Medical manpower: running out of doctors to serve in Irish healthcare

That the public hospital system in the Republic is in the midst of a medical manpower crisis is well recognised. What has emerged recently are the practical implications of the crisis and how it is impacting patient safety.

The Health Service Executive (HSE) has confirmed that doctors without the requisite specialist training are being appointed to fill temporary consultant positions in hospitals across the state. Some 128 doctors who are currently working as consultants in public hospitals are not on the specialist register of the Medical Council.

Acknowledging the appointments were in breach of regulations, the HSE said there were “significant risk issues” arising from the failure of hospitals to adhere to the national guidelines for employing consultants.

Although some 58 of the appointments predate 2008, when regulations were changed making it compulsory for consultants to fulfil rigorous training programmes laid down by the Medical Council, 70 consultants who were not eligible for entry on the specialist register have been appointed since then.

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A related manpower issue is highlighted in a new report from the Royal College of Surgeons in Ireland. It found that two thirds of new registrations with the Medical Council in 2015 were for medical graduates from outside Ireland. These doctors mainly fill posts that do not offer supervised training opportunities, which poses additional concerns for patient safety. The trend reflects the large number of Irish graduates who now emigrate to other English speaking countries which offer superior training opportunities and better working conditions.

Medical manpower challenges reflect a growing “brain drain” cycle, whereby a shrinking pool of fully trained specialists returning to Ireland now threatens the foundations of quality medical care here.

Although the problem is just one manifestation of HSE ineptitude, it must be urgently addressed. Peoples’ lives depend on it.