Leo Varadkar (Dublin West, Fine Gael) | Oireachtas source

I am sure the Minister for Health, Deputy Harris, will publish that report in proper order. The Government very much acknowledges that we have real difficulties in our health service when it comes to recruiting and retaining staff, not just doctors but also nurses, midwives, therapists and others. Notwithstanding that, it is not acknowledged, and it should be acknowledged, that there are more people working in our health service than ever before. There are 115,000 people now working in our public health service, which is 10,000 more than three years ago. The impression is sometimes created that more staff are leaving than are joining but that is not the case. It is not the case for the health service in general and it is not the case when it comes to doctors. There is a record number of doctors now working in our public health service. We have never had more doctors working in our public health service than today and there have never been more doctors registered in Ireland. The Deputy just needs to check the register of the Medical Council if she does not believe me. This is the true picture. Yes there is a real problem around recruitment and retention but never were more people working in the health service and never had we more doctors working in Ireland or on the Medical Council register.

The Deputy referred to 450 consultant post vacancies but this figure is not verified. The Pubic Service Pay Commission examined that and was not able to verify the correct, exact number of consultant vacancies. Often when the term "vacancy" is used the impression is created that nobody is doing the job but very often there is and the role is filled through a temp or locum doctor, which in some cases are long-term temps or locums. Last week I checked on publicjobs.ieand saw there were only 20 vacancies being advertised. I appreciate that the voluntary hospitals advertise positions in a different way but there are only 20 vacancies advertised. It begs the question whether there are jobs that historically have not been filled and will never be filled, and whether we need to take a more comprehensive look at what positions will actually attract staff and applications. I am aware of many registrars and doctors who are waiting for a job to be advertised. They are very keen to work in a particular area or hospital but the advertised jobs are in branches of medicine they do not want to be in, or for places they do not want to work. It is difficult to grasp that nettle but we do need to grasp it and advertise positions that will get applicants, rather than advertising for positions that, sadly, we know will not.

Deputy Shortall spoke about medical graduates emigrating. It is important to bear in mind that a very large number of medical students in Ireland are from overseas. When they emigrate they are actually emigrating back to the country which they came in the first place. That was always their intention. A very large number of Irish medical graduates who were born and brought up in Ireland leave and come back. Not as many come back as used to but going away for experience is not a bad thing. It is a good thing.

Reference was also made to non-training scheme doctors. It is true there are a lot of doctors working in peripheral hospitals, what were called county hospitals, throughout the State who are not in training schemes. They are not on training schemes because the medical colleges no longer recognise those hospitals as being training or teaching hospitals. In the past we were able to attract people to work in those hospitals from Ireland and overseas because it counted towards their training. Medicine has moved on, however, and those hospitals are no longer recognised for training purposes and may never be again. We must also face up to this. It is not an easy one.

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