Dr. Matthew Sadlier:

The overall problem is that for the first time in the history of the health service, we have a massive number of consultant vacancies. Ultimately, that is the problem, in terms of trying to fill posts. We have doctors who are not on the specialist register but who should be on it. Some of those doctors are qualified and experienced and come from countries where they had difficulties with registration. That is a legal issue and we will not get into that here. Some of those doctors are operating in places where they probably need some supervision. There are local supervision arrangements in place but, at a national level, there is no supervision policy of which I am aware. The solution to the problem is to reverse the 30% pay cut for new entrants. That pay cut created this issue. It has created a cohort of agency-paid consultants who are probably costing the health service more than a reversal of the pay cut would cost. However, for reasons that I cannot understand, this system has continued since 2012.