Mr. Martin Varley:

To add to what Dr. Ryan said, currently there are approximately 200 Irish trained doctors who completed their intern year last year working in hospitals in Perth. This is replicated across other parts of the English speaking world.

The major concern we have is that they are not coming back, they are remaining and going on to other posts and completing their training abroad. We are training a sufficient number of doctors at graduate level, but we are losing them. The key question is why that is the case. I have been in this post for approximately ten years, but prior to that I worked as a civil servant in the Department of Finance. During a previous recession, we had a golden rule in the Civil Service at the time that in spite of the financial difficulties the State would not breach contracts. If I were to reflect on the past ten years, I would say the root cause of this problem is the fact that the State and the health service management is party to persistent and blatant breaches of contracts. The examples are fairly obvious, the 2008 contract which was agreed with consultants ten years ago still has not been honoured. It has been ignored. That is sending a very negative message to professionals who are in very high demand internationally. To sum up, it means that the longer serving consultants today, partly because of the financial emergency measures in the public interest, FEMPI, but also significantly because of the breach of contract are being paid 30% less than they should have been if the contract was honoured effective from 1 June 2009. The new entrant consultants are being paid 45% less than was agreed practically ten years ago. Of course, other jurisdictions have moved on in the interim and they have been increasing salaries. The big difference is that highly trained professionals are embraced in other jurisdictions and in other hospital settings whereas, unfortunately, the opposite is the case here. To resolve this problem one has to address and resolve those issues, the breach of contract and the discrimination against new entrants. I think that is the key to the resolution of the problem. We did not have that problem prior to those two developments.