Hospitals hiring doctors without specialist skill, say consultants

Hosptial consultants association: Appointments to fill posts compromising patient care

The HSE acknowledged last weekend that there were occasions in emergency situations when doctors not on the Medical Council’s specialist register were appointed to fill temporary consultant positions. Photograph: Getty Images
The HSE acknowledged last weekend that there were occasions in emergency situations when doctors not on the Medical Council’s specialist register were appointed to fill temporary consultant positions. Photograph: Getty Images

Public hospitals are increasingly appointing doctors without specialist training, skill or expertise to serve as temporary consultants in particular areas due to staffing difficulties, it has been claimed.

The Irish Hospital Consultants Association (IHCA) said the appointment by hospitals of doctors who were not on the Medical Council's specialist register to fill temporary consultant posts was compromising patient care and safety.

The association's president, Dr Tom Ryan, said public hospitals were filling an increasing number of temporary consultant posts with doctors who were not on the Medical Council's specialist register as a means of circumventing growing problems of recruiting and retaining consultant staff. He said these problems were being caused by uncompetitive pay rates and working conditions.

Dr Tom Ryan, president of the Irish Hospital Consultants Association: “It is not acceptable that doctors who do not have the essential specialist training, skills and expertise are treating patients as consultants in our acute health services”
Dr Tom Ryan, president of the Irish Hospital Consultants Association: “It is not acceptable that doctors who do not have the essential specialist training, skills and expertise are treating patients as consultants in our acute health services”

The IHCA said this practice violated “the most basic professional standards within the public health services” and was in breach of the 2007 Medical Practitioners Act.

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Emergency situations

The HSE acknowledged last weekend that there were occasions in emergency situations when doctors not on the Medical Council's specialist register were appointed to fill temporary consultant positions.

“There are limited circumstances where, in order to ensure senior medical coverage, that an experienced registrar not on the specialist register may cover for an absent consultant to ensure the provision of safe, quality care. This will only occur as a final option in emergency circumstances,” the HSE said.

However, the IHCA disputed this stance and said in some cases doctors not on the specialist register remained in temporary consultant positions “for years”.

Minister for Health Simon Harris at the weekend said he noted the statement of the HSE on the issue, but said he expected the HSE "to comply with statutory and policy requirements when filling consultant posts".

Report

He said in February this year the HSE published a report aimed at improving consultant appointments and recruitment, and that this was being implemented.

Dr Ryan said the practice of appointing doctors who were not on the specialist register to work as consultants in the country’s health services must stop immediately.

"It is not acceptable that doctors who do not have the essential specialist training, skills and expertise are treating patients as consultants in our acute health services. This compromises and undermines the quality and safety of care that is provided to patients in our hospitals. The crisis in the recruitment and retention of consultants, which was acknowledged last week by the Public Service Pay Commission, cannot be resolved at the expense of patient safety."

The IHCA urged the Minister and the HSE to publish details on the number of consultant posts filled by doctors who were not on the specialist register for the speciality in which they were practising.

Martin Wall

Martin Wall

Martin Wall is the Public Policy Correspondent of The Irish Times.