Is NCHD solution Hanly by another name?

Dear Editor,
As a recently retired Health Service Executive medical manpower manager, I am dismayed to see that the much-predicted non-consultant hospital doctor shortage crisis has in fact been allowed to happen, with nothing except improving the visa regulations and a one-year extension on recognition by the Medical Council being done to address this serious crisis.

There is no mystery why we are not attracting junior doctors to work for us. We introduced so many new changes over a short period, all resulting in serious alterations to NCHD conditions, with very few of these changes being attractive to doctors.
The main difficulties are being caused by:
1. Changes in payments accompanied by legal European Union reductions in working time to a 48-hour average working week;
2. Serious unacceptable reduction in annual leave, as interpreted by the HSE (this may well be changed as the wording in the contract would lead one to debate the HSE interpretation);
3. The changes to the annual training grant and the cancellation of any grant for higher degrees;
4. The Medical Council registration changes, which result in NCHDs in training posts being restricted to work only in their training post, resulting in a total lack of safe training for NCHD locums;
5. With the strict introduction of the 48-hour week with no increase in non-consultant hospital doctor numbers (as happened in the UK when they introduced the 48-hour week) and little increase in consultant numbers, it was obvious that NCHD working conditions would become unattractive.
The HSE’s solution to the introduction of the 48-hour working week has been to reduce the NCHD tiers on call and introduce cross cover, with both such solutions resulting in seriously overworked doctors on call with frequently inadequate safe patient cover.
The HSE solution to the pending NCHD vacancies of more than 400 posts from July is to ‘reconfigure services which cannot fill all NCHD posts’.
Is this Hanly under another name? And, if so, how many of our smaller hospitals are due for ‘reconfiguration’ — or, to put it another way, how many of our smaller hospitals will become just cottage hospitals?
And will patient care be compromised?
Dr Detta Healy,
Ballingar,
Sligo