The way junior doctors have been treated is ‘causing harm to health service’

The way junior doctors have been treated in Ireland is “unacceptable” and “extraordinarily foolish”, the minister for health has said.

Stephen Donnelly was speaking as he launched a new report by a taskforce that looked at improving and standardising working conditions for non-consultant hospital doctors (NCHDs).

He said that there must be urgency in addressing concerns raised by NCHDs, including a lack of facilities for eating and sleeping during long shifts, issues with emergency taxation and the need for support when being rotated between hospitals around the country.

“Some (NCHDs) told me that their greatest fear was being asked to work night shifts and weekend shifts in the emergency department where they wouldn’t see a consultant from five o’clock on Friday evening to eight or nine o’clock on a Monday morning – and people weren’t any less sick in that one third of the week,” Mr Donnelly said.

“The way we have treated our NCHDs in this country is completely unacceptable. It’s also extraordinarily foolish and causing us incredible, unnecessary harm to our health service.”

The National Taskforce on the NCHD Workforce made recommendations for immediate implementation in 2024, as well as medium to longer term recommendations to be implemented on a phased basis from 2024 to 2026, which Mr Donnelly said the government fully endorses.

Mr Donnelly said that there was not an issue with recruitment of NCHDs, and that there are 2,000 more NCHDs in Irish hospitals now compared with the start of 2020 – an increase of nearly 30%.

He said the main issue is that two in every five NCHD are in a non-training role, a system which he said “we are getting rid of”.

He added: “One of the ways we do it is we grow the consultant population, so we’ve increased the consultant population in the lifetime of this government by over 1,000 – it’s a massive increase in the number of consultants – we are now well over 4,000 and I’ve set a target of 6,000. We’ll hire several hundred more this year and I think we have around 1,700 on the public-only contract.”

Mr Donnelly said he has written to the chair of the HSE board to ensure there is a focus on five areas – including improved working conditions, more education and training supports, an updating of “antiquated” computer systems, and more access to training places.

He added: “This marks a new era for doctor training in our country. Our ambition is to be one of the best in the world.”

Professor Anthony O’Regan, the chair of the taskforce, said that NCHDs are “the linchpin” of the health service, but because they work in a “transient, non-permanent” role, that creates “a unique stress that renders them vulnerable and often under-supported”.

He added: “Implementation now is absolutely essential. We know the NCHDs are the future healthcare leaders and we know that the NCHDs are the future of the health of this nation. This is an investment in all of our interests.”

Mr Donnelly said five million euro had been allocated last year to implement interim recommendations, and a further five million euro was being allocated this year to implement recommendations.

He said that purpose-built or bought accommodation for groups including NCHDs should not be ruled out to support them in their placements at hospitals across the country.

Asked about his trips to six Australian cities as part of St Patrick’s Day events, he said that he is happy for medics to go abroad and gain experience, but added “we want them to come home”.

“Word is getting out that Ireland is a good place to come as a doctor. Word has got out in the NHS that Ireland is in an expansionary mode, that we are adding beds at an unprecedented rate, we’re adding doctors and nurses and health and social care professions at an unprecedented rate. That Ireland is in the business of healthcare growth and reform and modernisation.

“So we’re getting a lot of interest already. We’ve got to build on that momentum.

“We’ve got to prove to any NCHD who’s gone abroad, who wants to come back here to finish their training or haven’t finished their training back here as a consultant, we’ve got to prove to them that we’re serious about them. And that while we will demand the very best of them, they can also expect to be treated well by their own country and that’s really what the report is about.”