Mr. Andrew Condon:

I might comment specifically and briefly in response to a comment made. I personally was involved in the recruitment of doctors in Pakistan a number of years ago. They were interviewed in English in Pakistan by our consultants and by human resources staff and they passed an English test with the Medical Council in Ireland before being able to take up work. I think that is an issue that is of concern and we also have a provision we have circulated to all employers that in cases in which an employer has concerns regarding the English language capacities of any health staff member, the employer can ask that staff member to undergo the international English language testing system, IELTs, test.

If they fail the IELTs, it would have consequences for their continued employment. That is an issue we take particularly seriously.

As regards the overall NCHD staffing issue and why Irish doctors do not occupy 100% of the junior doctor posts in this country, it is important to realise that since the 1990s approximately 50% or slightly more than that of the doctors who staff our hospitals have been recruited from outside this country. Over the past ten years there have been concrete efforts to address that. The Fottrell and Hanly reports were drawn up. Senator Burke referred to the latter. The Fottrell report mapped out a route suggesting that we could be self-sufficient in terms of medical graduates. In recent years as part of that process the HSE has increased the number of interns who are the first grade of junior doctor fresh out of medical school. That increase will continue. Professor McGovern can take up the issue in a moment. It will mean that we will have a decreasing reliance on doctors recruited from outside Ireland. In parallel, we have also increased the number of consultant posts by more than 500 in the last five years. Actions are under way to address systemic problems.

As regards the overall NCHD staffing position for July, which Deputy Ó Caoláin and Senator Burke in particular mentioned - reference was made to Letterkenny - this is indicative of a process that takes place every year through which we are addressing aspects of the process on a developmental basis. For example, a number of weeks ago Letterkenny was reporting 60 vacancies out of its cohort of just over 90 doctors. Today, our information is that Letterkenny has eight vacancies. That is paralleled in other sites around the country. What it illustrates is that on a day-by-day basis from April onwards each year the number of vacancies-----