Dáil Éireann Debate, Tuesday - 3 November 2020
83. Deputy Róisín Shortall asked the Minister for Health the number of public health doctors required and the number of these posts which will be at consultant level in respect of his undertaking to increase the numbers of public health staff; his plans in respect of the recruitment of additional public health nurses; his plans in respect of other public health staff; and the timeframe to which he is working for the filling of these posts. [33889/20]
Amharc ar fhreagraPrior to Covid, most people had not heard of public health doctors, although they did essential work in terms of population health, prevention, screening, vaccinations and all of that key work. Since Covid, many of them have been occupied entirely with critical Covid work. At the same time, they have been treated as the poor relation of medicine. It is now time to address that and to fund this critical service properly. Does the Minister accept that?
I do. There are many different things going on. The first of two of the big ones, of which the Deputy will be aware, is moving the public health doctors to consultant status, which is important. The Department is currently in preliminary talks with the IMO about how that might work. I am meeting with public health doctors this Friday. The second is an expansion of the workforce. I have sanctioned a doubling of the workforce. We are working through exactly how that might be deployed. There are public health doctors, public health nurses, data specialists and scientists. The Health Protection Surveillance Centre, HPSC, is looking for them as well.
Like the Deputy, I want to pay tribute to our public health doctors. They have worked incredibly hard. We have a small number of them but they are doing a huge amount of work in the community with testing and in the national response with the schools. They have been working damn hard and they are tired. They most definitely deserve our thanks and respect. More importantly, they deserve an investment in public health.
There are currently 72 public health doctors permanently employed as specialists and-or directors in public health medicine in the HSE. I have committed to the early introduction of a new framework for public health, as provided for in the programme for Government, as well as the establishment of a consultant-led public health model. Budget 2021 provides for recruitment of up to 250 additional permanent staff. The HSE is looking at hiring up to 400 temporary staff during the pandemic response. They will support the public health teams.
The public health doctors have been advocating for many years for consultant status, which we are moving on. They have also said they need support staff around them. They are having to do a huge amount themselves that support staff should be doing. We are looking to hire and deploy, first on a temporary basis around the pandemic, but also on a permanent basis to support them.
That all sounds fine. The reality, however, is that the discussions with the Department have not been successful. The Minister is talking about a framework which is all fine. We need commitments on this, however. Ireland is an outlier. There are 72 public health doctors who are specialists. They have the same qualifications as all other consultants and yet they are the only specialty that does not have consultant grade.
Will the Minister give a commitment tonight that those 72 specialists, with all the qualifications to become consultants, will be upgraded to consultant level? Will he agree that this is part of his plan? It is critical, as well as introducing the additional support staff but also other doctors and consultants.
We are an outlier also in terms of having such a low number of public health doctors, 72. The number is double or nearly treble that in other countries of comparable size such as Scotland or New Zealand. Will the Minister give that commitment tonight?
I thank the Deputy. I share her views. The 72 doctors she has mentioned include 15 public health specialists and 17 directors of public health, who obviously have wider remits. The public health doctors we have on the ground are even more stretched.
They are not consultants.
We are negotiating the consultant contract. Discussions are ongoing between the Department and the Irish Medical Organisation, IMO. With the greatest respect, I cannot get into the detail of those negotiations because they are ongoing. As the Deputy noted, various statements have been made. The public health doctors are considering a ballot, which I fully appreciate is their right. However, given the situation I am not in a position to get into details that are being worked out through these conversations in the House. I am sorry about that. It would not be fair to the IMO or to the process that is taking place.
A very important principle arises here. Does the Minister accept that these 72 doctors, who are specialists with full consultant qualifications, should be upgraded to a consultant grade? That is a straightforward question. Is there any justification for continuing to treat them less favourably than their colleagues in all other specialties? Is it not an absolutely shocking comment on the very valuable work of public health doctors to tell them that the Government is not prepared to upgrade them to the level of their colleagues in other specialties? There is no justification for not doing that. There have been umpteen reports recommending that since 2002. This is the way to deal with the issue. Let us not get to a point where industrial action is threatened and possibly taken by public health consultants in the midst of a pandemic while the Minister is making up his mind on whether to do the right thing by these doctors. Will the Minister make that commitment and agree to provide the additional posts and support staff? It is the least those doctors can expect.
I thank the Deputy. I can commit to a doubling of the public health workforce in consultation with the public health doctors, and to the creation of the public health consultant contract. The Deputy is quite right. This is something they have been seeking for decades. There is a process under way between the Department and the IMO. For me to make the definitive statements the Deputy is looking for would not be respectful of the process which the doctors' representative group is going through with the Department. With respect, I will leave it to the IMO, the Department and the Government to continue those conversations. I want to see those doctors respected and recognised as specialists. I want to see consultant-level contracts established for public health doctors as soon as possible.
That could happen on Friday. That is what they are looking for and that is what will prevent industrial action.
