Tuesday, 26 March 2013
Non-Consultant Hospital Doctors Recruitment
In 2011, more than 200 doctors were recruited in India and Pakistan and brought into Ireland. We rushed through legislation to create a new supervised division and the doctors were given two year contracts. Some of those contracts will expire in July and others in December, because some doctors did not begin working until January 2012. We may, therefore, have a shortage of junior doctors in June and July of this year.
While we have a contract with a university in Pakistan to bring in a new group of doctors, we may lose an opportunity to retain doctors who have been working in Ireland for two years. We will not be able to give them new contracts unless they can move from the supervised division into the general division.
Little progress has been made on this matter by the Department of Health, the HSE or the Medical Council, and this issue needs to be clarified. Some hospital are still awaiting receipt of CVs and, therefore, cannot even interview applicants for the vacancies that will arise in June and July.
I seek clarification on this matter. The HSE, the Department of Health and the Medical Council should work together to resolve this problem. People who have two years experience of working in Ireland should be given the opportunity to stay here, make a contribution to our medical service and fill the gaps that will arise in our hospitals and health system.
I would like, on behalf of the Minister for Health, Deputy James Reilly, to take this opportunity to outline to the House the current position on this issue.
Given the very significant difficulties the HSE faced in 2010 recruiting suitably qualified and experienced doctors, the executive commenced an overseas recruitment campaign in India and Pakistan. This process was aimed at addressing shortages due to arise with the changeover of non-consultant hospital doctors, NCHDs, in July 2011.
The key requirement for doctors to begin employment with the HSE is registration with the Medical Council. Urgent amendments to the Medical Practitioners Act were enacted in 2011 to create a new supervised division of the register. This provided a safe, effective registration process for a two year period for doctors recruited from abroad.
This recruitment process and the introduction of the supervised division resulted in almost 290 doctors working in the Irish health service for the first time. Candidates were fully informed of the conditions of recruitment. For most candidates, the two year period in the supervised division is coming to an end. The only option open to doctors wishing to continue employment in Ireland is to apply to either the general or trainee specialist divisions. The choice of division will depend on individual qualifications and experience.
Doctors in the supervised division only practise medicine in the post to which they have been proposed and under strict supervisory arrangements. Registration in the general division involves clinical assessments to ensure the practitioner is fit to practise in a range of positions. Transferring from the supervised division involves undergoing the pre-registration examination system, PRES, which is designed to ensure doctors demonstrate competence in a general scope of practice. This is a critical measure to protect the public.
The NCHDs may also seek registration in the trainee specialist division provided relevant criteria are met. These include access to a recognised training post, holding a document which is equivalent to a certificate of experience, and being successful at the PRES unless exemption criteria pertain.
The HSE contacted doctors in relation to the process for transfer in November 2012. This process was also outlined to representatives of this cohort at a meeting on 8 March by the Department of Health, the HSE and the Medical Council. The Medical Council has received and processed applications for some doctors. The remaining doctors have not yet provided necessary documents and information to the council to progress their applications. Doctors who have received final communication from the Medical Council regarding outstanding documents and information have until 2 April to do so.
For doctors not wishing to remain within the Irish health sector, the HSE has confirmed that the president of the College of Physicians and Surgeons of Pakistan indicated his willingness to discuss with them the possibility of returning to jobs in Pakistan, recognising their time spent in Ireland. The HSE will assist those who wish to explore this option. For doctors returning to India, the HSE will also assist by providing references and further information on the time spent here in Ireland.
I acknowledge the important contribution to the Irish health care system made by these doctors over the past two years.
While every effort will continue to be made to facilitate movement to the general division in a timely manner, the HSE must have sufficient NCHD cover in July in our hospitals. Contingency arrangements are in place by the HSE to ensure continued safe and timely treatment for patients.
I thank the Minister of State. I am a little concerned by the reply because of my own experience of dealing with the Medical Council. An Irish graduate who worked in an Irish hospital went to New Zealand for two years and when that person returned to Ireland and applied for registration, it took two months to get registered with the council. Even if applications are completed by 2 April, I am a little sceptical that the necessary processing will be done by the council by July. My understanding is the HSE has assigned an additional four people to the council to assist with registrations and I am concerned that this has been left to such a late date as 2 April. I would be surprised, having dealt with the council, if applications finalised on 2 April will be processed by end of June. I am seriously concerned about it.
I agree it is important to have an adequate number of NCHDs available in our hospitals and the Senator's concerns on this matter will be conveyed to the Minister and, ultimately, to the HSE or the Medical Council.