‘My future as a doctor in Ireland is looking increasingly bleak’

A junior doctor writes an anonymous open letter to all General Election candidates

Dear candidate,

I appreciated you taking the time to talk to me today. When you stopped by canvassing for the elections, I asked you about your views on the health strategy going forward. I asked you how you proposed to increase staff in the health service, as health policy is one of my key election issues. I’m not always so good at on the spot discussions, but after you left I did some thinking about what the problems are, and I started to worry. Really worry.

The issue of our healthcare staff, in particular young doctors like myself, leaving the country is not a new problem. However, I fear the extent of the problem, and how much it is going to affect our healthcare service in the coming years, is completely underestimated by our Government. Your answer to my question about how we attract our professionals back to Ireland was that you would like to see the introduction of tax breaks for certain returning professions, increases in wages, and reduction in the USC in order to create more attractive and financially competitive posts here in Ireland. That is all well and good, but I fear it rather misses the point.

While financial incentives would help somewhat, the reality is that wages are the very last thing driving our doctors away. We leave because we can get more intensive, higher quality postgraduate training abroad. We leave because we want more control over our careers, and not be used as pawns to provide service to the more remote understaffed areas of our country, when our lives are based elsewhere. We leave because we work hard with little recognition or respect, and Minister for Health Leo Varadkar’s comments this week just prove this.

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When I heard the stories about how Mr Varadkar thinks it is important to keep hospitals under pressure for beds and resources as it increased staff work rate and productivity, I was almost in tears. I felt demoralised. I felt like Mr Varadkar doesn’t trust me to work hard and work effectively, and that restricting beds and resources is the stick he uses to beat me into working longer hours, taking less breaks and taking less time to get the teaching and training I need to progress in my career.

It is true that when we are under pressure we work harder, we work longer and we push to increase throughput of patients and bed turnover, but as a result, every single patient I meet sees a drop in the standard of their care. Patient care suffers, while I suffer the consequences of feeling guilty, anxious and annoyed at myself that I can’t give them the time and attention that they deserve.

Not long before you arrived at the door my partner and I (he’s also a doctor) were talking about what English speaking country we are going to move to. As a graduate entry medical student, leaving the country was never on my radar. I always planned to stay in Ireland, as being near my family and friends is really important to me. We are both still in training and I intend to go on to do General Practice but I fear my future as a doctor in Ireland is looking increasingly bleak.

My Twitter feed at present is filled with stories and comments from senior GPs who are struggling to make ends meet, who are stretched beyond breaking point, and most worryingly of all, there is no light at the end of the tunnel. Training scheme applications in this country are falling, and the rate at which we are haemorrhaging doctors means there is absolutely no hope of our situation improving in the next few years.

There are only two things that will keep me here in Ireland. One is my family, and the second is my blind stupid faith, that surely, surely things have to improve. Surely I have to have some prospect of a decent career here in Ireland as a GP. Surely our health service needs GPs and will have to do something to protect them as they are the frontline of our health services. But I fear if the next government doesn’t do something to change the situation, I will most certainly be proven wrong and be left with little option but to follow my friends abroad and set up my life elsewhere.

I will anxiously await the publication of the next government’s healthcare manifesto, as my future and our nation’s health depend on it.