Emer Currie (Fine Gael)
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I thank the Minister of State for taking this Commencement matter. Not a week goes by now without us, as public representatives, hearing about shortages of GPs and the pressures on them. This is especially acute in areas where there are high numbers of Ukrainian people in crisis accommodation. We are all very aware of the unwelcome and unsavoury agitation by far-right individuals in communities.It makes sense that we respond to the shortages. More importantly, we must give an opportunity to Ukrainian people to be able to access Ukrainian doctors who understand the trauma they have experienced and understand what it is like to flee a war zone. It would also enable professional qualified doctors to work if they want. Work gives people purpose. It is an occupation. At the same time, we would never pressure anyone to do it given their experiences.

I am told there are approximately 400 doctors here from Ukraine. As non-EU doctors they need to pass an exam to show proficiency in medical English and they need to pass the Professional and Linguistic Assessments Board, PLAB exam. This is the clinical test that must be passed to register with the Medical Council. Normally non-EU doctors do these exams before they come to Ireland. Of course, Ukrainian doctors have not had this opportunity. It can take two years to access these exams. The Medical Council has not fully adapted to this situation and the urgency and opportunity we face. A company runs the PLAB for the Medical Council. The exams take place twice at year. I am told there is no availability until November 2023. This is not a good situation.

Meanwhile, doctors are ready and desperate to work. They want to help. They want to be part of our front line to help Ukrainian people. I call on the Minister for Health to intervene and arrange emergency PLAB exams. The doctors can study for the English exams at the same time. I am told that 10% of the doctors can speak fluent medical English while others cannot. The supports are there if we match them to people to get this proficiency. The HSE is providing materials.

There is significant goodwill to support these doctors. I commend hospitals such as St. Vincent's, which have been running observerships. They take groups of 20 Ukrainian doctors for two weeks and allow them clinical oversight to see the procedures and methods used in Irish hospitals. This is bridging the gap proactively. This is what we need to see. We need intervention. The response of the Medical Council is detached from the reality of the war. Quite simply we need Ukrainian doctors for Ukrainian people.

Anne Rabbitte (Galway East, Fianna Fail)
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I thank the Senator for giving me, on behalf of the Minister for Health, the opportunity to inform the House on the progress made to date in assisting doctors arriving from Ukraine to gain registration and employment in Ireland. She has raised a valuable issue. The Department of Health has been working closely with colleagues in the six health profession regulators to examine ways to support all Ukrainian health practitioners arriving in the State. The regulators fully recognise the importance of assisting these practitioners and have been actively examining the measures that might need to be taken to support them to join their registers where possible and to gain employment in the health service.

As the Senator will be aware, the Medical Council is the statutory agency responsible for the registration and regulation of doctors in Ireland. It is committed to supporting doctors arriving from Ukraine seeking to work in this jurisdiction. The Medical Council has established an internal working group to examine ways in which it can support these doctors. It has met the Ukrainian ambassador to Ireland and it has a dedicated email address and web page with information for Ukrainian doctors. The HSE has also been heavily engaged in this and is working on providing employment pathways for those with health care qualifications and experience. The HSE is exploring the possibility of observer roles in clinical areas while doctors are awaiting full registration and is working closely with the Medical Council in this regard. To be fair, the Senator addressed this and acknowledged that it is happening.

The HSE has a web portal open to Ukrainian practitioners who wish to register their interest in working in healthcare and it communicates regularly to inform them of updates on their profession. The Department meets on a regular basis with the HSE and health regulators to exchange updates and to address any issue arising in respect of Ukrainian doctors. In the course of this work, it has become clear that medical English language training is particularly required to assist many of the applicants to meet the standards necessary for registration with the Medical Council. I am pleased to inform the House that last week the Minister for Health approved a funding package for medical English language training to assist Ukrainian doctors and dentists in gaining registration here.

The medical language training package, designed in association with the HSE, consists of a language assessment and needs analysis followed by one of three subsequent training pathways. The HSE is finalising the application and operational details and will communicate shortly with Ukrainian practitioners, in conjunction with the regulators and the Ukrainian Embassy. Further funding will be made available to support Ukrainian healthcare professionals to meet additional costs that may be associated with achieving recognition and that may be outside the control of the regulators, such as professional competence exams. These supports will ensure that practitioners will not be precluded from registering because of financial barriers. These measures, when they come on stream early next year, will significantly boost the ability of Ukrainian doctors to gain registration.

I genuinely believe there is a brilliant opportunity here for the HSE. It is taking the proper steps and measures and putting them in place. the Senator mentioned 400 clinicians to which we would have access. The health services is on its knees needing people. That needs to happen at pace. I hear what the Senator said. Some of these doctors are proficient. Let them sit the language test and give them a clear pathway to do the exams. We see from the HSE portal that accessing employment takes approximately 38 other processes. It could take another 12 months. We need to ask the Minister, and after I leave here I will ask, how we can expedite the experience we have captured in this country not only for the benefit of Irish people but for the benefit of other Ukrainians in a similar position.

Emer Currie (Fine Gael)
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I thank the Minister of State. She knows full well about some of the barriers in the HSE with connecting qualified people to positions. This is why I am raising the issue. I am aware of what is happening with language support, which is positive. We have to look at the costs. I have raised practical issues. All of this information is great. The Minister of State and I know that when it comes to the HSE it is difficult to get it to remove the practical barriers. Not having access to the PLAB exam until November 2023 is a practical barrier that could be easily removed. Emergency PLAB exams could be held in Ireland for Ukrainian doctors. This is a solution.

Ukrainian healthcare workers are not breaking through in the HSE. The posts are there. They are applying for them but they are not getting them. This is why I am raising the issue. We need a bridge between Ukrainian clinical professionals, whether they are healthcare assistants or doctors, and the positions in communities. The reply of the Minister of State is great and language supports are fantastic but the practical issues always hold us up. There reality is that there is a war. The Medical Council and the HSE need to address these issues with pace, as the Minister of State has said, and with urgency.

Anne Rabbitte (Galway East, Fianna Fail)
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I absolutely agree with the Senator. There are practical issues involved. Not having a PLAB examination until November 2023 is not acceptable, to be quite honest. I will take that point with me when I leave the Chamber. I acknowledge and commend the Minister for Health, Deputy Stephen Donnelly, for ensuring that where English has been a barrier for some of the UK citizens who have arrived here, funding and space has been made available. That is welcome. However, there is a cohort of people who would be ready to hit the ground running if they were allowed the opportunity to sit that examination. It is less than a year since Ukrainians arrived in Kiltormer and there was an endocrinologist among them. Ballinasloe is just up the road and Galway is on the other side. There is a rich availability of talent that the HSE would be unable to recruit if it had three years to do so. We do not want to lose that talent. We have a dearth of talent across the board. We have a war on two fronts. There is the Ukrainian war and there is also a war to keep our health services ticking over. I will talk to the Minister about that issue. I will also write to the Medical Council of Ireland to see if the matter can be expedited. This is an exceptional circumstance that requires an exceptional intervention. There could be many winners.

Emer Currie (Fine Gael)
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May I say one more thing?

Mark Daly (Fianna Fail)
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As it is among the last Commencement matters of the year, I will allow the Senator in.

Emer Currie (Fine Gael)
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I thank the Cathaoirleach. The voluntary hospital at St. Vincent's is already carrying out observerships and it would be great if the HSE could catch up.