Over half of hospital doctors' CVs could not be found by HSE review

Patient safety could be at risk from hospitals’ inability to assess new doctors, an internal HSE audit has found.

Patient safety could be at risk from hospitals’ inability to assess new doctors, an internal HSE audit has found.

In more than half of the 6,000 cases examined, CVs could not be found for applicants. 

The audit urges the HSE to make urgent changes in hiring practices, with four of five recommendations linked to a “significant risk”.

However, hospital managers quoted in the audit say some requirements around international recruitment are “unfeasible” due to the high workload of Irish doctors and language constraints.

The audit, released under the Freedom of Information Act, assessed data from various branches of the HSE on recruitment for over 6,000 doctors. This includes only hiring systems for NCHD (non-consultant hospital doctor) who are not on a training path to become consultants.

Submitted in March to senior officials, including HSE lead for acute hospitals Liam Woods, it found 690 junior doctors were not Garda vetted before starting work.

Work permits did not appear to have been obtained for 2,205 international doctors, 19% of files tested did not have two references, and they found 3,213 cases where CVs were apparently not collected from applicants.

The audit was carried out at national level with fieldwork in six hospitals including Cork University Hospital and University Hospital Limerick.

Compliance

These two hospitals were found to be fully compliant across three of the six control measures, and partially compliant on three.

Hospital managers said some aspects of international recruitment are not practical under current working conditions.

“Management within the hospitals consistently insisted that it was unfeasible due to workload of consultants, time zone differences and language constraints,” the auditors found.

Delays with having up to 25% of new doctors assessed as fit-for-work before seeing their first patients are highlighted. Hospital managers told of “logistical difficulties” with this. 

The audit says the HSE National human resources office must review this system to avoid “potential impact on patient and staff safety”. 

Fine Gael spokesman on health Colm Burke said hospitals are often under pressure to find new staff, saying: “The whole system of recruitment of consultants is out-of-date, we are not doing any forward planning.” 

Rural hospitals

Mr Burke said the audit should be seen in the context of a recruitment crisis in rural hospitals, particularly.

“We have put a lot of junior doctors in who are not in training posts, the reason is the consultants don’t have to give as much time to them. Training does take time,” he said.

“Smaller hospitals outside of the main cities have a real challenge as regard trying to get locums and fill general hospital posts.” 

However, he expressed less concern about English-language tests findings, saying this is usually assessed at interviews.

The number of non-training posts has steadily increased since 2011, standing at 38% of junior doctor jobs by 2019, the audit says. It found the majority of non-training posts are filled by international medical graduates. 

The Irish Medical Organisation and the Irish Hospital Consultants Association have criticised the over-reliance of the Irish system on non-training posts.