LMfm Radio 9.45am -23rd September 2011

Ten minute interview discussing  the issues surrounding the doctors recruited by the HSE from India and Pakistan to fill a junior hospital doctor shortfall. Dr Mark Murphy is Chairperson of the IMO NCHD committee.

Michael Reade:
Now the recruitment of junior doctors or NCHDs in our hospitals has been problematic to say the least, especially this year, and in July and August some two hundred and eighty doctors came to Ireland to help fill the void, however a number of them are still waiting to be registered which the Irish Medical Organisation has criticised the HSE over.  Dr. Mark Murphy, Chairman of the IMO NCHD Committee is on the line.  Good morning to you Dr. Murphy and thanks very much indeed for joining us.  How many are in this situation at the moment, in around forty or thereabouts?

Dr. Mark Murphy: (Chairman, IMO NCHD Committee)
That’s what I believe, as far as I’m aware from the numbers which the HSE and the Medical Council have provided there were two hundred and eighty Indian and Pakistani doctors recruited as far back as I suppose six months ago and I’ve been told that one hundred and eighty of these doctors are now working but there are many  more, I suppose there are forty that maybe have all the paperwork sorted and are sitting idly in this country and are waiting to work when they’re really should be no barrier to them, and I suppose they would have left families and jobs behind in India and Pakistan so it’s a thoroughly dissatisfying situation.

Michael Reade:
Yes, they’re being housed and fed here but they’re unemployed as such.

Dr. Mark Murphy:
Yes that’s right and purely from an ethical point of view, I mean to take a doctor from another country, a developing world, and to promise them a salary of I suppose in excess of €100,000 when in truth many of them will be earning, the salaries quoted were €95,000 and €116,000, and then these doctors came here, having been unable to work, and in truth will only earn probably €38,000 to €50,000 max, it’s extremely disingenuous.  So not only does the HSE in our opinion treat all NCHDs badly and that’s why many Irish doctors elect to emigrate, not only do they treat the two and a half thousand non-EU NCHD doctors particularly badly in terms of training, but now this cohort, this incumbent cohort of doctors who wanted to start afresh and get training, they were promised things they did not get and I suppose the  HSE has really lost all respect and I suppose we may not be able to recruit doctors in the future and I suppose those in the HSE who have done this need to be held to account.

Dr. Mark Murphy:
And it really is an important issue which I think we’re all aware of at this stage because there was talk of emergency departments closing right around the country as a result of the shortfall in the number of junior doctors but having said that, you talk about the paperwork involved, obviously it’s very important paperwork because they’re required to pass exams.

Dr. Mark Murphy:
Yes, for example many of these doctors only came here in July, the start date for working was the 11th of July.  To give an example to the public, if I want to apply for a job starting in January I would have already applied for it now, probably applied for it three months ago, I would have the Garda vetting cleared, I would have my qualifications, my educational experience cleared, the HSE paperwork cleared, and it’s very important, and the Medical Council are right, to ensure the safety of the public that a thorough vetting procedure takes place and it takes time and if a doctor arrives here in the middle of July already, when the date for working has already passed, there are numerous checks that need to take place, and never mind the clinical exam to ensure that there is a competency to practise here, so really the fault for this entirely lies with the HSE and the IMO and the Medical Council, and I speak only on behalf of the IMO, we’ve been highlighting this for years.  We need to completely rethink how we train and keep doctors in this country and the HSE clearly aren’t doing a good job at the moment.

Michael Reade:
Are these exams that we ask doctors to sit sufficient?  We had a story this morning of a junior doctor who’d been found guilty of poor professional performance who had worked in Our Lady of Lourdes Hospital in Drogheda, where his colleagues said he wasn’t capable of carrying out basic functions.

Dr. Mark Murphy:
Well I can’t comment on that particular case, I hadn’t heard about it.  The exams that non-EU doctors perform when they enter this country are deemed to be of a calibre that would, I mean you have to bear in mind that these doctors have medical degrees and they have a significant amount of post graduate experience and the exams, the pres exams and this new exam that the Medical Council brought in for the supervised division doctors that have arrived from India and Pakistan, they’re deemed to be of an appropriate standard for a doctor to work within that division, so as far as the IMO are aware the Medical Council examinations are suitable for public safety.

