Stephen Donnelly (Wicklow, Fianna Fail) | Oireachtas source

I think we were all in a similar position on Committee Stage. We went back to the HSE with that in mind to ask whether we could facilitate this for the reasons we all discussed on Committee Stage. We got very strong pushback on patient safety grounds and I will now go through that. I was hoping to come in with something facilitating the discussion we had but we got very strong pushback. The HSE and others in the field came back and they unequivocally did not support the recommendation, which was one I was willing to support, with regard to the specialist input permitted under the Act by means of overseas doctors who are not accredited as specialists in Ireland. The concern is not whether they live in Cork or Manchester; it is whether they are accredited by the Irish Medical Council because that is our way of ensuring patient safety and ensuring that whatever specialist advice is being given is up to a level that we in Ireland can stand over. The determination of equivalence vis-à-vis specialist division registration is the legal domain of the Irish Medical Council and, as such, there was very strong concern that it would be legally attributed to another agency, essentially.

This is something I wanted to do and something we need to facilitate. However, we have very clear patient safety advice that we cannot just go around the safeguards that we have in place or go around the Medical Council. What someone living in Manchester, London or Stockholm could do is apply for accreditation via the Medical Council, in which case it does not matter where they are living. They would then be able to provide that advice and we would know, from a patient safety perspective, that all of our own clinical governance is in place and that we have done all of the background checks that are required for any specialists or, indeed, any doctors to work in Ireland. I hope colleagues will appreciate the governance and patient safety aspect and be open, as I am, to the argument that, from a patient safety perspective, the governance has to be in place. However, there is no issue with a foreign specialist registering with the Medical Council and then doing exactly what the ask is, which is providing this somewhat scarce expertise.

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