THE SHORTAGE of junior doctors in our health service is not a new problem. Two years ago, applications for junior doctor posts had fallen by up to 59 per cent at some hospitals. This time last year, the proposed closure of the 24-hour emergency department at Louth County Hospital was brought forward due to the shortages.
Today the emergency department at Roscommon Hospital is due to close and be replaced with an urgent care centre, a move partially attributed to junior doctor shortages as well as safety issues. Paediatric services in Louth-Meath, including outpatient clinics, have been curtailed because of the shortages. Both changes, and what must surely be many more to come, show the folly of politicians making rash election promises, as the Taoiseach is learning to his cost.
There are many reasons why we are short young doctors. Many junior doctors (non-consultant hospital doctors) are working over 70-hour weeks despite a European working time directive that they should not have to do more than 48 hours. Minister for Health James Reilly said recently there was one hospital where no junior doctor wanted to work because of how they were being treated. Other factors include pay cuts, lack of protected time for training and few opportunities for career advancement. As a result Irish doctors, educated at huge cost to the taxpayer, are emigrating, while at the same time changes in the 2007 Medical Practitioners Act make it more difficult for non-EU doctors, on whom we are dependent, to get into the Republic.
As usual, little is done to address problems like this until we are at crisis point. The HSE only tried to recruit doctors from India and Pakistan in March, despite knowing it takes considerable time for them to be properly vetted by the Medical Council before they can register to work here. However it did lobby for changes to the Medical Practitioners Act, which the Dáil adopted last week, making it easier for doctors to register. They will be retained on two-year rather than six-month contracts, which should help prevent future shortages.
It is essential that in its haste to get more non-EU doctors into the State, the usual checks remain in place to protect patient safety. As of last Thursday, 158 junior doctor posts which fall vacant today remained to be filled. HSE chief executive Cathal Magee said the full impact of this would not be known until this week, but it is likely to result in longer waiting times in some emergency departments, inflicting further misery on patients. Meanwhile little is being done to ensure Irish-trained doctors are retained here.
Making doctors work in Ireland for a period after qualifying, as a payback for their education, should be considered but we also have to examine why our system is so dependent on junior doctors, who can spend long periods completing tasks that could be ably undertaken by other health professionals. The 4,600 cohort of junior doctors needs to be reduced and consultant numbers increased so we can have a consultant-provided service for all patients. That could only happen in the current climate if consultants’ pay is cut.