HSE plans to recruit interns condemned

Clinical director of Beaumont Hospital to resign in row over psychiatric patients

Plans by the

Health Service Executive

to save money by filling key roles with interns and newly graduated nurses will seriously compromise patient safety, the nurses’ union has said.

The HSE intends to send graduate nurses into the community for the first time and to increase its use of healthcare assistants relative to nurses in care for the elderly as part of plans to make a further €80 million in cuts this year, according to the Irish Nurses and Midwives Organisation.

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It described the proposals, furnished to unions in a meeting last week, as “the most damaging set of measures brought forward in recent years” and warned that nurses would not agree to any changes that negatively impacted on patient care.

The HSE said it wasn’t correct to say it was seeking an additional €80 million in cuts. What was being sought was the original target of €290 million set by the Department of Public Expenditure.

According to the implementation plan, seen by The Irish Times, the HSE hopes to recruit large number of junior doctors this year from eastern Europe. Previous recruitment drives to fill shortages of medical staff focused on India, Pakistan and South Africa.


Vacancies up
The report says vacancies in rural hospitals are up 30 per cent and in these areas, existing junior doctors are opting for agency contracts over permanent posts because of the more favourable terms and conditions. It suggest that junior doctors should be offered extended fixed-term contracts for non-training posts and there should be a targeted conversion of junior doctor posts to consultant posts. This is expected to save money even if, as anticipated, starting salaries for new consultants are increased. The Irish Medical Organisation believes there is little prospect of making savings in this way this year.

The HSE report says care for the elderly is not an area that graduate nurses wish to work in in any great numbers. Some 65 intern healthcare assistants are already deployed in this area and a further 450 will be deployed this year.


Meetings sought
The INMO says filling nursing vacancies in the community with new graduates is contrary to best practice because newly qualified nurses require peer support and mentorship for a period before working alone in the community.

The union has sought immediate meetings with the three Ministers in the Department of Health to detail its concerns, as well as a meeting with the Oireachtas health committee and the head of patient safety in the HSE.

"These proposals are totally driven by the demand for the health service to deliver further cash savings. The plans, which have not been subject to a patient safety audit or risk assessment, ignore the implications for standards of care for patients, and their safety, as money is the only issue being considered by management," said INMO general secretary Liam Doran.

“The INMO will be calling on the Ministers, and the HSE, to withdraw these plans immediately and ensure, regardless of financial pressures, that frontline services are not subject to further cuts”.

Meanwhile, the clinical director of Beaumont Hospital is to step down from this position in a row with the HSE over the assessment of psychiatric patients out of hours in the emergency department.

Prof Shane O'Neill, who remains at the hospital as a respiratory consultant, resigned the clinical director position on Friday after telling management he could not stand over "significant clinical risks," the Sunday Business Post reported yesterday.

Paul Cullen

Paul Cullen

Paul Cullen is a former heath editor of The Irish Times.