Doctors' deal and patient care

Sir, – We are a group of trainee psychiatrists who wish to lend our support to the concerns expressed by our emergency medicine…

Sir, – We are a group of trainee psychiatrists who wish to lend our support to the concerns expressed by our emergency medicine (September 20th) and paediatric (September 21st) colleagues. The proposed unilateral salary cut for new entrant consultants and some of the proposed changes in consultant work practices are likely to have a detrimental effect on the recruitment, training and retention of doctors in Ireland

As trainees, we believe in providing the highest standards of care to our patients. However in Ireland, many doctors in psychiatry already work and train in an environment that presents huge challenges in providing this care to patients. Irish mental health services are grossly under-resourced (September 21st). The national policy on the delivery of mental health services, Vision for Change, published five years ago, has struggled to be implemented. Embargos on recruitment, early retirements and difficulties attracting recruits have seen mental health teams depleted and often demoralised. Most worryingly, all of this is occurring at a time when there is increased requirement for and demand on Irish mental health services.

The implementation of the European Work Time Directive (EWTD) in 2009 has already resulted in a reduction of time junior doctors spend in training. We are concerned that proposed changes to work practices, ie rosters for consultants, will mean a further reduction in “face to face” training time spent with consultants. Most importantly, unless rotas for all grades are adequately staffed and carefully planned, this will also result in reduced continuity in patient care.

Psychiatry as a specialty is already struggling to recruit junior and senior doctors. There are posts vacant across the country at both of these levels. Sadly this crisis in recruitment is not unique to psychiatry or indeed medicine but extends to all healthcare professionals. Significant changes to work practices and unilateral cuts in salary for healthcare workers, as exemplified by the proposed 30 per cent cut for future consultants, can only further exacerbate this recruitment crisis.

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If we are truly to encourage doctors to remain in Ireland and continue to develop and improve mental health services in the future, it is vital that the Minister and Department of Health consider the long-term implications of their actions on patient care, service provision and training of future consultants. – Yours, etc,

Dr ERIC KELLEHER (Chair) Dr KAREN O’CONNOR Dr ZAREENA ABIDEN, Dr CATHERINE DOLAN, Dr LEONARD DOUGLAS, Dr EMAM EL-HIGAYA, Dr NAVROOP JOHNSON, Dr IAIN JORDAN, Dr ERIK KOLSHUS, Dr AHMAD IQBAL, Dr GEAROID MOYNIHAN, Dr LINDA O’ROURKE, Dr ERIC ROCHE (Hon Sec), Dr CHRISTINA SIM,

Trainee Committee,

College of Psychiatry of Ireland,

Herbert Place,

Dublin 2.

Sir, – Whilst I have some empathy for the argument set forth by Turlough O’Donnell (September 19th), I must confess I breathed a sigh of relief when I realised as a female of the species that at least I would not be subject to the “emasculation of consultants” he describes. – Yours, etc,

Dr NIAMH LYNCH,

Halldene,

Bishopstown,

Cork.