Michael Creed (Cork North West, Fine Gael) | Oireachtas source

I welcome Mr. Foy, Dr. Farrell and Dr. Quinlan. My interest was piqued by Dr. Quinlan's comments about the Newmarket, Kanturk and Boherbue area, which is in my constituency, and the problems of GP practices in rural Ireland. It is true based on the experience of other members and my own experience because I represent a diverse constituency that goes from Ballincollig, which is the largest town in the county, to the more peripheral rural areas that this is not just a rural peripheral issue but is a national issue. More broadly, it is a global issue. There is a shortage of qualified medical personnel. Anybody who visits our hospitals or uses our out-of-hours GP call-out service will be aware that were it not for international expertise, our health service would grind to a halt. We have problems with retention and go all over the world to recruit GPs from other countries such as South Africa, India, Bangladesh or the Philippines where they have been trained at considerable expense. There is a global shortage of medical personnel across all areas.

All of us are also aware that there is a deficit of skilled services be they in hospitality, homecare or construction so we should not beat ourselves up and think this is something we suffer exclusively from. There is a global dimension to it - not just a domestic or even a rural or urban dimension to it.

The question is whether the investigation the Department proposes will address the issue in a meaningful way. I will pose a few questions and make a few observations in this context. It costs the Exchequer a considerable amount to train a medical doctor regardless of whether he or she then decides to pursue general practice or a hospital-based career or opts for employment in other areas where his or her qualification can be used. This is a big challenge. Do our witnesses accept that given the considerable cost to the Exchequer and if this investigation by the Department is to make any meaningful progress on it, it is time to introduce a contractual obligation on the graduate to work in the Irish public health service for a number of years given the Exchequer pays a substantial amount per annum to train a medical graduate? This is not a radical proposal. It is something other countries in a similar development phase to Ireland such as Israel and Canada have considered and implemented. Should we oblige medical graduates to commit a certain number of years post qualification to working in the Irish public health service as a way of addressing value for money in respect of the expense the Exchequer commits to their training and dealing with retention?

I listened with interest to the numbers. Eight hundred to 1,000 graduates come out per annum. I do not have the figures but the witnesses might educate me on this. I suspect that approximately 60% of the intake in any given year in our universities is female undergraduates. If out of 1,000 graduates, 600 are female, for understandable reasons such as child rearing in particular, many of those will either disappear from the workforce for a number of years or significantly reduce their hours. How many graduates do we need to train to have the equivalent of 1,000 whole-time employees in the health service per annum because a figure of 1,000 is not delivering if after a number of years, a substantial number of those graduates will not be working in the public or private health service? The feminisation of the profession is not a bad thing but it has consequences. What intake is needed to reach to secure the equivalent of the prominent provision in the health service?