NCHDs play a vital role in the delivery of the country’s health services but it’s a role which is unappreciated and undervalued by the policymakers and HSE managers.
Fundamentally there is a disconnect between the attitude of the HSE to NCHDs as cost-effective highly skilled labour to staff hospitals without due regard to career planning on the one hand and the aspirations of NCHDs themselves on the other for whom their time as NCHDs is a critical step on their career path during which they expect to receive training and critical hands-on experience leading to a specialist post. Add in an absolute disregard by the hospital management for the NCHD contract of employment and appropriate working conditions and the consequences are as inevitable as they are damaging; a crisis in morale amongst NCHDs best exemplified by the finding of the IMO Benchmark Survey 2011 that 57% of NCHDs would NOT recommend a career as an NCHD to a family member. This crisis in morale together with poor manpower planning by the HSE directly leads to NCHDs travelling abroad in order to complete their specialist training while the Irish health services are left tackling a doctor shortage which threatens the ability of many hospitals to continue to function.
The IMO recently launched the NCHD Engage for Change campaign the key objectives of which are;
• A better, safe and efficient Irish health service with the highest standards of patient care
• An engaged, proactive & positive NCHD cohort
• To Stop the brain drain
The IMO’s recommendations to achieve this are:
• Full implementation of NCHD Contract 2010
• Improved working conditions and removal of inappropriate tasks
• Reduction in onerous working hours and appropriate application of EWTD
• Improved structured training in terms of access & funding including the introduction of more flexible, family friendly training and restructuring of current non-training posts
• A strategic planned approach to manpower planning to determine defined career paths for all grades & specialities including addressing career progression of long service hospital doctors
• Increase in the number of Specialist and GP posts
• Continued roll out of Clinical Care Programmes and expansion of primary care to contribute to a reduction in the reliance on NCHDs in staffing hospitals