‘New crisis’ from NCHD cuts

The IHCA is to meet the HSE at the end of the month to discuss the implications of a planned 900 drop in NCHD posts across the health service this July, which the Association has described as a ‘new and unnecessary crisis in the Irish health system’.
The consultants believe the Executive is going to have to explore ‘every possibility’ to recruit doctors at the NCHD grade, who are competent, eligible for the Medical Register as it currently stands, and proficient in the English language, according to Irish Hospital Consultants Association Assistant Secretary General, Donal Duffy.

The HSE has designated just 3,600 NCHD posts as recognised training posts from 1 July, which will mean a reduction of approximately 900 posts from current figures. Duffy fears the greatest impact of these cuts in numbers will be seen in anaesthesia — with knock-on consequences for surgery and obstetrics — and in emergency medicine.
It has been suggested that the 900 doctors could be given a temporary training designation for the next two years to resolve the pending crisis. Another possibility would be to convert some of these NCHD posts to consultant posts, which would fulfil commitments given by successive Ministers that there should be a significant increase in the number of consultants.
Under the Medical Prac-titioners Act, the Medical Council oversees training and the HSE is obliged to designate training places. Whereas heretofore, every NCHD was regarded as a doctor-in-training, the Medical Council has now designated 3,600 such places – a drop of 900.
Meanwhile, the RCPI has described its new structured postgraduate medical training programme at registrar level as a ‘major advance’ for trainees, which will help resolve the glaring deficits of the unregulated ‘gap years’ between Basic and Higher Specialist Training. Launched last week (May 13, 2010), the Registrar Training Programme (RTP) will provide approximately 200 places to SHOs in general medicine (125 places), paediatrics (35), pathology (25) and obstetrics and gynaecology (25) looking to enter an SpR programme.
The programme has been approved by the Medical Council and HSE, and will be introduced as a one-year programme on a pilot basis on July 1.
Speaking to IMT, RCPI CEO Leo Kearns stressed that this new programme was primarily designed for those who had just completed BST, or who were one or two years finished, not for long-term registrars.
“There could be anything up to 1,100 to 1,200 NCHDs who don’t necessarily fall into these training programmes, either the existing programmes or this new programme. But they would be people who are much longer in their post,” he said, adding that the lack of accurate data made it difficult to come up with precise numbers.
Prof TJ McKenna, Chair of the Irish Committee on Higher Medical Training, added that the new programme was in no way an attempt to address the problem of these so-called ‘long-term registrars’. “We have made suggestions as to the best way of optimising the position of those individuals within the health service, but that is at a very early stage. But I think it is the next big thing to tackle,” Prof McKenna told IMT.