Dr. Mathew McCauley:

The points raised are related to recruitment, retention and terms and conditions of service. I can develop what has been said about the specialist side of the RDF. Comments I make are solely in my role as a member of the national executive of the Reserve Defence Forces Representative Association, RDFRA, not in any official capacity in representing the medical corps.

Some of the points raised alluded to the fact that section 7.2 of the 2015 White Paper on Defence specifically highlighted the utilisation of RDF specialist members in cases where the relevant skill was not retained in the Permanent Defence Force, PDF. It is four years since the Department was tasked with developing recruitment and utilisation policies for this group within the Defence Forces. Despite support from the military healthcare authorities and their encouragement of the single force concept, it has not really come to fruition during that time.

If the Chairman allows me a moment or two, I will elaborate on a few of the key issues. The context is the 2012 Defence Forces reorganisation which saw the number of Reserve personnel in the medical field reduced from 213 to 35, an 84% reduction. The number who are filling permanent duty stations, PDS, is around 37%. I understand there are about three clinical medical corps officers left. This has had huge implications, on which my colleague has elaborated. The use of those clinical medical corps officers is restricted to the direct provision of clinical care for Defence Forces personnel, partly owing to the rank they hold and where they sit within the organisation, despite often being consultant-level clinicians in their civilian careers. This compares shockingly with the position in other jurisdictions. For example, 60% of the US army's medical assets sit in the US army reserve. Some ten of the United Kingdom's multidisciplinary comprehensive field hospitals sit in the reserve. As to why that might be the case, the RDFRA has been notified through representations of our members in the medical field that there has been no overt or strategic recruitment campaign for medical professionals. There are no opportunities for military personnel to engage in direct clinical provision. There are no opportunities to engage in specialist activities outside the State. There are limited career opportunities once someone is in the system. There are insufficient numbers of RDF medical personnel to engage in RDF medical exercises. My colleague has alluded to the lack of reciprocity between RDF and PDF medical corps officers. Through discussions and liaison with medial corps RDFRA members, we can attest to a view that is increasingly held that this is unsustainable, despite the support from military healthcare authorities. It is also in spite of the fact that it has been ten years since publication of the PA Consulting report on the future of Defence Forces medical services, seven years since the Defence Forces reorganisation and four years since the publication of the White Paper on Defence. We all agree that the strength, skills mix and use of Reserve assets in the medical field are totally within the remit of the military authorities and we are not trying to step into that domain. However, from our discussions, there is increasingly a view that if there were proper investment and recruitment, we might see PDF medical assets more fully augmented by RDF assets; an expansion of the breadth and depth of Defence Forces medical capabilities; and an ability to deliver a full spectrum military medical operational care pathway, as seen in other jurisdictions. PDF medical personnel could be augmented in engaging in medical and domestic military clinical activities, which would also be an opportunity to enhance the Defence Forces' overall medical resources.

While there are these difficulties, the colleagues who have come to RDFRA with these representations are loyal, dutiful and committed members of the Defence Forces. They believe it is an honour to serve in the RDF. Their only objective is to see its medical cadre thrive. Despite the support we are getting from the military medical authorities, the problem persists.

Collectively, we see the need for change and investment but, as already stated, with policies in R5 and so forth, we feel political support needs to be applied in order to see some change in light of the years and years of challenges.