Hospitals across the country have received a letter from the HSE stipulating that they must stop recruiting locums to fill vacancies in emergency medicine, according to the Irish Medical News (IMN)
However, a senior consultant in emergency medicine has questioned the HSE’s contention that the recent recruitment drive in India and Pakistan has “solved” the need for locum cover in emergency departments (EDs). It is understood that the memo, sent by Ms Laverne McGuinness, the HSE’s National Director of Performance and Financial Management, on October 25, has caused particular issues at University Hospital Limerick where there has been an ongoing shortage of middle grade doctors to staff its ED. Dr Fergal Hickey, former president of the Irish Association of Emergency Medicine (IAEM) and a consultant in emergency medicine at Sligo General Hospital, told IMN that due to the recruitment drive for doctors from India and Pakistan, the HSE believes “there is now no need for locum cover”.
According to Dr Hickey, vacancies in EDs are mainly at registrar grade, however, he said that the HSE “seems to believe that very junior, very inexperienced doctors from India and Pakistan recruitment schemes” are adequate to fill these vacancies or that doctors can be arbitrarily transferred from other services. The HSE responded saying that “significant savings” can be made by filling posts that are currently filled by locums with doctors recruited through the drive in India and Pakistan. However, Dr Hickey contended that there is “a clear lack of understanding at senior management level in the HSE about where the vacancies in emergency medicine are and the calibre of doctors required to fill these vacancies”. “Our main vacancies are at middle grade whereas the available doctors from this particular recruitment drive are at a more junior level, so the problem will continue,” he said. Dr Hickey said that HSE management “think that they have solved the recruitment crisis, which clearly they haven’t”.
Dr Hickey said that neither the HSE nor the Department of Health understands the mismatch between existing vacancies and the doctors who have been recruited from India and Pakistan, who do not have “the experience or expertise” necessary. The HSE told IMN that doctors recruited in India and Pakistan are highly qualified and experienced and “are particularly well suited to working in the Irish health system” as they train in the same system used in Ireland. According to Dr Hickey, this is a “naive” perception. “A middle grade doctor working in the ED might have three or four years experience in the Irish healthcare system, and a year or more in an ED,” he explained. “And they’re seeking naively to replace those with people who have just literally arrived in the country.”