‘Brain drain’ of medical staff blamed on bad work conditions

HSE culture must change to encourage doctors and nurses to return, says study

Young Irish doctors and nurses are emigrating because of difficult working conditions, poor training and career opportunities, rather than for financial reasons, a new study has indicated.

Many had "rediscovered the joy" of practising their profession in Australia, the UK and the US in contrast to the difficult work environment in Ireland, the study by researchers from the Royal College of Surgeons in Ireland (RCSI) has found.

To attract back doctors and nurses, the Irish health system would have to reform in order to compete with opportunities offered by other countries in a global market, it warned.

Many of more than 500 junior doctors and nurses who were surveyed complained of a “general disrespect” for health professionals in Ireland from the media and health employers.

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Some said there was an “anti-doctor narrative” in the media and claimed the HSE fuelled this in order to weaken the negotiating power of health professionals.

A third of those who responded to the survey had emigrated to Australia, 29 per cent to the UK and 17 per cent to the US.

Almost 1,200 doctors and more than 2,300 nurses have been given Australian work visas in the past five years, according to figures in the qualitative study.

Just 12 per cent said they had emigrated for financial or personal reasons, compared to 30 per cent who cited working conditions and 27 per cent for whom training was important.

Many respondents described emigration as a form of escape from difficult working conditions in the Irish health system. They spoke of “superior” working conditions in the countries they now lived in “which appeared to both vindicate their emigration decision and complicate the decision to return”.

One doctor said: “Emigration is a matter of self-preservation. The working conditions . . . are killing us slowly.”

Another said: “It’s not about the money, it’s about respect . . . we love working in medicine, but we love our families and health more.”

Another respondent reported ending up in hospital twice “because of the ridiculous amount of work we did due to long hours and under-staffing”.

While many talked about the possibility of returning to Ireland, they wanted reforms to the health service, such as better staffing levels, before they came back.

The study said there was a time-limited window of opportunity for return – the longer doctors and nurses stayed away, the less likely they were to come home.

A group chaired by DCU president Prof Brian MacCraith has made a series of recommendations for improving medical training and working conditions which are in the process of being implemented.

But according to Prof Ruairí Brugha of the RCSI’s department of public health medicine, the study showed the culture of the Irish health service also needed to change.

“These issues are not unique to Ireland. We’re in a global market and we need to decide how we are going to retain nurses and doctors in that context.”

The health services also needed to identify the types of specialists needed, how many were required and when, he said.

Paul Cullen

Paul Cullen

Paul Cullen is Health Editor of The Irish Times