Michael Reade:
Okay, because into the hearings into this, a Dr. Milner, who’s at Our Lady of Lourdes Hospital said that the qualifications that doctors receive in other countries may be questionable.

Dr. Mark Murphy:
Well I suppose there is a disparity in the type of medical training that everyone gets in the world, I mean a medical student in Germany might be different from a medical graduate from Ireland and there are differences and there are differences in GPs, there are differences in the type of work obstetricians do, but these differences have to be teased out and there isn’t I suppose an equivalency for any doctor in the world and there needs to be a process to make sure that doctors are of the same calibre and that’s the process that the Medical Council do to take note of these and to be mindful of the differences within undergraduate training, and there may be differences but I suppose the purpose of the Medical Council exam is to ensure that there’s a competency to ensure that patient safety will be paramount and I can’t comment I suppose for the Medical Council but we are told that those exams are sufficient.

Michael Reade:
And I understand that you’re not aware of this particular story or the doctor involved in it but it would appear to question these exams when somebody who’s employed can’t be left work unsupervised, can’t be left on call, finds it difficult with suturing or canulas or other basic procedures such as....

Dr. Murphy:

Well Michael I can only agree with you, I mean ultimately we train, it should be known and the public should be aware that we will soon be training seven hundred EU doctors a year and we’re tlaking, there are a hundred and ninety vacancies that created this deficiency, we’re training plenty of Irish doctors, too many, and all these doctors are forced to emigrate because there aren’t enough GP and Consultant positions at the end of the day, so the numerical mismatch, this historical problem that the Irish healthcare system  has had, forces doctors to leave and we need a complete rethink about how we structure postgraduate training, how we structure the lives that, the worsening lives of doctors, and this needs to be done urgently because we have enough intellectual capital within this country, enough excellent undergraduates coming out, enough excellent doctors here to keep them here, but they’re forced abroad because of the poor working conditions, because of the lack of respect that the HSE shows Irish NCHDs, non-EU doctors and these newly incumbent doctors from India and Pakistan, we really need the HSE to listen to us and to respect us and we wouldn’t have this problem.

Michael Reade:
We’ve many excellent doctors who’ve come here from India and Pakistan and elsewhere but sometimes it’s very difficult to understand them, the Medical Council has requested that they would also sit a language test but the Department has dismissed this.

Dr. Mark Murphy:
Yes, no you’re right, I mean one of the core issues that has come out within the medical profession internationally over the past ten or twenty years is that communication is the most important thing and doctors are better communicators these days and clearly if a member of the public has difficulty understanding a doctor that is a problem, but that is again something that the Medical Council, and it is an ongoing problem, it’s an issue that the Medical Council needs to address, but I mean of the two and a half thousand of the four and a half thousand NCHDs in the country, I mean the majority of junior doctors are from North Africa and from India and Pakistan and they’re my friends and colleagues and I can of course vouch that their English is, on the whole, absolutely superb and they are excellent communicators, but there may be a cohort that particularly, and perhaps of these incumbent Indian and Pakistani doctors, who’s language skills might not be but that’s only hearsay at the moment.

Michael Reade:
Alright.  And the HSE has agreed that the delays in recruiting these doctors who are in the country his last couple of months is unacceptable.

Dr. Mark Murphy:
The HSE has said that?

Michael Reade:
Yes.

Dr. Mark Murphy:
Yes, I didn’t hear Dr. Crowley’s comments last night, I believe he spoke on RTE News, and I mean look there’s no room to equivocate in healthcare, we have to be honest and if someone, if there’s culpability somewhere we need to put up our hands and I’m glad that a medical professional involved with the HSE has said that the HSE has messed up this time.  It might not be good enough, I still think the HSE needs to be held to account here but at least it’s encouraging that they’re admitting their culpability here but it’s not good enough, we need a high level talk.  Why can’t I and other representatives in the IMO and the Forum of Postgraduate Training Bodies speak with the Minister and come up a clear career plan for NCHDs, for the Irish doctors and non-EU doctors currently here and to keep them here and to make Ireland one of the best places in the world to train?  I mean that’s the big picture stuff that Ireland is not doing at the moment.

Michael Reade:
Okay, we’ll leave it on that note and thank you indeed for joining us here on the programme this morning.  Dr. Mark Murphy, Chairman of the IMO NCHD Committee.