Professor Eilis McGovern:

The second question Senator Burke asked was about the supervised division doctors who came here two years ago and why they cannot have their posts renewed for a third year. He also gave an example of where there is a vacancy where someone who now has two years of experience could step into that post. We are bound by the Medical Council regulation, the wording of which is that no doctor may spend more than two years of aggregate time on the supervised division. There were approximately 290 doctors in total who came into the supervised division through the India-Pakistan initiative and the registration for the first group of those will be complete in September or October of this year. As that is a statutory instrument, there is not a facility for those doctors to remain on the supervised division. If they wish to remain in employment in the Irish health service, they must transfer to a different division. The options are the other divisions, namely, the specialist division, the trainee division or the general division. For most of them, the vast majority, the only option they have for various reasons is the general division.

The third question Senator Burke asked was about the Pakistan initiative that we are introducing in July of this year. This differs completely from the India-Pakistan recruitment initiative of two years ago. We felt that we have a tradition in Ireland of training doctors from low and middle income countries - it is not fair even to restrict it to that. We have a tradition of training doctors from overseas who come to Ireland. Irish doctors go overseas and they are overseas doctors when they are in America, Canada or wherever. It is a tradition within international health services. In Ireland, up until now we have had no structured way of doing that. Doctors come in a random way, usually singly, and they themselves are not happy with the experience that they get. There has been a HRB study done of a cohort of these doctors and they come to Ireland for the same reasons that Irish doctors go abroad, to get structured training and career progression, and they are not getting that here in Ireland. They tend to end up in the service grade posts where they are not getting structured training and they are not able to progress in their careers. We felt that a better way of training doctors from other countries, what we call international medical graduates, would be to do that in a structured way by developing partnerships with other countries' governments or government agencies. The HSE signed a memorandum of understanding with the College of Physicians and Surgeons of Pakistan in November 2011. Under that memorandum, we are carrying out a pilot programme where in July we hope to bring 60 trainees from the training programmes in Pakistan here for two years of structured training. At the end of that two years, they will return to Pakistan to complete their training and to add value to the health service there, which is analogous to our own doctors, who go abroad who, we hope, will come back to add value to the health system here in Ireland.