Reiteration of concerns over ‘high’ number of ‘non-specialist’ consultants

Continued concerns over the “high” number of HSE consultants who are not on the Medical Council’s specialist register have been raised within the Executive. 

The issue was discussed during a HSE audit and risk committee meeting in October. According to minutes, the committee expressed its “continued concern” about the high number of non-specialist-registered consultants employed by the HSE.

At the end of January 2026, there were 119 consultants employed by the Executive who were not on the specialist register, according to figures provided to the Medical Independent (MI). The HSE employed 4,973 consultants in total at the end of last month.

In March 2008, the HSE amended the qualifications specified for consultant posts to require registration in the relevant specialist division. The consultant contract 2008 and public-only consultant contract 2023 reflect this requirement.

According to a HSE spokesperson, the Executive put in place an exceptions process to allow consultants who are not on the specialist register to temporarily take up consultant posts.

“This process, which has been communicated across the HSE, is only to be approved by senior management in the health regions if all other options for employment of a consultant on the specialist division have been exhausted.”

In such a situation, the clinical site is required to seek permission from the Regional Executive Officer and confirm that clinical governance structures and arrangements are in place.

“The initial permission to employ is for a three-month period; thereafter, the clinical site must seek renewal of this exemption every three months.”

The spokesperson informed MI that a process of quarterly reporting from the health regions is now in place to track the employment of such consultants at national level.

Concerns about the issue were also recently raised by the IHCA.

In the Association’s new policy document FutureCare: Action Plan for Health 2026, the IHCA said the recruitment of these consultants was in breach of the Medical Practitioners Act 2007 and “the HSE’s own recruitment rules”.

“Specialist registration is the minimum standard to ensure high standards of patient care and safety,” according to the document.