Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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I welcome the IMO representatives and the further address of the employment conditions and role of non-consultant hospital doctors. I have often thought it a curious thing that we describe a cohort of health professionals by what they are not, as against what they are. In any event it has been known and widely recognised for many years that the hospital system is over-reliant on non-consultant hospital doctors and successive Governments have clearly failed to address this over-reliance. It led to the crisis faced in 2011 which led to emergency legislation in order to address the significant shortfall in supply. At that time, I recall the Bill facilitated the continuation, at least for the time being, of the current system and at least it prevented the collapse and the consequent loss of services. One would have to ask how long we have to wait for real reform of the situation and when the ramshackle structure, which is how I described it at the time, will be replaced by a proper system of medical training and hospital staffing.

The presentation goes to the core of the issue. The witness pulled no punches, for which I say, "Well done". It is very important that we have a wake-up call. One would have to ask what is the Minister for Health's plan to end the reliance on non-consultant hospital doctors and to get better value for patients and whether he has such a plan. This is critically important. The system was flawed enough but has been compounded by the recruitment embargo and the widespread cutbacks which are being imposed making an already difficult situation infinitely worse. In the context of all this, the IMO update today, which is an update on the last submission on 20 October 2011 which was the last time we engaged on the issue, makes what I have described in my notes as grim and alarming reading. I wish to emphasise again what the witness has put on the record. We are told that little, if any, progress has been made since the last time we engaged some 18 months ago. This is March 2013 and conditions have clearly deteriorated. We are told that NCHDs are working "dangerous and illegal hours". Most significantly, I note the IMO says patient care is being jeopardised and that an accident will happen as a result of this working regime and it will have serious and, perhaps, fatal consequences. The witness spoke of "consistent and dangerous flouting of the law" every day in hospitals around the country. So far as patient safety and care is concerned, as well as the well-being of hospital staff, of its own professional involvement, I believe it is an indictment of the Minister that there has not been a substantive address in the period since we had a huge focus on the issue in mid-2011. I wish to ask a couple of questions.

The IMO recommends removal of inappropriate tasks from NCHDs. Is this compatible with the Irish Nurses and Midwives Organisation's proposals for expanding the role of nurses? I do not have to go over the detail of the IMO proposals as the witnesses are already familiar with it. What does the IMO see as the next essential step? What would it recommend should be done immediately? I hope we as a committee will set aside all our differences, whatever our views of the Minister, and I have expressed mine. I believe we have to address the issue together and urge immediate action because this is not tenable and cannot be tolerated further.