Dr. Peadar Gilligan:

In relation to increases in certain areas, there is definitely a greater challenge for certain hospitals to recruit and a greater challenge for certain departments within hospitals to recruit and retain staff. That is largely due to the reputation some places have but it is also due to the resources available in those hospitals. For example, a surgical trainee is not going to want to go to a hospital where he knows that the likelihood of him being in theatre more than once a week is slim to nil. Therefore, that hospital is going to find it challenging to recruit surgical trainees. Emergency departments that are massively overcrowded do suffer challenges in recruiting and retaining staff. I certainly have had the experience of doctors resigning from the department in which I work because they just cannot tolerate the level of crowding in which they are expected to work. It is definitely the situation that certain areas find recruitment easier and it is more challenging for other areas. That is where the embargo was particularly harmful, because those challenged areas were then told they could not recruit above that level, even though they had not filled all of the required spaces to provide the expected level of care.

Consultant expansion does need to happen but, as Ms Clyne has said, it is very important that it happens in such a way that when a person takes up the post, he or she is facilitated in the delivery of the care he or she is trained to provide. For example, a specialist in emergency medicine should have an expectation that he is going to have some space in which to see the patients who are attending the department.

Interestingly, the recommendation from the Royal College of Emergency Medicine in the UK is that we should have one consultant in emergency medicine for every 3,500 patient attendances. There is not a department in Ireland that comes even close to half of that requirement. We are hugely challenged in terms of the number of consultants we have and the expectation of the care that will be provided by their teams.

I take the point about the cuts and the necessity for them, but we are no longer in that environment and yet the progress has been slower than it needs to be. I acknowledge that there has been investment but the investment is still not keeping pace with the requirements of our population in terms of healthcare provision.