Róisín Shortall (Dublin North West, Social Democrats) | Oireachtas source

I want to raise with the Taoiseach today the crisis in healthcare staff recruitment, specifically the crisis in recruitment of hospital doctors, and the serious implications for patient safety and the future of the health service.

Currently there are 450 vacant consultant posts. Even if all of these posts were filled we would still have the lowest number of consultants per capitain the OECD. Downstream there are also more serious problems that need to be addressed very soon.

Ireland trains high numbers of doctors at very high cost. The vast majority of these doctors emigrate. In 2014, for example, there were 684 medical graduates, 627 of whom left Ireland. In 2017, 700 medical graduates who left the country. A key contributor to the deplorable waiting lists is the shortage of hospital doctors. Nearly 1 million people are waiting on hospital care of one kind or another. In the last few days we heard that 30,000 women are waiting for gynaecological hospital services.

It is also a major contributor to the dysfunction within our health service. There are many reasons why Ireland cannot hold on to its hospital doctors. The unmanageable workloads and the inevitability of burnout is a key factor for a lot of doctors. There is also the hierarchical nature of the career structure for consultants and the lack of career prospects. Pay is undoubtedly an issue and the two-tier health system, as in many other careers, is hugely damaging with regard to hospital doctors and should be addressed urgently. The convoluted two-tier recruitment system in operation is also inexplicable. There is a lack of reform of the health service. Hospitals are stressful places for doctors to work and there is no indication that the Government is serious about a reform programme.

Getting timely access to care has a significant bearing on this because it means there are increasing difficulties for patients. This is also depressing for doctors. Knowing that delays have resulted in conditions becoming more serious for patients, knowing that treatment is less successful due to those delays and knowing that the system is failing patients, with doctors constantly having to apologise, is very stressful.

On top of all these issues is the recent HSE report that has pointed to serious problems around the importation of doctors with many doctors coming from developing countries, with questionable practices in relation to whether that is ethical or not, issues about the qualifications of those doctors, inadequate clinical oversight of those doctors and the transient nature of those foreign doctors, who are basically propping up our health system currently. We know that 50% of the non-consultant doctors are now called "non-training scheme doctors". This is a new category. Non-training scheme doctors are mainly foreign doctors and in some hospitals 80% of the non-consultant hospital doctors fall into this category. I call on the Taoiseach to publish that report and let the House know what action the Government will take on the crisis in the recruitment of hospital doctors.

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