Inexperienced doctors being thrown into the deep end of the Irish health system has led to dangerous and disruptive situations, a leading consultant in emergency medicine has said.
Dr Chris Luke, an emergency department specialist at the Mercy University Hospital, revealed he has worked with doctors in Cork who were flown in from the UK just to cover one shift.
He said that often their language skills and experience was not up to par, which led to a significant impact on hospital departments, other staff and even patients.
His revelations come as pressure mounts on Health Minister Simon Harris to audit the number of "rogue doctors" in the health system amid fears that patients are being needlessly put at risk by unqualified and inexperienced medics.
The State Claims Agency revealed last week that Ireland is facing more than 3,000 medical negligence cases due to serious errors in public hospitals — including 113 claims predicted to cost more than €10m each.
Among the cases are 614 in the South/Southwest Hospital Group, including 22 expected to cost more than €10m.
Dr Luke said the economic recession around 10 years ago led to a significant decrease in doctor recruitment, as many chose to emigrate.
“We had huge difficulties recruiting staff to work in Emergency Departments (EDs) across Cork and Dublin and much of Ireland,” said Dr Luke.
“At that point, we began to see a growing number of locum (temporary cover) doctors arriving.
“Locums have always been an important part of the service. They’re vital for covering sick leave, maternity leave or unexpected leave but there did seem to be a surge in the use of locums from abroad, who just were not used to the Irish system,” he added.
“Many of us will recall doctors being flown in from London or elsewhere to work one nightshift in Cork, for example, having never worked in Cork before.
“There would sometimes be concerns about their language skills and general competence.
“This has been going on for years and it’s always a risk.”
While Dr Luke admitted it is less of an issue now and it was a minority of doctors, he said that doctors who were not up to par have led to some “painful experiences”.
“It’s very dangerous, it’s very disruptive and it’s very dispiriting,” he said.
“Every ED that I know of is under pressure.
“So if there are only three doctors and one is performing at a fraction of the level that is expected, it puts terrible pressure on other doctors, nurses and patients,” he added.
“It’s not fair on everyone concerned, not to mention the fact that it’s dangerous.
“The highest risk scenario is someone who’s never worked in the system before being asked to do high-risk activities under pressure, it’s a recipe for difficulty.” The best locum is “a local and familiar locum,” Dr Luke added.
“These are doctors who have qualified locally, passed all relevant exams, they meet language and clinical skills requirements and who are used to the system.
“I’ve worked in EDs over the years where we’ve had huge difficulties in staffing sometimes and we’ve been absolutely desperate,” he added.
“But particularly at the front line, at the acute edge of hospitals and healthcare, you really shouldn’t employ doctors who’ve not worked in Ireland beforehand.
“They should have either trained here or they’ve worked in different wards here before transferring to ED.
“The same goes for operating theatres or where there are complex practices going on.
Dr Luke stressed that there are other departments where training staff from abroad would be welcomed.
“We have always done our best to train overseas doctors and students, I’m very keen to promote and do that.
“They can start as observers, get to know the system and we can get to know each other.”