Huge drop in applications for junior doctor posts


A HUGE DROP in applications for junior doctor posts in hospitals across the State which fall vacant in January has been blamed on the fact that many young doctors are now emigrating.

The Irish Timeshas seen internal HSE documents which show that applications for junior doctor posts which need to be filled by the new year have fallen by more than half, when compared to a year ago, at some hospitals. Both large and small hospitals are affected and the recruitment problems may result in “significant gaps in service areas” next year.

Many junior doctors in training rotate jobs every six months and a review of applications lodged for those jobs falling vacant in January 2010, now that the deadline for applications has passed, shows there has been: a 59 per cent drop in applications for NCHD (non-consultant hospital doctor or junior doctor) posts at Tullamore Hospital; a 56 per cent drop in applications for posts at Connolly Hospital in Dublin; a 56 per cent drop in applications for posts at Cavan/Monaghan hospitals; a 48 per cent drop at Waterford Regional Hospital; a 45 per cent drop at Cork University Hospital and a 35 per cent drop at Dublin’s St Vincent’s hospital.

Data from all hospitals is not yet available.

The HSE’s national medical manpower managers have discussed the issue at recent meetings and “are very concerned at the reduction in applications for NCHD posts in our hospitals”, an internal HSE document states.

The memo from one HSE official to another warns: “This substantial reduction in the number of applications will lead to major difficulties in filling these posts”.

It adds: “Where we can not directly fill posts, we will have to rely on medical recruitment agencies that are high cost and are not the solution to this problem.”

It goes on to state that the posts proving most difficult to fill are general surgery, anaesthetics, emergency medicine, radiotherapy, oncology, plastic surgery, cardiothoracic and orthopaedic surgery.

A separate letter states “it is likely that we will have significant gaps in service areas” as a result.

Dr Anthony O’Connor, a member of the NCHD committee of the Irish Medical Organisation, said the talk among junior doctors in all hospitals now was how quickly they could get out of Ireland. “There has been huge turbulence over the last 12 months for NCHDs,” he said, adding that their contracts had been unilaterally changed before the High Court intervened and then there had been a Labour Court recommendation on new working hours and rosters to ensure compliance with the European working time directive which states they should not work more than 48 hours a week.

He claimed the reduction in their hours was being introduced in a “ham-fisted” way.

“Earlier this year when that happened [contracts were changed], I was getting e-mails from recruitment companies in Australia and New Zealand saying we have heard about the difficulties people are having in Ireland and offering jobs,” he said.

“Every NCHD in Ireland would know at least five to 10 people that would have gone to Australia or New Zealand in the last few months,” he added.

Some NCHD posts would usually be filled by doctors trained overseas but Dr O’Connor said: “I think word has gotten out that Ireland is not as attractive a destination as it used to be for doctors any more.”

A HSE spokesman said that while there have been reductions in NCHD income arising from reductions in working hours related to the implementation of the European working time directive and the public sector pension levy, the HSE “anticipates that the new NCHD contract to take effect from 1st January 2010 will be attractive to those interested in working in Ireland”.

He added that while the HSE faced a challenging recruitment environment, the numbers of stand-alone NCHD positions to be filled should be fewer in January than in the previous year.

There are about 4,000 junior doctors working in Irish hospitals. The HSE plans to reduce their numbers by extinguishing two NCHD posts for each new consultant employed.

NCHDs are currently seeking pay rises of between 25 and 40 per cent to make up for loss of overtime since their hours were cut. The HSE has been paying €250 million a year in overtime to junior doctors.

'Now I do not want to come back to a system in chaos'

DR PATRICK O’Sullivan (25) began working as a junior doctor on July 1st this year at Tallaght hospital, Dublin, after graduating from Trinity College.

He plans to go to work in Australia once his intern year has been completed in six months time.

Several of his friends are also travelling, he says.

Dr O’Sullivan stresses that many junior doctors travel overseas to get experience during their careers but what made his mind up for him was the multitude of changes introduced for junior doctors in the healthcare system here in recent months.

“What made me decide to go was the kind of atmosphere that’s been created by these attempts by management to put the 48-hour week in place without employing extra staff,” Dr O’Sullivan says.

“We are expected to have the same productivity in less hours, which is unrealistic and unfair and it’s left a bad taste in the mouth,” he adds.

Many junior doctors had to work longer than the permitted 48 hours a week to ensure patients were cared for and there was then uncertainty over whether they would be paid for these extra hours.

“I’m going to be earning less in Australia, but it’s more the atmosphere and having a system that is adequately staffed and resourced and where you are not made to feel you are expected to compress all of your work into a shorter timeframe,” he says.

“In the beginning I was looking at going for 12 months but now I do not want to come back to a system that is in chaos and where you feel like you are under attack for doing your job.”