Dr. Tom Ryan:

There is good training provided in the country, but we all move abroad. I moved abroad for six years and many of my colleagues move for three or four years. It is regarded as finishing school. We get someone who comes back with new thinking, fresh ideas and some initiative who may have answers to some of our old insoluble problems. If he or she is an orthopod or a surgeon operating three or four days a week, he or she comes back to Ireland and is given a half-day operating slot every week. He or she will not come back to that arrangement or stay at it. He or she will try to tough it out for a year or two to make the system work and in complete frustration will leave and either move back to North America or the private system. It is worth realising that when many surgeons are appointed, they are given an outpatient slot but no operating theatre time. As such, they immediately generate a waiting list and have no capacity to deal with it. We are not going to attract highly trained, high calibre, motivated consultants back to that scenario. To sort out the system and the recruitment problem, the State must provide more beds and more outpatient facilities, open more operating theatres and double the size of ICUs.