Departure of 4 middle grade doctors with supplementary questions

3.4   Deputy J.A. Hilton of St. Helier of the Minister for Health and Social Services regarding the recent resignation of middle grade doctors:

Would the Minister confirm whether 4 of the 8 middle grade doctors employed in the hospital have left during the past month or so as reported at a recent Scrutiny hearing by one of the medical directors. If so, can the Minister explain why this happened, what notice the doctors gave, and what immediate action was taken to address the vacancies?

Deputy A.E. Pryke of Trinity (The Minister for Health and Social Services):

For clarification, 4 middle grade doctors have not left in the past month; 2 have left in the last month, having resigned in the last 4 months; 2 different middle grade doctors resigned last month but are still serving out their notice period. Action taken includes implementing a timely recruitment process with one vacant post already recruited to and arranging locum cover to ensure continuity of service. The answer to question 7488, which sets out which middle grades have left or resigned since December 2012, also sets out the reasons for leaving, which include promotion, family or personal reasons.

1. Deputy J.A. Hilton:

I am referring to the answers given to a written question submitted by Deputy Southern . I note that one of the posts that were advertised has been filled but apparently the successful applicant will not take the post up until August 2013. I am curious, because I do not think this question was answered, as to how much notice was given by the 2 doctors who left for personal reasons. It seems to me that applicants coming from the U.K. have to give their U.K. post 6 months' notice but does that happen in reverse?

The Deputy of Trinity :

All Health and Social Services doctors, in line with all other medical posts, provide a minimum of 3 months' notice on resignation. While the recruitment process starts immediately, it takes a minimum of 10 weeks plus the notice period that the incoming candidate must serve, which also depends on their training commitments where they are.

2. The Connétable of St. John :

Of the locum cover, is the remuneration higher than that of middle grade doctors and, if so, by how much? How many locums has the Minister got within the hospital at this time?

The Deputy of Trinity :

I have not got the exact figure of how many locums we have got but the locums are a fact of life of a hospital because we always have to account for sickness or going to have some training or continuing with our continuous professional development. To make sure there is continuity of service we will always have to rely on locums, but the number of locums, I know, has dropped over the last couple of years especially, but I do not have the number of actual locums at the moment.

3. The Connétable of St. John :

The answer was not sufficient because I asked if the locums' remuneration was higher than that of middle grade doctors and if so, by how much?

The Deputy of Trinity :

I do not have the exact figure of how much but I would presume it would be higher.

4. Senator S.C. Ferguson:

The General Medical Council paid a surprise visit to the Island because of the number of concerns being raised. What comments did they make on this significant number of resignations?

The Deputy of Trinity :

To put the resignations in perspective, we have 54 middle grade doctors working within the hospital and, as you see, some have gone to promotion to the U.K. That should be kind of applauded that within this small busy hospital we have enough experience so that the middle grades can go on to be promoted and some go because of family reasons. I wish none would go but that is a part of life that we have to contend with. Regarding the G.M.C. (General Medical Council), I have not seen that report as yet.

[10:15]

5. Deputy G.P. Southern of St. Helier :

It is interesting that the number should be 54 when the answer to question 7488 lists 11 vacancies, recent leavers or about to leave, and 8 locums in place. Does the Minister consider it a healthy situation to be working with 20 per cent of your staffing requirement covered by locums?

The Deputy of Trinity :

As I said, locums are a fact of life. To help the middle grade doctors too, we have appointed 3 Clinical Fellows, which are like Foundation 3 hosts who assist the middle grade doctors in the undertaking of daily work. Also we are helping middle grade doctors with transferring patients to the U.K. that need to have medical cover. Locums unfortunately are a fact of life.

Deputy G.P. Southern : Supplementary, if I may, Sir? The Deputy Bailiff :

The Minister has answered, Deputy . The Minister is also subject to questions without notice shortly and so there will be an opportunity for come back then and I also have other Members wishing to ask questions.

6. Deputy K.L. Moore of St. Peter :

Does the Minister consider that pay is an issue for middle grade doctors and is her department giving this issue their consideration?

The Deputy of Trinity :

Pay was an issue a couple of years ago and it was the Locum Negotiations Committee that renegotiated the pay and conditions, if I remember rightly, and so it is there but also you have got to work out that there is a shortage of middle grade doctors too from the U.K.

7. Deputy J.H. Young of St. Brelade :

The Minister has given the impression that there is not a problem here and all is fine. Could she tell us, has she done any comparative figures of medical staff turnover at other equivalent acute hospitals elsewhere and can she indicate clearly whether or not there are any factors which give her cause for concern and doubt that there is no complacency? Can she confirm that she is not complacent about that?

The Deputy Bailiff :

For the purposes of Hansard, Deputy Young is pretending to be Deputy Higgins but not to worry. Minister, would you like to answer the question?

Deputy J.H. Young:

Sorry, Sir, apologies to the House. The Deputy of Trinity :

I am never complacent because it would be nice to think that we had a full quota of consultants, middle grade doctors, nurses and allied health professionals but we have a staff of over 3,000 and there will always be some turnover. That is just a fact of life. We work hard with our middle grade doctors but by the nature of what they do and in a small busy hospital where they gain an awful lot of experience, some of them will just move on to promotion or go back to their home country, having gained a lot of experience. Some will retire when they get to 60 or 65 but I am never complacent because recruitment and retention is an important part of running this hospital.

8. Deputy M.R. Higgins:

The Minister earlier side-stepped the question from Senator Ferguson regarding the G.M.C. visit by saying she had not seen the report. Will she tell Members what she does know about the G.M.C. visit and what their concerns were, even if she has not read the report? Please fill us in with the background.

The Deputy of Trinity :

I was aware that the G.M.C. came over. I think it was in relation to part of the revalidation but I do not have all that information.

9. Deputy J.A. Hilton:

Is the Minister satisfied that her H.R. (Human Resources) Department is dealing with these vacancies in a robust manner?

The Deputy of Trinity :

Yes, but I can say it is a complex issue because it does take time to employ anybody if they only give 3 months' notice because by the time you have relooked at their job description, gone out to adverts  and  interviewed  and  the  new  applicant  gives  his  or  her  notice  and  starts  working, providing they have not got any training still left to do or part of their C.B.D. (case-based discussion) to continue, it does unfortunately take longer than 3 months. I wish it did not but unfortunately it does.