Extended hours for junior doctors just not working
Young clinicians are on the verge of industrial action over what they consider unsustainable shift patterns
Caroline Spillane, chief executive of the Irish Medical Council, which has audited the number of doctors in Ireland.
The fate of young doctors will be in the news for some time as they ballot on a strike that, if it goes ahead, would have a serious impact on an already overstretched health service.
The source of the grievances of the 2,000 junior doctors in the system is the long hours they continue to work despite repeated pledges that it would be reformed.
An overwhelming majority are expected to vote for some form of rolling industrial action after balloting ends on September 2nd.
Meanwhile, the European Commission, which has repeatedly taken Ireland to task about not implementing the European Working Time Directive, is monitoring hospitals that already have a 48-hour week to ensure that progress is being made.
The Government faces the prospect of being fined millions of euro if the commission decides to refer Ireland to the Court of Justice over the issue.
The cause of the long hours worked by Irish doctors would appear to be a case of misallocation rather than a lack of resources.
The Medical Council of Ireland, which retains the registration details of all Irish doctors, has conducted the first comprehensive audit of the number of doctors in Ireland; who they are, and where they come from.
According to registration data from the end of 2012, there are 16,392 doctors in Ireland, giving an average of between 3.6 and 4 per 1,000 depending on the time of year, according to the council’s medical workforce intelligence report.
This puts Ireland either third or seventh among 28 OECD countries, depending on when the registration is taken.
Mass of data
The situation is complicated, though, by the number of foreign doctors in Ireland, of whom some are in Ireland all year and others who come and go. A quarter of all doctors registered in Ireland either work part-time outside the country or practise only outside Ireland.
When their numbers are discounted, Ireland ranks only 13th or 18th out of the 28 countries.
The most startling fact that emerges from the mass of data provided by the Medical Council is that the percentage of female doctors has grown in every generation.
Some 61.9 per cent of doctors in Ireland between the ages of 25 and 34 are women. Overall in the health service, the gender balance is reversed as men dominate in the older age categories.
Between 35 and 44, there is still a small majority (53.4 per cent) of women in the profession. At the other end of the scale, of the doctors who are still practising over the age of 65, fewer than one in five (18.1 per cent) is a woman.
More than one-third of all doctors (35 per cent) in the Irish system are from abroad. Of all the OECD countries, only New Zealand has a higher proportion of foreign-born doctors.
The largest number in Ireland, 13.4 per cent, come from the Middle East. This is followed by Africa (7.5 per cent) and the rest of Europe (9.6 per cent)
Critically, 10 per cent of foreign-born doctors in Ireland are from countries identified by the World Health Organisation (WHO) as being challenged with a critical shortage of human resources for health.
This is in breach of the WHO Global Code of Practice on the International Recruitment of Health Personnel, which states that countries should strive for self-sufficiency and sustainability in the development and retention of health workers.