Dr. Rachel McNamara:

The impact is that those hospitals already under pressure to recruit and retain staff, because they are often in more remote areas and generally do not have the tertiary treatment centres that are very attractive to trainees, are already at a disadvantage. This embargo is a very blunt instrument to make the situations in those hospitals in particular worse. This is one of the many reasons we are against this embargo and want it to be lifted.

When it comes to the impact of not being able to recruit the NCHDs, there is a bit of confusion in the context of the embargo, in that NCHDs on formal training posts are excluded from it, but this is the group that is set out at the start of the year. If a service demand is then introduced in the course of the year, if there are record levels of presentations or if new services are introduced, the manpower departments are hamstrung in that they cannot recruit to fill the need. Sligo University Hospital is certainly feeling this impact. Many model 2 and model 3 hospitals are feeling this impact the most. When we talk about the cost-saving measures that will, ultimately, result from this embargo, and Ms Clyne has mentioned this point already, there are none. The work still needs to be done. It is the complement of NCHDs there already who end up having to do more and more overtime, which costs a premium. In fact, when we were on our comfort break, I checked my phone and locum requests had come in for unfilled NCHD shifts all around the country. I have signed up to locum agencies that issue requests when there are gaps to be filled in rosters. I am inundated with text messages in this regard. The locum agencies, therefore, are still being asked to fill vacant positions and these cost a premium too. If we could just appropriately and sustainably recruit staff into these hospitals, then we would not have to end up costing ourselves more money.