Growth in NCHD numbers means HSE not moving towards policy of Consultant delivered service


The overall number of NCHDs in Ireland continues to grow at a similar rate as the growth in the number of consultants, thus not moving the HSE towards the policy of a consultant delivered service, according to Prof. Brian Kinirons, Medical Director, HSE National Doctors Training and Planning and Personal Professor in Anaesthesia at NUI.   Maureen Browne reports.

Some medical disciplines such as Emergency Medicine had particularly high proportions of NCHDs to consultants. In addition, some Model 3 and Model 2 hospitals had high proportions of NCHDs overall and were heavily reliant on Non-Training Scheme Doctors (NTSDs), he said in the NDTP 2021/2022 Medical Workforce report.

“It is essential that consultant and training posts continue to be created in line with workforce planning projections, as informed by Clinical Programmes and Postgraduate Training Bodies. Future increases in medical consultants and training doctors must happen in tandem with a decrease in the number of NTSD posts. Such measures will lead to a more consultant delivered service with better patient care,” said Prof. Kinirons.

The report said that a comparison of health care systems across countries highlighted that while Ireland had among the lowest ratios of consultants per 100,000 of the population, it had among the highest ratios of NCHDs. “The number of non-training NCHD posts increased by 5% to 3,081 this year. Emergency medicine is very reliant on non-training NCHDs; there are 3.3 NTSDs per consultant in Emergency Medicine, compared to 1.1 in Surgery and Medicine.”

Continued higher levels of new consultant posts would need to be created and filled, if Ireland was to achieve its health policy aim of moving to a consultant-delivered model of care delivery, as opposed to a consultant-led service.  However, this would need to happen in tandem with the correct number of training doctors being available to meet demand.

The report also revealed that 12 per cent of clinically active consultants were working less than full time, many on half time contracts, 101 consultants in HSE funded services were not on the  Medical Council register specialist division and recruitment of doctors in Model 3 hospitals remains a significant challenge, which the NDTP was seeking to address.

There were 2,935 posts filled on a permanent basis, 437 filled on a non-permanent basis and 360 vacant posts. The majority of vacant posts had been vacant for less than one year. However, there were 71 posts that had been vacant for more than one year.