Marie Moloney (Labour)

I commend his speech.

I support the Bill. We do not have an alternative. If we do not introduce the Bill, it will have devastating effects on local hospitals, especially smaller hospitals. What on earth were the Minister for Health and the HSE doing in recent years that they did not see this coming and take steps to remedy the problem without having to rush legislation through at the 11th hour? The problem has been flagged for years. It has been coming down the tracks but nothing was done to divert it. I commend the Minister for Health, Deputy Reilly, on grasping the nettle and tackling the immediate problem. I am delighted that he is committed to addressing the wider issues which have contributed to the situation in which we find ourselves today.

The problem is that the public health system is heavily reliant on non-consultant hospital doctors, NCHDs, to provide the service. There is a major shortage of junior doctors. I am slow to call them junior doctors because many of them are well into their 30s and have received training up to consultant level. One can ask why there is such a huge shortage. The explanatory memorandum tells us that the reason for the shortage is complex. To me, it is simple. The lack of consultant positions results in prospective consultants doing their internship and without the prospect of a job at the end of their training they choose to emigrate to continue their training and get a consultant position abroad. We are competing in a free market. We lose our best and brightest to countries such as Canada, New Zealand, Australia and the United States where working conditions, pay and training are far superior. Although pay may be difficult to compete with in the interim we should compete by providing high-quality training in conjunction with a defined career path that would incentivise doctors to stay. NCHDs in this country are very service-driven. Doctors are often forced to work long hours, far in excess of the European working time directive. It is both dangerous to the health of doctors and patients alike. Instead, NCHD posts should be purely training posts supervised by consultants.

Senator MacSharry referred to the difficulty of students accessing medical courses. I agree with him because I have first-hand experience of the problem. My son was a medical student. My husband and I supported him through ten years of medical school, both financially and emotionally. We watched him go to work on a Sunday morning at 8 a.m. and work straight through until Monday evening at 6 p.m. He was expected to make life-saving decisions. He was so tired at the end of his shift that we disallowed him from driving home. We did not want him to drive from Cork to Kerry for fear he would go over the ditch. In the meantime he was expected to fit in his continuing studies around those working hours. Those are the young people who are expected to make life-saving decisions.

The Minister of State should be warned that we are facing the same problem in the GP service as the majority of GPs are scheduled to retire in the next ten years. We will be faced with a similar problem to that which we currently face with a shortage of junior doctors. We will have a shortage of GPs unless we address the problem now. The Minister must give his attention to ensure the provision of increased training places and to make the GP training scheme more accessible.

Today's debate should be taken in conjunction with realistic plans to increase the number of specialist posts for consultants. The health service should be driven by consultants with support from NCHDs. That would provide a better standard of care, reduce waiting lists, provide more training and support to NCHDs and would also offer a defined career path for NCHDs. The Bill will provide for the establishment of a new division to be known as a supervised division. It was said to me that it should be known as "the lack of foresight division". The shortage of junior doctors has been forecast and foreseeable for some time, yet we failed to act.

As Senator Crown pointed out, it is ironic that Ireland has the largest number of medical schools per head of population in Europe and we now have to pass emergency legislation to allow foreign trained doctors come her to take up the shortfall. We are just putting our finger in the dam.