Dáil debates

Wednesday, 28 September 2011

3:00 pm

Photo of Robert TroyRobert Troy (Longford-Westmeath, Fianna Fail)
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Question 10: To ask the Minister for Health the number of junior doctors recruited from abroad; the total costs of accommodating them; and the time line for assessing them and ensuring that they commence working [26271/11]

Photo of Derek KeatingDerek Keating (Dublin Mid West, Fine Gael)
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Question 11: To ask the Minister for Health if he will outline the progress made for filling vacant non-consultant doctors' posts; the number of unfilled posts in all of the public hospitals here in tabular form; and if he will make a statement on the matter. [26146/11]

Photo of James ReillyJames Reilly (Dublin North, Fine Gael)
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I propose to take Questions Nos. 10 and 11 together. I am pleased to advise the Deputies that excellent progress has been made in filling vacant non-consultant hospital doctor, NCHD, posts over the past three months. I appreciate the co-operation of the Deputies opposite in achieving this.

The decision to recruit from abroad was made due to an ongoing vacancy level of approximately 150 NCHDs and a significant number of additional vacancies anticipated in July 2011 arising from the cyclical rotation of posts. Most doctors start their careers in July after their exams, at which time the greatest rotations occur, although they also feature in December and January. In total, 259 NCHDs have been appointed from centralised recruitment and a further 226 doctors recruited in India and Pakistan for the July rotation.

Given the shortage of NCHDs over the past two years, the HSE developed a range of strategies and initiatives to maximise recruitment, including the development of a centralised recruitment process for service or non-training posts. All vacant service NCHD posts were advertised as "professional development posts" under two-year contracts to one of the four HSE areas, with a minimum of six months in a regional centre and participation in a professional development scheme under the relevant postgraduate training body. Notwithstanding these measures, about 150 posts remained vacant and it was decided to undertake a recruitment campaign in India and Pakistan.

I introduced legislation on 8 July to amend the Medical Practitioners Act 2007 to facilitate the registration of these doctors. The Act was amended to allow for the creation of a new supervised division on the medical register. Registration in the supervised division means a person is registered for a period not exceeding two years in an identified post approved by the Medical Council and subject to supervision by the employer in line with criteria set down by the council.

No exam is perfect. In the old system, there were problems with staff who were found not to be competent leaving a job in Donegal to take up a position in a different speciality in Cork. The supervised division means this cannot happen with the doctors in question. It is a step further in terms of protecting patients.

The Medical Council introduced new rules for the supervised division and with co-operation from the medical schools and postgraduate training bodies organised specialty-specific examinations for the candidates. Two hundred and thirty-six candidates were successful and as of 28 September, 226 NCHDs have been registered on the supervised division, and more will be registered in the coming days. As of 26 September, approximately ten NCHD posts of the 190 identified as vacant by the HSE before the recruitment of doctors from India and Pakistan remain vacant. Approximately 60 doctors are expected to sit further assessments for the supervised division and if successful will be offered employment.

To date, the HSE has spent €80,000 accommodating NCHDs recruited from India and Pakistan. The HSE is allowing these doctors a modest weekly allowance in respect of accommodation, €100, and the provision of meals. It cannot be argued that these allowances are in any way excessive.

The doctors are making significant contributions to vacancies which existed in areas such as anaesthetics, paediatrics, emergency medicine and general surgery, and are delivering a safe, effective service to patients. In addition, they are reducing the HSE reliance on agency staff, reducing overtime costs, improving the quality of the service and ensuring further compliance with the European working time directive.

Photo of Derek KeatingDerek Keating (Dublin Mid West, Fine Gael)
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I thank the Minister. I ask my question fully aware that the Minister is a mere six months in his new post and has inherited his difficulties. He is committed to his tasks. It is heartening that, even within six months, progress has been made in this area. Can the Minister assure the House that where there are unfilled doctors' posts, priority will be given to front-line services such as accident and emergency services and surgery?

I am concerned about doctors who trained in our educational system, commenced their medical internship and senior house officer post and who may be attracted to working in the private sector. We may have a brain drain in this area. Will the Minister comment on this? What can be done to assist in this area? I am grateful for the Minister's response.

Photo of Billy KelleherBilly Kelleher (Cork North Central, Fianna Fail)
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In the context of concerns I raised about doctors on the supervised medical register when we discussed the medical practitioners legislation, we must ensure the doctors are not regarded as yellow-pack doctors or doctors with lesser qualifications. This is critical. If campaigns are required to prove they have the same competencies as others, so be it. If they are not regarded as the same, inherent difficulties could arise.

Photo of James ReillyJames Reilly (Dublin North, Fine Gael)
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There is the old phrase, "belt-and-braces approach". In more rural areas, we say, "to be sure to be sure". It is absolutely the case that the doctors are extremely well screened and trained. They have been interviewed by the consultants in respect of language skills and ability and have gone through the documentation and examination processes. In their places of work they have been monitored. I thank the doctors who have come to this country and wish them well. I expect that when they leave to return to their own countries in two years, they will do so with enhanced skills and knowledge which they can use when treating their fellow countrymen.