BIG READ: 'Problem getting junior doctors in many smaller hospitals such as Clonmel'

A TD has claimed in the Dáil that "there is a problem with getting junior doctors in many smaller hospitals such as Letterkenny, Mayo, Drogheda or even Clonmel".

Cork TD, Colm Burke, raised the issue with the Minister for Health, Stephen Donnelly, at the Oireachtas Select Committee on Health.

Deputy Burke said: "I will move to the junior doctor issue, which has been raised. There is a problem with getting junior doctors in many smaller hospitals such as Letterkenny, Mayo, Drogheda or even Clonmel.

"Going outside the major centres such as Cork, Limerick, Galway and Dublin, many of the hospitals are finding it difficult to get junior doctors.

"In previous schemes there may have been a rotation of doctors from one hospital to another. They started at the bigger hospital and move to the smaller hospital.

"Many of the rotations did not work out and people stayed in bigger hospitals and never came to the smaller hospitals. If we are doing something with junior doctors, we must do it in a planned way so smaller hospitals do not lose out.

"On the junior doctor matter there is also the question of Stamp 4. This cuts across the Department of Health and others; it may take in three Departments.

"My understanding is a person must be in Ireland for five years and it was agreed that stamp 4 permits would be given to anybody who was here for two or more years. What progress has been made in implementing that?"

Stamp 4 offers the right to work without preconditions.

Doctors who have been working here for more than two years will immediately be able to access a Stamp 4 permit and spousal work rights. 

In response, Minister Donnolly said: "There are several pieces to this. The first was to remove the ban on non-EU doctors training as specialists, and that was received well by those doctors.

"We are looking at the Stamp 4 matter, as the Deputy outlined, and it takes in the Departments dealing with health, justice and perhaps foreign affairs. I want to see this moved quickly.

"The Deputy has correctly point out that we have non-EU doctors who have had the training stipulation removed but are still caught with the Stamp 4 element. I will get the Deputy a detailed update on that.

"More broadly with the non-consultant hospital doctors we are increasing the number of training posts and we must increase it further.

"That partly involves increasing the consultant body workforce because there tends to be one-to-one training relationships there as well."

Deputy Burke added: "There are many people staying here in the hope they can get sorted out but they are finding if this is not sorted by July, for example, when they are applying for the next round of jobs, they will have to leave rather than stay. They will say they have been promised a resolution but eight months later it has not been delivered."

In September of last year, the Minister for Health Stephen Donnelly scrapped a system that gave doctors from Ireland, the EU, Iceland, Liechtenstein and Norway preferential access to specialist/postgraduate training places.

However, under the new scheme non-EEA (European Economic Area) doctors first needed to have a Stamp 4 visa.

'Train Us for Ireland' raised concerns that non-EEA Non-Consultant Hospital Doctors (NCHDs) would have to spend five years in Ireland before being able to start such training.

It said that the practice of employing NCHDs on contracts of between six and 12 months precluded them from accessing a visa that would fast track this process.

Speaking in the Dáil last December, the Tánaiste and Minister for Enterprise, Trade and Employment Leo Varadkar confirmed that a number of changes were in train.

On December 6, his Department announced that NCHDs would now be issued with two-year multi-site employment permits, instead of needing to apply for a new permit every time the place of their employment changes.

"In addition to that we are going to offer Stamp 4 visas to non-European doctors who are here for more than two years and that will then allow them to get on specialist training schemes and apply for consultant posts on the same basis as an Irish or EU citizen once they've been here working in the system for two years and we will be implementing those changes in a matter of weeks," Mr Varadkar told the Dáil.

It was expected that this change would come into effect in January 2022.