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medical workforce, for medical education and training, and for the
CAU can now take place in a more unified and cohesive manner.
"It's logical to have these three functions working alongside each
other as each impacts significantly on the other. Planning impacts
on training, which in turn impacts on availability of Consultants,
and so on."
CORE PRINCIPLES
The MET has recently produced its first six-month interim report
outlining development work to date on the medical manpower
planning system. A key step in the initial phase was the articulation
of core principles that would form the foundation for the system.
Professor McGovern outlines some of these fundamental principles:
"It was important that the system would be framed in a manner
consistent with the Fottrell Report's recommendation that we should
aim to be self-sufficient, as a country, in terms of our supply of
medical graduates. Equally, important is the aspiration that more
care should be located in the community, which will require more
GPs. It's also vital that the manpower planning system addresses
the needs of the entire community, both in terms of publicly- and
privately-driven care."
Another pre-requisite is to ensure that medical workforce planning
is consistent with the WHO global code on international recruitment
of healthcare personnel: "Ireland is a signatory to the code which
aims to eliminate the poaching of doctors from low- and middle-
income countries by more affluent nations experiencing personnel
shortages."
PREDICTING FUTURE TRENDS
Assessing the multiple factors that affect care needs will be
the most critical aspect of the project, according to Professor
McGovern: "While making predictions about the supply of doctors
is challenging, measuring the numbers of trainees in the system is
an accessible process. The greatest difficulty will be in predicting
need. Unfortunately, there is no off-the-shelf planning tool for this.
Every national population has its unique mix of needs. In Ireland,
the incidence of diabetes, smoking and obesity will all impact on
demand."
Other influential factors also come into play, some of the most
complex include:
the implications of continually evolving health policy;
the wider national macro-economic outlook; and,
advances in technology and pharmaceutical innovations.
Professor McGovern comments: "New drugs and new technologies
are important influencing factors but not necessarily the most
significant. The wider economic situation has a defining influence
on changes in medical workforce demand. For instance, with the
economic downturn, there is evidence that a significant number of
people have had to give up private health insurance and this trend has
had significant implications for both public and private sectors.
"In addition, policy developments, such as the establishment of the
Hospital Groups and Clinical Programmes, as well as future initiatives
that have been signalled, such as Universal Health Insurance, must
be taken into account in developing workforce projections. The
impact of a universal healthcare policy, for instance, will be profound.
Evidence shows that when care is free, it's used more often. More care
episodes will generate a need for more GPs."
Professor McGovern emphasises that the objective of the workplace
planning project is not to deliver another report: "We want to develop
a mechanism that perform an ongoing live function within the
HSE. We have had many reports that make recommendations for a
specific moment in time; this planning mechanism is intended to be
a function that will adapt, effectively, on an ongoing basis to real-time
changes.
"We're grateful to training bodies for their support and co-operation,
as they have a central role to play in the achievement of the primary
objective of the workplace planning system the delivery of the
right people at the right time and location to provide the right care
services. For example, we're working closely with training bodies to
agree increases in intake in July this year. Normally, there are 230
SpR posts each year, but we're looking at an additional 70 in 2014. We
want to prepare now to have availability as demand grows."
The development of the manpower planning system is just the first
of many steps on a journey, according to Professor McGovern. "The
destination is a dynamic, real-time, medical workforce planning
system in the HSE that will help us implement a more strategically
effective response to care needs."
A graduate of University College Dublin Medical
School, Professor McGovern completed internship
and basic surgical training before obtaining her RCSI
Fellowship in 1982. She then trained in cardiothoracic
surgery in Dublin, followed by a clinical fellowship
in the Mayo Clinic, Rochester, Minnesota. She was
appointed as a Consultant Cardiothoracic Surgeon
to the Mater and Royal City of Dublin Hospitals in
1987. In 1999, she transferred to St James's Hospital
in Dublin to oversee the opening of a new cardiac
surgery unit.
In the field of undergraduate medicine, she chaired
the Medical Faculty Board of RCSI's medical school
from 2001 until 2006. She has also been actively
involved in teaching in St James's Hospital, which is
one of the two major teaching hospitals for Trinity
College Medical School. With a lengthy track record
in postgraduate training, she is a past member of
the Intercollegiate Board for cardiothoracic surgery
(UK and Ireland) and a former examiner. She chaired
the Irish Postgraduate Medical and Dental Board
from 2003 to 2007 and currently sits on a range of
committees and groups dealing with postgraduate
medical education and training. Professor McGovern
was President of RCSI, from 2010 to 2012, having
been a Council Member since 1993.
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