Concerns as key hospital roles across Cork and Kerry filled by locums

One in six hospital consultants nationwide are now working on locum contracts, HSE confirms

In response to questioning by Cork TD and former Junior Health Minister Colm Burke, the HSE has confirmed that one in every six consultants nationwide (16.5%) are locums.

In total, there are more than 760 locum consultants working on non-permanent contracts across hospitals in Ireland.

Of those, 131 are currently working in Cork and Kerry, with 56 staffing clinical positions across Cork University Hospital and the maternity hospital, and 32 at Kerry University Hospital in Tralee.

No fewer than 17 clinical positions across child and adult mental health services in Cork are currently being filled by non-permanent locum staff.

“As a member of the Oireachtas Health Committee, I have constantly raised the need for forward planning in the recruitment of hospital consultants,” said Fine Gael TD Colm Burke, who noted the challenge faced by smaller hospitals in attracting candidates to vacant consultant posts.

“Of particular concern is the fact that posts are only advertised after a consultant has retired, even where HSE management have adequate notice of their intention to leave the service.”

The largest cohort of roles is in medicine, where 14 positions in Cork and 15 in Tralee are currently filled by contracted locum doctors, while no fewer than 10 locums are carrying out roles in Cork University Hospital’s surgery department.

“Many of the current cohorts of locum consultants are filling posts intended to be part of a new clinical service. It is difficult to see how a consultant who may have no prospect of being made permanent can develop and lead a team,” Deputy Burke said.

“Moreover, recent research from the UK shows that a reliance on locums can likely cause quality and safety problems in healthcare organisations, and is likely to mean that such problems are not properly addressed and resolved in ways that improve quality and safety.”

Six locums are currently posted in Child and Adolescent Mental Health Services in Cork, with a further 11 working in adult mental health services in the city. Five positions in mental health services in Kerry are currently filled by non-permanent staff members.

“Existing consultants have expressed concern to me that departments with an excessive reliance on locum staff affect the delivery of patient care through disruption to continuity of care and team morale. Communication and the therapeutic relationship can become very fragmented,” said Colm Burke, who served as Minister of State with responsibility for Public Health and the Drugs Strategy at the Department of Health until January of this year.

Mallow General Hospital currently has two locum consultants in place, while 11 are carrying out roles at Mercy University Hospital in Cork City.

Eight locums are currently carrying out permanent duties at South Infirmary Victoria University Hospital.

“Of particular concern is the fact that posts are only advertised after a consultant has retired, even where HSE management have adequate notice of their intention to leave the service,” Deputy Burke said, highlighting the publication of a new report, Ireland’s Future Health and Social Care Workforce, which he said underscores the need for better planning and structuring of Ireland’s healthcare workforce.