Peadar Tóibín (Meath West, Sinn Fein)
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Question 20: To ask the Minister for Health if he will elaborate on his statement that smaller hospitals will struggle to cope in the context of the non consultant hospital doctor shortage; and if he will make a statement on the matter. [17904/11]

Bernard Durkan (Kildare North, Fine Gael)
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Question 42: To ask the Minister for Health the extent to which it is intended to provide the full complement of junior hospital doctors at all hospitals throughout the country; and if he will make a statement on the matter. [17876/11]

Willie O'Dea (Limerick City, Fianna Fail)
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Question 45: To ask the Minister for Health the measures that he has implemented since his appointment to address the shortage of junior doctors in hospitals here. [17879/11]

Denis Naughten (Roscommon-South Leitrim, Fine Gael)
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Question 61: To ask the Minister for Health the steps he is taking to deal with the shortage of non consultant hospital doctors; and if he will make a statement on the matter. [17865/11]

James Reilly (Dublin North, Fine Gael)
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I propose to take Questions Nos. 20, 42, 45 and 61 together.

I am working with the HSE and other stakeholders to ensure the filling of as many as possible of some 475 NCHD posts which are due to be filled from 11th July 2011. The HSE conducted an extensive recruitment drive in India and Pakistan in recent months and succeeded in identifying 439 potential candidates for NCHD positions in Ireland. I have held meetings involving my Department, the Medical Council, medical training bodies and the HSE with a view to identifying measures to facilitate the appointment of suitably-qualified doctors from abroad. Drafting of a Bill to amend the Medical Practitioners Act, 2007, to enable the Medical Council to register doctors in supervised posts for a defined period, is at an advanced stage.

Notwithstanding this and other initiatives, it is unlikely that all NCHD vacancies can be filled by 11th July. Hospital management are working with Clinical Directors in a planned way to devise contingency arrangements which can be implemented if required, to ensure that any resulting impact on services is minimised and that safe delivery of hospital services is assured. In the medium-term, ongoing reform of the system will result in changes in how care is delivered in certain locations. This will be done on a basis that takes account of the need to reduce the current reliance on NCHDs.

While there is no plan to cease any current services, the configuration of services is constantly reviewed and from time to time re-arranged to improve access and quality of service and minimise risk to patients. This programme of realignment of services has received recent impetus from HIQA in relation to the need to implement the recommendations from the Ennis and Mallow reports. The reports deal in particular with the type of services that can safely be provided in smaller hospitals and the structures required for good governance and accountability. The HSE must ensure that this happens and I will be monitoring the situation closely in conjunction with HIQA. I can assure the public that no hospitals will close, regardless of the difficult economic situation we find ourselves in. However, ongoing reform of the system will result in some changes in how care is delivered in particular locations across our health system.