Written answers

Tuesday, 18 February 2014

Photo of Eoghan MurphyEoghan Murphy (Dublin South East, Fine Gael)
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766. To ask the Minister for Health his plans to tackle the emerging hospital consultant recruitment crisis. [8264/14]

Photo of James ReillyJames Reilly (Dublin North, Fine Gael)
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Notwithstanding the need to reduce the numbers employed across the public service in order to meet fiscal and budgetary targets, the HSE has the capacity to recruit consultants. Arrangements are in place in the HSE to allow the recruitment of front-line staff where there is an established service need. More generally, in order to mitigate the impact on front-line services of the reduction in employment numbers, the priority is to reform how health services are delivered in order to ensure a more productive and cost effective health system.

It is Government policy to move to a consultant delivered service and there has been a significant increase in the number of consultants (Whole Time Equivalents) over the past 5 years, the number increased from 2,260 in December 2008 to 2,555 in December 2013. However there are some specialties in which there is an international shortage and which have been traditionally difficult to fill, regardless of the salary scale. There are also some hospitals to which it has historically been difficult to attract applicants, in particular smaller hospitals that have onerous rosters due to the limited number of consultants. The establishment of Hospital Groups will help to address this issue, as this will allow doctors to be appointed as group resources - instead of to just one hospital.

The ability of the public service to attract and retain high quality consultants shapes the extent to which the HSE can maintain and develop the range of health services required. If the health services are to continue to provide consultant-level opportunities for doctors to replace consultants who retire and eventually to expand overall capacity, this can only happen on the basis of a lower-cost model, hence the decision to reduce the pay of new consultants by 30%. This decision is being modified to enable consultants currently working in permanent posts within the public service to move to different posts, while retaining their existing salaries. Application of the revised guidance will support consultant mobility. Allowing serving clinical consultants retain their existing salaries will remove a blockage on movement within the system at present. This mobility will, in due course, also facilitate the roll-out of the Hospital Group model with staff appointed to the Group rather than being confined to specific locations.

I set up a group under the chairmanship of Professor Brian McCraith last July to carry out a strategic review of medical training and career structures. The Group submitted an interim Report focused on training to me in December and is now progressing examination of the career structure to apply on completion of specialist training with a view to reporting to me by the end of March. Broader issues relating to recruitment and retention of NCHDs and consultants will be given further consideration on receipt of this report.

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