Clare Daly (Dublin North, Socialist Party)

The backdrop to this problem is the peculiar and probably very lopsided situation that exists in this country. On the one hand, we invest a phenomenal amount of time and resources in training doctors who we export while on the other hand, we are resorting to panic measures to import doctors frantically to deal with the chaos and crisis. That situation reflects deep-rooted problems in our health service and in the area of medical training which need to be addressed.

Obviously, I am happy to see any measure which will address the crisis but I echo the concerns of other Deputies that the speed with which this legislation is being pushed through may cause us problems in future. As Deputy Catherine Murphy said, we only received the Bill yesterday. We need to be cautious.

As we are discussing recruiting doctors from other countries, it would be remiss not to mention the situation of Irish-trained doctors imprisoned in Bahrain and the very inadequate response in standing up for those doctors. If we want doctors to work in our service, we should be prepared to stand by them when they take humanitarian actions and are penalised for so doing. There was a very poor response and a lack of support for them by the Royal College of Surgeons and the Royal College of Physicians.

The nub of the problem is the shortage of junior doctors. There is a 25% deficit of junior doctors in 32 of our 24-7 accident and emergency departments along with a shortfall in middle grade doctors. The loss of these doctors to the system is causing major problems and has major implications for the future. We need to deal with that but instead we seem to be just plugging the hole by importing hundreds of primarily Indian and Pakistani doctors to do a narrow range of duties and for a narrow timeframe. Will the Minister explain why it is only for two years and why their activity is being restricted? Does he envisage this being repeated after the two years? Presumably, many of these people will be really able and experienced and will make a valuable contribution, so why is it being limited to two years?

The position of non-consultant hospital doctor is not attractive because it is non-training. It does not contribute to the career prospects or the educational advancement of the doctors concerned, so they are not inclined to take up those posts. Therefore, we need to look at measures which will overcome that. One of the ways to make the position more attractive would be to count hours worked as training hours to incentivise more doctors to take up that position. It is noteworthy that the five accident and emergency departments which are not experiencing problems are those which are fully resourced and have dealt with the overcrowding issues. There is a link between the shortage of these doctors and overcrowding.

We need to take a holistic approach and address the other issues in regard to the crisis in the health service if we are to overcome some of the difficulties doctors have. I do not believe we can divorce this from the overcrowding issue. The most important point is that the whole system needs to be looked at.

We must look at measures which will incentivise and encourage doctors trained in Ireland to stay and use their skills here. That is really the nub of this issue. We could do that in a number of ways. Irish-trained doctors should be required to work in Irish hospitals for a certain period after their training and that if they do not do that, there could be some form of pay back to the State of the subsidy provided for their education. Some measures should be adopted in that regard but it should be balanced with enhanced resources and training opportunities which would encourage doctors to stay. Unless we address the issue we will increasingly resort to panic measures which are not the ultimate solution.

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