How will the €200 million package of medical education reforms announced last week help the health service?
By more than doubling the intake of EU (mainly Irish) medical students to 725 every year, the medical manpower needs of the health system into the future have been addressed.
The Fottrell report estimated that an annual intake of 700-740 students would be required to achieve self-sufficiency in manpower. At present more than 60 per cent of the 782 students accepted into Irish medical schools are from non-EU countries. Many of these return home after graduation, leaving a significant shortfall of Irish- trained doctors here.
Irish College of General Practitioners chairman, Dr Eamonn Shanahan, has said the Republic needs to produce one extra GP every fortnight on the basis of projected population increases alone. At the same time, about one-third of current GPs are due to retire in the next 15 years. Overall, there is a need to produce 150 family doctors every year.
At a consultant level it is widely accepted that we need to shift from a consultant-led to a consultant-provided health service. It is esimated we need an additional 1,000 hospital consultants to make this happen.
Graduate students are known to be well motivated and are more likely than undergraduate entrants to remain in medicine, so the move to a multistream entry system should help. But the major loss of doctors in the Republic occurs during postgraduate specialist training. Many leave to pursue this training abroad but never return to consultant posts.
The Buttimer report suggests measures to enhance the quality and attractiveness of postgraduate training, the lack of which prompts departures.
There is no reason why we cannot provide specialist training to a high standard in the State, in partnership with centres of excellence abroad. When these proposals are implemented, the days of medical emigration should largely be over.
From the healthcare consumer's viewpoint, there is a need for assurance about clinical training quality. The commitment to national quality standards will be welcomed by patients, who need to know they are being treated by doctors who have been trained to a uniform standard. Significantly, both Ms Harney and Ms Hanafin promised new oversight structures aimed at improving governance and accountability in the delivery of medical education.
Both the health service and patients will benefit from the reform package.