Doctors without specialist qualifications face contract termination

Temporary or locum hospital consultants who do not hold required specialist qualifications may see their contracts of employment terminated early under a new circular issued by the HSE.

The Minister for Health Simon Harris said the HSE circular provided for a "risk mitigation plan" to be put in place in cases where a consultant did not possess relevant qualifications specified for the position.

The Irish Times reported last week that official figures provided to the Irish Hospital Consultants Association (IHCA) revealed there were now 81 doctors working as consultants in Irish public hospitals who were not on the specialist register of the Medical Council.

The IHCA said this was a “major issue” as the public needed to be sure they were being treated by doctors who had completed specialist training in their particular areas.

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IHCA secretary general Martin Varley said 54 doctors were in temporary posts and 27 were doctors provided to the HSE by employment agencies for a period of one month or more.

He said the overall figure could be higher when figures for agency doctors contracted for less than one month became known.

Regulatory functions

Mr Harris said, in answer to a parliamentary question tabled by Fianna Fáil’s Billy Kelleher, the HSE circular reaffirmed its regulatory functions in relation to all consultant appointments in the public service, including new and replacement posts, locum and temporary posts, contract type and qualifications to apply.

He said it stated health service employers were required to seek the prior approval of the HSE before making a consultant appointment and to comply with the HSE letter of approval concerning any post in making an appointment.

“It also provided that a risk mitigation plan be put in place for each consultant post where the appointee does not hold the qualifications specified for the appointment, and this should include appropriate arrangements for senior clinical oversight as required.

“It also provided for the early termination of contracts of temporary/locum doctors who do not hold the qualifications required.”

Risk assessment

The HSE said it was envisaged a risk assessment would be at hospital level rather than be targeted at individuals.

“This would include putting a mechanism in place to rapidly identify any failings or deficits that could result from the consultant’s lack of qualification. That mechanism could be review/reporting to the relevant clinical director, for example. Single-handed appointments are very rare.”

The HSE also said appointments “may be terminated in line with the contractual arrangement in place for such doctors”.

“For example, in the case of fixed-term workers, the Minimum Notice and Terms of Employment Acts 1973-2005 allow for termination subject to a week’s notice for each year of employment.”