THE DISCLOSURE that some junior doctors working at Our Lady of Lourdes Hospital in Drogheda require “extremely close supervision and support” will be a source of concern for patients. It has emerged that four of nine junior anaesthetic staff have a limited capacity to perform the full range of duties expected of them. Two have minimal experience with epidural anaesthesia – a high-demand procedure in an institution offering maternity services. In the case of one individual, such is his poor command of English, he cannot participate in the hospital’s on-call rota.
In addition, the hospital has been unable to fill five of its 14 junior anaesthetist posts for the six months from July to January. It is therefore attempting to offer a safe and comprehensive service to patients with just over a third of the junior anaesthetic staff it requires to operate on a full out-of-hours basis. How could a teaching hospital in the State find itself in this position?
There is a general difficulty filling non-consultant hospital doctor posts at present, with particular pressure being felt in anaesthetic and emergency departments nationally. The Health Service Executive may argue that recruiting an anaesthetist without the ability to perform epidural anaesthesia is better than not filling a post at all. But such a decision can only be made if a full risk assessment has been carried out.
The recruitment of a doctor with poor English language skills is, in some ways, more serious. The physician in question is from an EU member state, which means that unlike a counterpart from outside the EU, he is not obliged to undergo a language proficiency test. According to Medical Council president Kieran Murphy, it is prohibited by EU legislation from assessing the English language competencies or clinical skills of doctors who qualify in the EU. This is an admission that, in effect, acceptance of certain doctors on to the council’s register no longer reflects their professional abilities.
Although primarily a problem with an EU solution, both doctors and employers must be mindful of section 12.1 of the council’s guide to professional and ethical conduct which states: “if you do not have the professional or language skills, or the necessary facilities to provide appropriate medical care to a patient, you must refer the patient to a colleague who can meet those requirements”.
What will concern the public most about the Drogheda revelations is that despite much rhetoric and some progress, the Minister for Health has presided yet again over a serious breach in patient safety.