Kate O'Connell (Dublin Bay South, Fine Gael) | Oireachtas source

I thank the witnesses for coming into us this morning. I am sorry I was late and if I am repeating questions that have been asked, I apologise in advance. Following Deputy Durkan's questions, somebody made a comment - I think it was Dr. Breslin - that there was a marginal increase in complaints regarding people on the non-specialist register. Are there data to show how this has resulted in disciplinary action? There could be many complaints about somebody but they may not be held up. The key data we need to know are whether, with this marginal increase, these people are more or less likely than the regular guy to have disciplinary action taken against them.

The Chairman recently mentioned standards. Can Ms Mannion tell us today that the public can be assured that these doctors are competent to perform their roles? It is a fairly simple question for the head of human resources. Who is liable if somebody on this register makes a catastrophic error? Would it be the hospital manager or the Health Service Executive? There has been reference to indemnity insurance. If the indemnity insurance is not covering it and these people are employed by the State under this set-up, is it the responsibility of the State Claims Agency?

Who is paying? Are these people value for money, do they do the same job as hospital consultants? Do they do the same rate of on-call and is their net income in the year the same or higher? Is it cheaper to employ someone who is not up to the same standard? My understanding from anecdotal evidence is that these people are not performing the same on-call duties as regular hospital consultants. On-call is included in regular non-locum consultant contracts. In the current contract are they paid an hourly rate and are we getting the same bang for our buck as for a regular consultant?

I am very concerned that these individuals seem to be channelled into small peripheral hospitals. When the hospital constantly employs locums and there is nobody in situtaking responsibility it seems very obvious, without doing any study, that there will be a drop in standards in that hospital and that will have a snowball effect. When there is a drop in standards it is not an attractive place to work. No Irish qualified hospital consultant wants to be responsible legally or ethically for people who are not up to scratch working under them. The answer probably will be that this is a false economy. Somebody spoke about recruitment and retention, Mr. Gilligan said that when consultant salaries were cut by 20% or 30% consultants were leaving the country. Logically, if the locum costs 30% more we have made a bit of a bags of things because it is costing more to keep a lower standard of individual in employment.

Could somebody elaborate on the comment about locally appointed versus centrally appointed? My understanding was that HSE recruitment was central and if this is a local issue are the same governance issues in place?If the HSE has bypassed the proper methods of centralised recruitment to do it locally what is the damage to the system? The witnesses spoke about legislation drafted to overcome the barriers that prevent people getting on the consultant register. Does anybody on the panel have any issues with this legislation? Are there any concerns that this proposed legislation will in any way diminish the standards of Irish hospital consultants? Are we doing something that will lead to inferior quality? Is there, or has there been, any training programme put in place to get these people up to scratch such that a person doing the job competently wants to be a consultant but there is a technical barrier? Is there a programme to bring these people to consultant level with perhaps a pay cut in the intervening period? It seems logical that if the parameters of different countries are not aligned we would have some sort of get up to scratch course that would be approved and competency levels would have to be reached and assessed. Of those in locum positions how many have signed temporary contracts and how many are Irish graduates?