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A patchwork quilt in healthcare delivery

This has been a deeply frustrating obstacle for many physicians. Unfortunately, the inconsistency around the recognition of some qualifications and not others is just one of the many mysteries currently at large within the health service.

Perhaps some insight can be gained from the building in which the HSE has made its headquarters.

Every night, coming to the end of my dash to the train station, I share a footpath with Dr Steevens’ Hospital. It is an incredible building; the sheer size of the thing ensures this — a massive, seamless, yellow lump. But try as it might, it cannot hide its eccentricities.

A gate that would not be out of place in a medieval castle, a merry-looking weather vane on top of an onion dome. Well, a shallot dome, really. It’s a lot like the organisation it represents. A hodge-podge.

On the one hand, it relies heavily on physicians from outside the EU and on the other hand, it discriminates positively in favour of Irish doctors when it comes to training posts. Adding to the mess, increasingly, this latter group has no faith in the service within which they work.

Answers on a post card please.

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Elsewhere, it is good to hear that the Medical Council is going to be prepared to take steps to tackle the stark and unfortunately all-too-familiar spectre of bullying. The results of the ‘Your Training Counts’ survey, which showed that trainee hospital doctors in Ireland are much more likely to experience or be exposed to bullying and undermining than their UK counterparts, will come as no surprise.

However, these types of behaviour rely on a ‘say nothing’ attitude.

Bullying in any profession is unacceptable but when in environments which are supposed to be conducive to education, it is bordering on criminal. As Dr Paul Kavanagh told us: “If we find that recommendations are not being taken seriously, and aren’t being taken forward, we have a responsibility, we have a duty, and we have statutory powers to then affect the status of that clinical site as being a place where trainees can train.”

A firm stance is exactly what the system needs.

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