"Locum Cover" In Hospitals


Sir, - Recent media coverage of apparent misdiagnoses by a 78-year-old pathologist in the UK made interesting reading. It appears that this doctor provided "locum cover" to two hospitals in Ireland. I am fascinated by the reaction of the media to what is obviously an unacceptable situation.

Would you allow a 78-year-old pilot to provide "locum cover" for an Aer Lingus captain and command a scheduled flight to New York? This would not happen because it would not be countenanced by the airline. The question no journalist has asked is: why are "locum" pathologists working in Irish hospitals?

Almost 40 years ago Prof Paddy FitzGerald advised the Government that a smaller number of fully equipped and staffed hospitals was required to provide a modern medical service to all Irish patients. The Faculty of Pathology of the Royal College of Physicians of Ireland carried out a long and somewhat acrimonious battle with the Department of Health almost 20 years ago, advising against the appointment of single-handed specialists, again to no avail.

The Irish Government and the health authorities have a statutory obligation to provide an adequate health service. In ignoring the advice of the professional bodies and common European practice they have patently failed in their duty.

Currently there are three health authorities which provide no specialist haematology consultant service to almost a million people. Two of these authorities are in the process of appointing a single-handed consultant haematologist in the year 2000 with no possibility of a second colleague for many years.

The reaction from the Department of Health and Children that Irish doctors should be retrained every five years is irrelevant to solving the problem. Presumably single-handed specialists, even if they were to retrain every day, will be allowed to take holidays and will still depend on "locums". The answer is for the Government to provide adequate numbers of trained staff immediately.

It would be refreshing if a mature debate could take place in Ireland about the sad state of the health services. Perhaps by doing this now we might prevent the next inevitable public inquiry into the low levels of consultant staffing in publicly funded hospitals in Ireland. - Yours, etc.,

Prof Shaun R. McCann, Professor of Haematology, TCD, St James's Hospital, Dublin 8.