Madam, – A HSE spokesperson is reported as attributing the Irish non-consultant hospital doctor (NCHD) recruitment crisis to a worldwide shortage of doctors (Home News, April 18th). The notion that the HSE is a passive victim of global forces beyond its control is simply nonsense and brings to mind another failed administration, whose early spin suggested that the destruction of Ireland’s economy was due to a global economic downturn. In this latter instance events subsequently showed that much of the responsibility lay far closer to home and the same applies to the NCHD recruitment crisis.
The immediate reasons for the NCHD shortage are that many more Irish medical graduates than previously are choosing to work abroad and far fewer overseas doctors are choosing to work in Ireland. Changes to Medical Council registration rules account in part for the collapse in overseas applicants, but the employer must acknowledge its significant role in the unfolding crisis.
HSE actions include the implementation of a new NCHD contract with significantly less favourable terms and condition than the one it replaced; the drip feed of propaganda about “outrageous” NCHD overtime bills (these sums are a direct mathematical product of hours worked and hourly rate); the casual breaching of the new consultant contract; the unchecked vilification of the “most highly paid consultants in the world” – a lie nailed by OECD data and purchasing power comparisons; the introduction of a centralised recruitment system that delayed its own (HSE) hospitals recruiting while the academic and voluntary hospitals (mainly in Dublin) recruited apace; and the effective prohibition of HSE hospitals marketing their posts.
The clear message is that doctors are personae non grata in the Irish hospital system and many NCHDs have taken the hint and are either taking their skills to countries that welcome and value their contribution or are staying away from Ireland altogether.
You don’t need a medical degree to appreciate that understanding the cause of a problem is the first step in finding a cure. As long as the HSE fails to acknowledge its starring role in the crisis that poses an immediate threat to the viability of the acute hospital service in many parts of the country, the short- to medium- term future of the service looks bleak. – Yours, etc,