Professor Frank Murray:

I would like to comment on that. I have just taken up post as director of National Doctors Training and Planning, NDTP, and one of the things I am focusing on is having an efficient, timely process that anticipates people retiring and considers proleptic appointments. We know many people retire when they are 65 and some retire before that. We should question people, when they are considering retiring, not in order to push them out but just to get a sense of what needs to be done to minimise the gaps. The point Mr. Varley made is a fair one. We want to minimise the gaps and have an efficient and effective recruitment process. That is only part of what we are trying to do. The problems with recruitment are not single-factorial but multifactorial and that is clear from the discussions we have had here this morning. I would see it as my responsibility to make sure we improve all of those processes as best we can.

There was a question from Deputy O'Connell on value for money I would like to address directly. The best way to do things is to do things the correct way for the correct reason. That is what we should be aspiring to do. We should not have protracted periods with doctors working as locums at consultant level. We should aim to minimise that. One of the targets I am going to set is to reduce our dependence on locums right through the system.

I would also like to answer another of the Deputy's questions on locally appointed and centrally appointed staff. Centrally appointing staff to a substantive post includes going through a process called CAAC, the consultant appointment approval committee; and the approval of a consultant through a competition either at hospital level or through the PAS, the Public Appointments Service. For many locum posts, this process does not operate; there is a short-term gap, somebody retires or is ill or there is an extra post and that post is then filled locally rather than centrally. That is the difference between locally and centrally appointed or centrally approved.