Major flaws in the recruitment of young doctors have been highlighted in a series of HSE internal audit reports.
A quarter of all NCHDs had not fully completed all of their occupational health assessments, according to a report, and recruitment procedures are not fully up to date.
The auditors also found that the obligation for the recruiting consultant to obtain a verbal referral directly for NCHDs recruited from abroad was not met. And because employment record reports are not reviewed, potential non-compliance issues are not identified and addressed.
According to the auditors, only a fifth of the applications sampled had the two required references.
Other systemic issues emerged from the field verification work at six hospitals – interview notes were not detailed, required references were not on file, applicants were not required to provide documentation. identity at the interview stage and telephone interviews rather than video.
The level of assurance regarding the recruitment of NCHDs is not satisfactory, the report concludes.
The audit focused on non-formal training positions, often lasting six or twelve months, not recognized for training and occupied by international medical graduates. Many of them have never worked in Ireland before.
“With the short-term nature of the roles, the lack of designated formal training, the lack of exposure to the Irish acute care hospital setting and the challenges of background and international experience checks [this] leads to increased risks in recruiting non-training positions.
In 2018/19, there were 2,500 NCHD without training, compared to 4,000 in training to become consultants.
According to the auditors, Limerick University Hospital, Mater Hospital Dublin and University Hospital Cork have not implemented a Garda control for NCHDs, nor a structured interview process that conforms to guidelines. These hospitals, along with Cavan General Hospital and Galway University Hospital, do not get oral referrals before hiring applicants.
The country’s largest hospital, St James’s in Dublin, does not carry out international police checks for an NCHD recruited from outside the state, according to a report. Two references were not on file for 40 percent of the cases tested and the hospital does not require candidates to provide identification when questioned.
In the RCSI hospital group, two of the four staff employed have not been developed minimum pay scale, in violation of government policy. Interview committees were not chaired by someone independent of the hospital group and interview notes were not available for two of the files reviewed. Probation periods have been set at six months instead of the 12 months required nationally.
At Cork University Hospital, the Garda check was not recorded for 40% of the files reviewed and applicants were not required to provide identification at the interview stage. For 20 percent of the NCHDs tested, there was no record of passing the required English tests.
Mater Hospital did not have two references on file for nearly 60 percent of the cases tested; management said it had been requested numerous times.
Meanwhile, at Limerick University Hospital, 15 out of 20 NCHDs reported working more than 48 hours per week, despite the EU Working Time Directive which limits the work week to that time. The overtime hours worked range from eight hours to 35 hours.