Seanad debates

Wednesday, 22 October 2003

National Task Force on Medical Staffing: Statements.

 

10:30 am

Mary Henry (Independent)

I welcome the Minister to the House and while I welcome the report, I regret it has been so belated. At the end of his speech, the Minister said we must now proceed to implementation. To implement even the EU directive on NCHD working hours before next August will be extremely difficult. It is not true to say we must have EU directives to drive us to do anything that would obviously be for the betterment of the health service in this country. After all, we had the excellent Tierney report in 1993 – would to heaven that we implemented it then. At that stage there were about 2,500 NCHDs. There is now more than 4,000 NCHDs and we will have an even greater problem in paring down this number.

While it is to the advantage of the patient that this report should be implemented, it is also to the advantage of the medical profession. Non-consultant hospital doctors in this country are carrying far too great a burden in the service area. In particular, non-national doctors are dealing with heavy workloads in small hospitals around the country, often with inadequate consultant support. This cannot continue and I hope the Minister manages to implement this report. I am not referring to the Minister when I say that while the political spirit may be willing, the political flesh is fairly weak. It may even be weaker on the Minister's side of the House than on this side of the House. I will do anything I can to help the Minister implement the report.

We have already heard Mr. Hanly saying that the report will be implemented immediately, while the Secretary General of the Department, Mr. Kelly, is not quite so sure. A definite urgency must be found to bring forward the changes in NCHD working hours.

Will the Minister insist that every hospital immediately puts a member of its administrative staff in charge of rostering? This should happen before the end of the month. We know there are already serious problems in some of the big hospitals that have such positions. This must be the first area to be addressed and the report says that getting rostering right is important. It may have to be more flexible than that which is suggested in the report. It cannot be left to consultants and junior doctors to work out private arrangements between them. That will only lead to disaster. Such arrangements must come from management level.

The Tierney report was extremely well written and it is most unfortunate it was not implemented at the time. We have seen that we were making far greater increases in the number of NCHDs than other parts of these islands. For example, between 1988 and 1992 there was a 6% rise in the number of consultants in the State, but a 25% increase in the number of NCHDs. In the same period there was an 11% increase in the number of consultants and a 2% rise in the number of NCHDs in Northern Ireland. The same circumstances prevailed in Scotland, England and Wales. We have continued the bad practice of relying too heavily on NCHDs.

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