James Reilly (Dublin North, Fine Gael) | Oireachtas source

Senator Colm Burke raised the issue of the percentage of agency staff and their cost as a proportion of what we spend on hospitals. I will ask Ms McGuinness and perhaps Mr. Mulvany to address those. The Senator contends that nothing has been done about retaining the non-consultant hospital doctors and addressing their terms and conditions. I am on record as having made it very clear that I was astonished that interns are still doing what I did as an intern more than 30 years ago. That was the purpose of the three MacCraith reports. The Senator made the point that they were not furnished to this committee. They were on the website but I believe he had some difficulty accessing that. We can make the hard copies available to any member of the committee who wishes to have them. There is no problem with that. This is an area that is critical to the future of our health services. I commend Professor McCraith and the people who worked on the group with him who gave of their time freely and had hundreds of hours of interviews with many stakeholders, including junior hospital doctors, which was critical. It was critical they were all interviewed, that is, not all NCHDs but people at every level. They were all interviewed because the needs of somebody finishing their specialist training is very different from that of somebody who is still trying to get on a specialist training scheme.

The issue of it taking 12 years to train a specialist in this country when it takes six years elsewhere is clearly a matter of serious concern. The lack of respect and dignity that many junior hospital doctors feel is what drives them out of this country. Those issues are all addressed in those documents. As a consequence of the middle report, negotiations are taking place at the Labour Relations Commission on the starting pay for consultants and how that might operate into the future. As I have said previously, it was never my intention that this reduced salary would apply to someone who had been, for example, an associate professor in Toronto or somewhere else and is returning here having been away for ten years. We have already addressed the issue of the unintended consequences of the movement of consultants within the country being such that they are forced to go back to a starting level. That was not something that was intended, that has been ironed out and the remainder of this will be ironed out. Having a proper structured salary increase for years of experience once one becomes a consultant is appropriate. That is what is done in so many other walks of life. The guy who has been the manager for one year is not on the same rate as the fellow who has been a manager for ten years. It should be no different in the medical field. We need to address this issue. Without being political about it, it is an issue that was ignored for more than 30 years. It is like so much else in our health service. It just evolved in a chaotic fashion over a period of time. In terms of our reforms around hospital groups, primary care and health insurance, this is part of it as well around training.