HSE’s €100 per hour bill for locums

Hospitals are paying agencies €100 an hour for locums to plug the gaps in emergency departments (EDs) when the shortfall could be substantially addressed by creating a new grade of staff doctor.

That’s according to the Irish Association of Emergency Medicine (IAEM) which claims eight hospitals have a vacancy rate of 50% or more when it comes to unfilled registrar (middle grade) posts in EDs.

The figures are based on the IAEM’s census of medical staffing in EDs for January and taking into account the effect of the India and Pakistan junior doctor recruitment drive.

IAEM secretary John McInerney said the drive supplied just four non consultant hospital doctors (NCHD) at registrar grade. He said 44 registrar posts (29%) out of 152 were vacant nationally, requiring expensive agency cover.

The Health Service Executive (HSE) put the figure at 36 as of February 6. Mr McInerney, a consultant in emergency medicine at Dublin’s Mater Hospital, said hospitals were paying agencies approximately €100 an hour for locum registrars and that some hospitals were totally dependent on locums to meet ED middle grade staffing requirements.

“For instance our figures show Naas General Hospital and Our Lady’s Hospital Navan have a 100% locum requirement for registrars. Usually a hospital will require a minimum of seven such doctors to maintain a 24/7 EM roster. This is not sustainable.”

Mr McInerney said continued reliance on locum staff in EDs was expensive and the shortfall of such doctors represented “an unsafe deficit”.

The IAEM has suggested creating a new staff grade in emergency medicine for middle grade doctors who did not wish to continue to consultant level but who nonetheless had a significant amount to offer because of their experience and expertise. This would help staff the service permanently.

In a statement yesterday, the HSE said it welcomed the ‘staff grade’ proposal and would “progress discussions in this area”. The HSE said as of February 6, there were 62 vacant posts in all specialties — including emergency medicine — and that a “significant number” were being filled by locums. It said the HSE was working to address the dependence on agency staff.

According to the IAEM, hospitals with EDs where 50% or more of middle grade doctor positions remain vacant include Children’s University Hospital, Temple Street, Dublin (a spokeswoman said there was currently just one vacancy being covered from another department); Connolly Hospital, Blanchardstown; Galway University Hospital; University Hospital, Limerick; Mayo General Hospital; Naas General Hospital; Letterkenny General Hospital and Our Lady’s Hospital, Navan.

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