• Positive recommendations but needs major investment and implementation plan

Wednesday February 7, 2024. The Irish Medical Organisation (IMO) has given a guarded welcome to the publication today (Wednesday) of the final report from the NCHD Taskforce.

However, it warned that while the recommendations in the report are positive it is critical that there is an implementation plan with sufficient funding to allow the recommendations to become a reality. 

Speaking today, Dr Rachel McNamara, Chair of the NCHD Committee of the IMO, said: “We have been experiencing ever-increasing numbers of NCHDs emigrating to systems where they are valued, supported and offered a work/life balance. 

“The recommendations in this Report go some way to addressing the issues faced by NCHDs today but for any of us to have real confidence we need to see major investment and implementation to make those recommendations a reality.”

She said that a long-term strategy is important but we cannot ignore the reality facing NCHDs today.

The IMO expressed disappointment that key areas are not addressed adequately in the Report including:

• Arrangements for childcare for NCHDs (who will routinely work nights and weekends when childcare is simply not available);
• A medical workforce plan to match the aspirations of the report ;
• A realistic plan for the delivery of a best-in-class IT system to digitise the health service.

Dr McNamara said the plan is ambitious and that the IMO is prepared to work with the Department and the HSE, however the current reality for NCHDs means building confidence and trust will be challenging when NCHDs are currently facing:

• Illegal and unsafe working hours (77% of NCHDs are routinely working in excess of the legal 48 hours a week);
• Staffing shortages and covering for colleagues who are on sick leave or maternity leave due to the recruitment freeze;
• enormous expenses and disruption when rotating for training schemes every six months;
• Consistent contractual breaches

While this report makes detailed reference to the agreement brokered by the IMO last year as well as aspirational rostering arrangements, the reality on the ground is seriously challenging with the ongoing recruitment freeze and services under constant pressure.
 
This is exacerbated by the way in which NCHDs are treated, with unsatisfactory childcare provision, under-resourced allied healthcare support, and the ongoing use of paper-based records which has a major negative effect on all aspects of doctors’ work. None of these issues has been adequately addressed by this report.
 
“We need to see unprecedented reform in order to address the many issues that our NCHDs are facing,” said Dr McNamara.
 
She said that it was critically important that aspirational recommendations were reflected in NCHD contracts to prove the Government was serious about meaningful reform. “NCHDs are being driven out of the country every day due to sub-standard working conditions and a non-existent work-life balance. They now need to see a real commitment for change and a start would be to honour the terms of the current contract.”