Dr. Matthew Sadlier:

Several reasons explain why this is happening. The first aspect concerns the vacant consultant posts. Most college rules state that a trainer needs to be a permanent consultant. Consultants who are rotating might be there for the duration of training, but equally they might not. Extra supports are also needed for such posts, however. The problem is that our service is struggling to survive; it is running to keep up. The problem with a training post is that it requires a doctor to be engaged in non-service provision for a certain percentage of his or her week. That is especially the case in the higher specialist training, where the percentage might be as high as 20% to 30% of the week. That is a luxury that cannot be afforded when there are huge waiting lists.

All of this comes back to three major aspects. I refer to this being a numbers game, the difficulty with the recruitment of consultants and trainers and, as I mentioned at the start, the ongoing difficulty of Ireland's rapidly increasing population. That accounts for many of our problems in general. Some 64,000 people were added to the population last year and it will be similar next year. Our population has increased by 50% in just over 20 years. That is a great thing, but there is a requirement for the provision of the requisite extra infrastructure and services. The situation at the moment means that we can set our target figures for this year, but they will have shifted by the time of delivery.