THERE ARE “grave concerns” in hospitals across the country about a significant fall in the number of applications for junior doctor posts which fall vacant in January.
Internal HSE correspondence seen by The Irish Timesshows that serious concerns about the situation were expressed during a teleconference between senior managers and clinicians at the end of last month. The issue was also discussed at a meeting of the HSE board last week.
While there were also shortages of junior doctors applying for posts in January and July this year – which resulted in around-the-clock emergency services at Louth County Hospital in Dundalk coming to an end earlier than planned – there are fears now that a further drop in applications for posts next year will result in more services having to be closed or amalgamated.
Anaesthetic services at Our Lady’s Hospital in Navan, which has already lost acute surgery in recent months, are especially at risk, with four applicants for registrar posts in the speciality pulling out recently. A shortage of anaesthetic cover at the hospital could also threaten the continued viability of the hospital’s emergency department, minor surgery and its acute medical services.
There is already a shortage of junior doctors in anaesthetics at Our Lady of Lourdes Hospital in Drogheda. The head of the hospital’s anaesthetics department, Dr Michael Staunton, recently warned that as a result the level of anaesthetic cover at his hospital “is highly unsafe for patients and staff”.
In a letter to colleagues on September 30th, Andrew Condon, general manager of the HSE’s office of the national director of human resources, said that while in July 2009, January 2010 and in the months leading up to July 2010 the reported drop in applications for junior doctor posts did improve “the vacancy level increased by approximately 80-100 over the figure reported six months previously”.
Around 260 junior doctor posts are currently vacant and if this increases in line with recent trends there could be up to 360 posts vacant next January.
“In July 2009 we started experiencing problems staffing NCHD posts – well in advance of any changes to registration, contractual or training arrangements,” Mr Condon wrote. “The UK and Northern Ireland have experienced the same problems to a lesser degree.”
He noted that despite working with 11 medical recruitment agencies to source doctors across the EU and in non-EU states such as Malaysia, only a limited number of suitable candidates to fill vacant posts could be found.
“Some of us might recall the recruitment agencies assuring us in May of this year that they had hundreds of suitably qualified NCHDs on their books. This has not proven to be the case.”
He claimed it was not a recruitment problem as the cohort of NCHDs “to solve our vacancy issue does not exist”.
Organisations representing doctors claim, however, that the reason for the shortage is excessive workload, cuts in pay to junior doctors, changes in visa regulations, and a reduction in the number of recognised training posts for doctors of this grade.
Mr Condon warned that “while recruitment may assist in some instances, the evidence is that recruitment will not enable us to avoid difficult decisions regarding staffing and service configuration in the coming weeks and months”.
In a statement last night the HSE said it has been working over the past few months to address the issue of a potential shortage of NCHDs, who rotate posts every six months in the hospital system.
“As we move closer to the next NCHD rotation [January 2011] efforts remain ongoing to ensure that the shortage of junior doctors and any associated impact on services are minimised,” it said.