Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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I join in the welcome to all the representatives of the HSE. This is the second part of a two-part meeting. The opening session heard very strong representations from representatives of the non-consultant hospital doctors. Some 18 months after the last time we met them in October 2011, what they had to record here before the committee today is hugely worrying.

It is at least two years or perhaps longer since we adopted emergency legislation to facilitate the recruitment of NCHDs externally to meet a very serious crisis then presenting. I would like the witness to indicate the position currently regarding the cohort of NCHDs within the system and if we are looking at a further period of difficulty leading into July of this year and the two year anniversary of that initial recruitment in India and Pakistan.

Regarding the points made by the NCHD voices earlier, it is important to share those with the witnesses, if they have not already picked up on what they put on the record today. They have indicated to us that since our last meeting with them in October 2011 little, if any, progress has been made across the list of areas of concern they shared with us at that time. They have spoken of dangerous and illegal hours. They have indicated that patient care is being jeopardised - I emphasise "is being jeopardised" - and that "an accident will happen as a result of this working regime and it will have serious and perhaps even fatal consequences". The seriousness of what they have shared with us, and the way they have followed it through in their support of subsequent commentary, has left the members of this committee fairly certain that this is a serious problem, despite all that Ms McGuinness has put on the record in her contribution. We cannot fail to ignore their further comment about "consistent and dangerous flouting of the law every day in hospitals around the country".

I noted Ms McGuinness in her contribution spoke in statistical terms quoting averages in a number of instances, but the reality for many NCHDs is very different from the ostensible average position. The reality is as grave as the voices we have already heard have indicated to us. Ms McGuinness mentioned an average 48 hours. They spoke earlier about a HSE claim in regard to 54 hours, but the truth is that we are talking about something of the order of 65 hours per week in many instances, and in some cases far exceeding that.

They outlined what is required to address the situation immediately as against what we have all acknowledged previously was required in the medium to longer term, that is, a clearly defined career path opportunity with greater numbers of consultant posts to properly accommodate this number of committed young doctors, something which all of us in this committee support.

They made two key proposals on what is required now, namely, to introduce a 24-hour on-site shift and to change the roles. Many of us, from our respective experiences as patients, would know of incidents in which highly trained nursing staff would have been well capable of carrying out many of the functions that non-consultant hospital doctors currently carry out in a number of hospitals. There is a neat fit with the case presented by the INMO regarding several of these responsibilities. I refer to the removal of inappropriate tasks from the list of functions and responsibilities currently overburdening non-consultant hospital doctors in many hospitals.

We have explored further where the signal came from in respect of the EU working time directive. It may have come from the HSE that the European Court of Justice may well be considering taking a case against Ireland for its failure to adhere to the directive. Despite the progress being made and the signalled intent to cover much, if not all, of what is required by 2014, it strikes members of this committee that it is inexcusable in 2013 that circumstances remain as they are. I am concerned not only about the interest of the doctors, their health and ability to carry out their tasks and make professional judgments but also about the interest of members of the public, who depend on a quality service that puts their safety first.