Rotunda master: Quality of doctors ‘dumbed-down’

The quality of doctors taking up posts in the Irish health service has deteriorated because there are few incentives to attract the highly trained, while workloads are so onerous that there is little scope to utilise expertise acquired abroad.

That’s according to the outgoing Master of Dublin’s Rotunda Hospital, Dr Sam Coulter Smith, who said the situation has worsened in the past two years.

“We are not seeing the same numbers and quality of people. I think we are getting some good people coming back but there is not the same competition there might have been in years gone by. Generally speaking, the level has gone down a bit,” he said.

This was not just the case in obstetrics but in other specialities as well, while smaller hospitals suffered more, he said. “People may come back to a job in the Rotunda but not in Clonmel,” Dr Coulter Smith added.

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He said ideally, hospitals should see a range of people applying for a post, with relevant qualifications and experience.

“But what we are seeing to some extent has been a dumbing-down of the levels.”

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Dr Coulter Smith said there was often little incentive for doctors who qualified in Ireland to return because while they spent years training in a sub-speciality abroad, they were expected to be on call for a range of conditions here.

“You have someone who has trained in cardiology or gastroenterology and they are very good at that particular thing — someone that worked in America.

“But if you come back to a hospital in Ireland, particularly one of the smaller hospitals, there may only be three or four physicians there.

“You are expected to be on call and take the cardiac, renal, and other stuff, but you may have gone off and trained to be quite specific in your expertise.

“Understandably, people are not going to come back to those posts.”

An example of this was when efforts were made to put in place a joint appointment for a foetal medicine specialist to provide a service both in the Rotunda and other maternity units in the north east.

“But there were no applications for the post,” Dr Coulter Smith said.

This was because if such a person was to return to Ireland they would end up providing a service “as a single-handed specialist in a peripheral hospital” where they would have little support or time to do anything other than run the service.