Dr. John Hillery:

A question about specialists and consultants was asked. We do not actually have numbers, but we worry that it is becoming normalised and not safe. People are not overseen to the proper level when they are the final decision maker on the provision of treatment. I have given an example of the concerns I have come across in my daily work. We must realise part of the problem is the delay in appointing people about whom Deputy Pat Buckley. Locum posts are not attractive to specialist trainees. They want consultant posts in which they can do something. As they cannot do it in a locum post, they will go elsewhere. This means that people who are not as highly trained occupy the positions. As they will also move on, there is no service development. As well as being unsafe for the individual, it is unsafe for the region because a service does not evolve with a leader in place. One wonders if this is influenced by the consideration that if temporary staff were used, the same pension and leave issues would not arise as in the case of a permanent appointment, but I am sure that is not a factor. Perhaps the committee might explore this issue with the employers who would be more able to answer the question than we are. It is a worry.

Dr. Kennedy was our leader on the issue of competence assurance. She will outline what a specialist is about and what we expect of specialists which is not expected of non-specialists.