Professor Frank Murray:

I thank the Chairman for inviting us to appear before the committee today.

People are lost at all stages from the training programme both here and abroad. It is not just an Irish issue. The problem is particularly marked here, especially after internship where many doctors go away, as Mr. Varley said, and a proportion do not come back and then particularly at the end of higher surgical training, HST. I personally believe that we urgently need to attack the issue of recruitment and retention. It is a fundamental issue and feeds back to many of the other issues that create unhappiness from consultant to trainee consultant level. Some of those steps include making Ireland a very good place to work. Other improvements include optimising the process of appointing consultants so that it is a kind of one-stop-shop rather than having a number of steps and reducing as much as we can isolated or silo thinking and joining things up as best we can. I argue that we are losing trainees at all stages and that we should make the end, that is being a consultant or a general practitioner, so attractive that people want to stay rather than leave.