Dr. Gabrielle Colleran:

There is a huge value in permanent staff who are invested in a hospital, in a service and in a patient population. Somebody who is planning to spend the next 30 or 40 years working in an area is invested in looking for resources, as well as innovating, leading and bringing in the newest changes. We have many excellent locums. However, when one is transient, clocking in and clocking out, one is doing a clinical service job but one does not have the commitment to the education, the research or the quality improvement, namely, all those elements that consultant leadership brings. Importantly, one is not a trainer.

One of the most important points going forward concerns our next generation, our excellent medical graduates who are wanted everywhere in the world. Dr. Rita Doyle has been a magnificent advocate for non-consultant hospital doctors, NCHDs, and for all doctors. She describes interns as the jewel in the crown. We want our interns and NCHDs to see a future, leading and innovating within our health services. It is important we really tackle this now because we are at a tipping point. One in eight of the population is over 65 years of age. By 2030, it will be one in six. There will be a shortage in Europe of 200,000 doctors by 2030. We need to hold on to our people.

We keep replacing the doctors, however. We really need to fix our system to ensure our brilliant NCHDs want to work in our system. Deputy Alan Kelly has left the meeting. UHL and smaller hospitals around the country are at a tipping point. I will not name the hospitals but there are some where the majority of consultants are either locums or non-specialists, as well as the majority of their NCHDs in non-training posts. This is a health apartheid and it has to be tackled. Until ten years ago, we had excellent physicians wanting to come back and work in these hospitals. These are wonderful communities which are paying the same taxes. They should expect the same access to health care. We really have to fix this.