless of the salary scale. There are also some hospitals to which it has historically been difficult to attract applicants.
Though the HSE has the capacity to recruit where it is necessary to do so in order to ensure patient safety and to support service delivery, there is evidence that there are, at present, difficulties in recruiting consultants. The ability of the public service to attract and retain consultants shapes the extent to which the HSE can maintain and develop the range of health services required.
I am currently progressing measures to ensure that we will have an adequate supply of highly skilled consultants and NCHDs. Last July I set up a group under the chairmanship of Professor Brian MacCraith to carry out a strategic review of medical training and career structures. The Group will make recommendations aimed at improving the retention of medical graduates in the public health system and planning for future service needs. It provided an Interim Report in December 2013 focused on training. In April 2014 the Group submitted its second report to me and this dealt with medical career structures and pathways following completion of specialist training. The final report of the Group will deal with workforce planning and this is due to be submitted by the end of June 2014. The work of the Group is fundamental to ensuring that positions within the public health service are attractive to consultants and doctors in training, NCHDs, in the years ahead.