Dr. Matthew Sadlier:

I will deal with the non-EU and non-EEA doctor issue. It is a very complicated issue because one can divide doctors from that category into non-consultant hospital doctors and consultants from those areas. When we focus on the non-consultant hospital doctors the problem is that they are not able to access the formal training. The IMO brought up this issue as far back as 2008, and it has taken 12 years give or take for the State to solve this problem. They can work in posts in Ireland and can work beside somebody who is in a training position. They are getting the same experience and often getting the same education and the same level of competence as that person, but because of a legal technicality they have not been able to have that experience and education recognised and thus have not been able to achieve the certification to say: "I am a fully trained specialist". That is their difficulty. Ultimately, this leads to those doctors having a problem in getting a consultant post because in order to get a consultant post one has to be a fully trained specialist.

On the issue of whether there are enough doctors in the system to fill vacancies in the consultant posts, if we were to increase the number of consultants to get to where we should be at, which is increasing the number of consultants by about 2,000, the answer is "No". This is because these doctors, unfortunately, have not been able to get the certifications to be able to take on these posts. As Susan said earlier, there is also a massive ethical problem with countries in the western developed world continually relying on importing healthcare staff, specifically doctors who are being trained in the developing world where we know there are huge heath needs. The solution here is that we need to have more training places overall; allow those training places to be open competition for doctors, irrespective of what country they trained in; and, increase the numbers of doctors we train in the State so that for every doctor who takes an Irish training post there would be an Irish doctor taking a training post in another country.

The history of medicine has always relied on doctors travelling to different countries either for training posts or for long-term posts for that cross-pollination of ideas and academics.