Colm Burke (Fine Gael) | Oireachtas source

I thank the Minister and his officials for their presentations. The shortage of junior doctors is an issue I have been dealing with for the past two years. In the question I submitted for this morning's meeting, I referred to the fact that more than 4,000 junior doctors are on six-month contracts only. In 2011, we had a major crisis in regard to junior doctors. Two years later, however, we are still dealing with the same type of structure in terms of the contracts we offer while, at the same time, we are prepared to offer two-year contracts to individuals from Pakistan. That does not make sense when we are spending some €75 million per year in producing 600 medical graduates. A survey I undertook last year shows that two thirds of these graduates will leave the county after completing their intern year. Again, that does not make sense.

This is not a criticism of anybody here but I am concerned about the structures that are in place. The delegates referred to the Revenue Commissioners and the issue of termination of contracts. If we can go to Pakistan and South Africa to recruit personnel, surely we can tease out these issues with the training bodies and Revenue in order to offer contracts that are structured so that people are not in a state of uncertainty from one half of the year to the next. Graduates can go to the United Kingdom and obtain a two or three-year contract, but we are not prepared to review the process. No progress has been made in this regard in the past two years and it is time now to sort it out. Am I correct in saying there are 2,000 individuals on six-month contracts only? Will action be taken to extend these to 12 months, even if it requires the operation of rotas between hospitals? I accept that the new regional programme being rolled out offers a way forward in this regard but, in the interim, we must at least begin to put the structures in place for dealing with the situation whereby individuals in whose training a great deal has been invested are leaving the country in large numbers.

Reference was made to difficulties that have arisen in regard to the quality of applicants for positions in smaller hospitals in terms of training or experience. That is a major problem. We have a situation in smaller hospitals where medical consultants are on one in two or one in three rotas and under extreme pressure because of the quality of the junior doctors available to them. This matter must be given urgent priority so that we are not coming back in 12 months time facing the same issues.

In regard to the fair deal scheme, the Irish Nursing Homes Organisation has been in contact with me on several occasions to point out that there is no forum in which all of the people involved in elderly care can sit down together. This is an issue I have raised on the Adjournment debate in the Seanad. As it stands, the Department is meeting people individually, but the Irish Nursing Homes Organisation is seeking a more coherent approach.

It is seeking the establishment of a forum involving people from within its ranks, those who provide home care packages, the HSE, the Department, HIQA, community nurses and home helps which could tease out all of the issues in order that we might put in place a better, more structured programme in dealing with the provision of elderly care. From one week to the next, the organisation is not sure about its requirements in providing nursing home care and in the context of the changes expected of it by the Department, the HSE or HIQA. It is seeking the establishment of such a forum and I request that one be put in place.