Dr. John Duddy:

I will try to address a few of the questions asked.

Deputy Louise O'Reilly asked whether management guidelines would be sufficient. Her question was linked with Deputy Kate O'Connell's request that hospitals be made responsible for poor conditions. In short, I do not think simple guidelines would be sufficient. I have already spoken about the double standards. If a doctor or a nursing professional is in a management role, he or she is accountable to his or her regulatory body, whereas an administrator who is not a health care professional is not. There needs to be proper regulatory oversight of those in administrative roles in the health care service.

Deputy Kate O'Connell asked why hospital consultants should be responsible for the actions of non-consultant hospital doctors, NCHDs, they have not hired. That raises a few questions because a lot of the time NCHDs come from other countries and have not worked in the Irish system before. They are thrown in at the deep end in a different culture and health care environment in which speak people speak a different language. The Medical Council is working on a programme, Safe Start, to assist new doctors in joining the system, both interns who have graduated from Irish universities and those who come here from abroad. Having a proper induction process to introduce them to the health care system in Ireland will improve matters.

The Deputy asked whether the issue of burnout was addressed during training. I can only answer from my own experience as a trainee in the Royal College of Surgeons in Ireland and confirm that it provides such training. It identifies the symptoms of burnout in order that one will be able recognise them in oneself, will know how to address them and what support systems have been put in place by the college and one's employer to prevent burnout from happening. The issue has been addressed in the surgery community, but I cannot speak for other specialties.