Sir, – In 2003, (when I was 12 years old and in sixth class), the then government under the then minister for health Micheál Martin published a fair, thoughtful and exacting document called the Hanly report, also known as the Report of the National Task Force on Medical Staffing. This document outlined the changes needed in the medical workforce to ensure a sustainable, more efficient and safer health service. The vision was there, under at least one former minister for health.
Some of the recommendations around centralisation may be unpopular, but politicians need to start asking themselves and the electorate which is worse: inadequate services because they have no appropriately trained doctors or a more centralised hospital system.
Can the well-remunerated civil servants in the Department of Health just please implement this now 19-year-old policy document to avoid impending industrial action? The greater than two-thirds of doctors who are not consultants working in the healthcare system don’t expect miracles or indeed huge fortunes, just something that at a service level is significantly less bad, more accessible, and specialist delivered.
These same departmental mandarins are overheard talking of needing “sharper elbows” and taking “minimalist” approaches to reform in another publication. Reminder: nobody voted for them.
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Equally it’s time for our own profession to start thinking realistically about what the workforce should look like in 10 years. The profession’s current state, and the illogical, inequitable and reactionary ways it has developed in the last decade are unacceptable and constitute failure. Particularly when seen through an equality, diversity and inclusion lens we have failed (notably some specialities continue to fail much more spectacularly than others in this regard).
One policy provision could be to phase out the general register of the Irish Medical Council in five years. This would ensure that every doctor is either a specialist trainee or a specialist. It’s important that intelligent, highly trained professionals feel they are valued and going somewhere in life.
Currently we shunt many non-consultant hospital doctors from six-month contract to six-month contract up and down the country without any real medium- or long-term professional prospects. The most marginalised groups are not from the EU. You don’t have to be a fan of critical race theory to see that overwhelmingly from the pool of non-consultant hospital doctors, a higher proportion of white male doctors’ progress in prestige specialities with ample opportunities for future lucrative private practice. It’s time to start acting like this is no longer acceptable.
Its funny that I mention this is a contemporary problem, but when I talk to family members who worked in the health service a long time ago (as support staff), they say the same issues were very visible back then (indeed when I was 12 and in sixth class).
Unequal opportunities, particularly if you weren’t born in the right place, even if the HSE did actively recruit you from your home country.
Cutting the Irish Medical Council’s general register would solve many issues in the medium to long term and force modernisation on systems completely unwilling and seemingly unable to change by themselves. Force is necessary – vested interests will only respond to brute regulatory force. – Yours, etc,
Dr EMMET POWER,
Beaumont,
Dublin 9.