Barry McElduff (Sinn Féin)

5. asked the Minister of Health, Social Services and Public Safety what efforts his Department has made to reinstate gynaecological and obstetric services at the Tyrone County Hospital in Omagh and the Erne Hospital in Enniskillen.   (AQO 5/10)

Allan Bresland (DUP)

11. asked the Minister of Health, Social Services and Public Safety if he supports the decision of the Western Health and Social Care Trust to move all gynaecology services to Altnagelvin Hospital.       (AQO 11/10)

Michael McGimpsey (UUP)

With your permission, Mr Speaker, I will answer questions 5 and 11 together.

The delivery of health and social care services and the recruitment and employment of the appropriate staff to deliver those services are primarily the responsibility of trusts. I am satisfied that the Western Health and Social Care Trust has done everything possible to recruit and retain the appropriately skilled and trained staff. I am pleased to say that that is reflected in the fact that, from today, all services — outpatient, inpatient and day cases — have been reinstated.

William Hay (Speaker)

I call Mr McElduff to ask a supplementary question.

Michael McGimpsey (UUP)

I have not quite finished.

The safety of patients receiving treatment in any part of the Health Service is my first priority. To ensure their safety, patients should always be treated in facilities where the skills and expertise appropriate to their needs are available. On that occasion, due to a short-term difficulty in recruiting the appropriate staff, the Western Health and Social Care Trust was unable to assure itself of the safety of the gynaecological services at the Erne hospital: that is why the services were temporarily suspended, and I am satisfied that that was the right decision.

William Hay (Speaker)

I now call Mr McElduff to ask a supplementary question.

Barry McElduff (Sinn Féin)

Go raibh maith agat, a Cheann Comhairle. I welcome the Minister’s response, particularly the news of the reinstatement of those essential health services taking effect from today. I ask the Minister to provide a categorical assurance that there will be no removal of essential gynaecological and obstetric services west of the Bann in future. The Minister will know that the mere mention of removing those services causes huge anxiety and inconvenience among women who are already disadvantaged by residing west of the Bann.

Michael McGimpsey (UUP)

Seventeen women were sent to Altnagelvin Area Hospital; some have now been returned as they did not require treatment in Altnagelvin and have gone back to the Erne Hospital. Altnagelvin, as I understand it, is west of the Bann.

Although I appreciate and understand the anxiety that Mr McElduff referred to, the Health Service — this relates to a previous answer that I gave to another Member — has been seriously under-resourced over many years. Specifically, that under-resourcing relates to the recruitment of junior doctors. To address the problem, we have increased the number of students going through medical school by 40%, from 150 to 246, per annum. However, they must work their way through the course, so it will be 2012 before we start to see the benefits. That is why that problem occurred.

I will always work to ensure that those services are retained, not just west of the Bann but in Omagh and Enniskillen. However, I will not do so at the risk of patient safety.

Allan Bresland (DUP)

Thank you, Mr Deputy Minister. Does the Minister accept that the forced closure of the gynae services in the Erne and Omagh hospitals a few weeks ago because of a shortage of junior doctors reflects badly on mismanagement of the Health Service? There are similar shortages in other hospitals in Northern Ireland.

William Hay (Speaker)

I call the Minister.

Michael McGimpsey (UUP)

Thank you, Mr Speaker, or “deputy master”, as you were referred to.

No, I do not accept the Member’s assertion at all. The Western Health and Social Care Trust is, clearly, very well managed, as is the Health Service throughout Northern Ireland. However, we must consider the large numbers of patients and staff whom we are dealing with and the difficulties in a number of areas. I just explained in a previous answer the difficulty of recruiting junior doctors. We recruit about 1,700 junior doctors per annum. In this case, although the Western Trust could not have known it, of the six doctors who were allocated to it, one began work; two are awaiting visas; two withdrew at the end of July within a week of their start date; and one did not meet the required competencies, so the trust will look at that through retraining.

We are now back in a satisfactory position. It was one of those situations that could not have been foreseen. However, there are difficulties because, as I said, the capacity is not there, and, therefore, we are relying on recruitment, currently from inside the EU and then from northern India. Historically, northern India was a very fruitful recruiting ground for the Health Service for doctors, but we are not allowed to recruit there until we have exhausted Europe. That is the issue, and that is one of the problems that we face.

Full service was restored in two weeks, and I expect that we will be able to carry on, but I give this caveat: we have a shortage of doctors. I have increased the numbers going through medical school by 40%. When those graduates start to come through, I expect that our problems in this particular area will be obviated.

Michael McGimpsey (UUP)

The Western Trust is discerning in its recruitment. Two applicants were awaiting visas. I do not know the exact circumstances, but I presume that those visas have come through. Two withdrew because they got better offers somewhere else, and one is undergoing more training. Therefore, the trust has been able to extend the recruitment period. This has occurred not only in gynaecological vacancies and not only at the Erne Hospital, but five out of six applicants falling through was a most extreme situation. That is very unusual, but within two weeks the trust was able to plug that gap, and I am assured that the quality of patient care and safety will not be compromised.

Tom Elliott (UUP)

I am pleased to hear the Minister say that services have been restored to the Erne Hospital as from today, but will he tell me whether any discussions are taking place with the body that is responsible for appointing those junior doctors to ensure that this situation does not reoccur in this or any other service?

Michael McGimpsey (UUP)

I have arranged to talk in depth with the trust. However, of course we undertake HR planning as far as the various competencies are concerned. It was not entirely in the trust’s control that two people withdrew at the very last minute to take what, I suppose, they regarded as better jobs, or that two others had visa problems. That was the situation. As I said, we have an historical shortage of junior doctors.

Demand on the Health Service is rising all the time. To deal with that, I have increased the numbers of students who will go through medical school by 40% from 150 to 246. The benefits of having those extra 96 students will be seen by 2012. Perhaps that action should have taken earlier, but that is not for me to say. I can talk only about my time in charge, and I believe that the steps that I have put in place will go a long way to meeting the need.

Tommy Gallagher (Social Democratic and Labour Party)

Does the Minister agree that the fact that people appointed to those posts can withdraw two weeks before starting time or not turn up because their visas are not in order shows that the procedures in the Department, the trust or the Northern Ireland Medical and Dental Training Agency must be reviewed? Will procedures be reviewed in whichever place the responsibility lies?

Michael McGimpsey (UUP)

I have largely answered that question. Responsibility lies with the people who, historically, made the decisions on the number of students at medical school. The answer is to recruit more students to train at medical school. There is no problem in recruiting very high-quality students to the medical school at Queen’s University. The increased recruitment should have dealt with the issue by 2012.

Issues regarding visas are outside the Department’s control, as is the withdrawal of two individuals to take a better job. I manage the situation as it stands, and we are where we are. I am not clear that I can put a stipulation on a student going to Queen’s University that they must take whatever job they are offered through our local recruitment process. The two individuals who withdrew at the last minute were irresponsible, and that is obvious to all of us. I wonder, with some trepidation, what sort of doctors they will eventually make.