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The governance of the College is under constant review and, the
current governance committee, under the chairmanship of Professor
Tom Gorey, has proposed the establishment of a College Board,
which will report to Council and be responsible for governance
of the day-to-day administrative, legal and business affairs of the
College. The establishment of a College Board is a challenging but
hugely important project which is critical to the future success of the
College in all its activities.
Surveys of Council have shown that the vast majority of Council
Members are motivated to contribute specifically to the regulation
of surgical education, training and practice. The establishment of
a College Board will facilitate the broadening of expertise beyond
medicine and education to include competencies relevant to the
management of RCSI's property portfolio, international Colleges and
wider business activities.
The Board will consist of seven Council Members and six others,
of whom two will be the Chief Executive of RCSI and the Dean
of the Faculty of Medicine and Health Sciences. In Council, we
have also seen the benefits of co-opting two lay Members and the
positive changes experienced in the Council dynamic augur well
for the success of the proposed College Board and its diverse mix of
Progress in developing our re-envisioned Surgical Training Pathway
continues to be extremely encouraging. It is heartening to confirm
that 90 per cent of our initial intake of trainees (2013) have been
accommodated with their first choice of specialty for the second
year of their training programme. This is a particularly positive
outcome as there had been some concern that there might have been
a disproportionately high level of demand for a small number of
Looking forward to our July 2014 trainee intake, I can report
that 56 candidates were successful at interview in February. Their
appointments to their hospitals have already been announced.
I am also pleased to announce that we have 10 Hospital Programme
Directors in place for ST1 and ST2, the core years on the Surgical
Training Pathway, which, through progression and competence
criteria lead on to the ST3 - 8 (Specialist Training) years. The
Programme Directors will have a significant role in ensuring trainees
can undertake case loads sufficient to enable them to acquire the
required levels of experience and proficiency. I want to express our
gratitude to the 10 individuals who have undertaken these vital roles.
I am also extremely grateful to all in the Surgical Training Office who
have driven this very significant change process during the last 18
months, in particular Mr Kieran Tangney, Mr Eunan Friel, Professor
Oscar Traynor and Professor Sean Tierney.
We're all too familiar with the increasing difficulties in retaining our
trainees and in recruiting high quality specialists of all kinds to come
to Ireland to practise. In surgery, as I highlighted in my Presidential
Address at Charter Day, the situation is even more complex and the
causes are, in fact, multi-factorial. It is not just about the reduction
in pay. It is also about the lack of basic theatre resources, rolling
theatre closures and the lack of protected beds.
The Clinical Programme for Elective Surgery has demonstrated
clearly that ring-fencing and protecting surgical beds, in conjunction
with guaranteeing access to theatres, is essential in order to
treat surgical patients who need planned surgery. In doing these
elective lists, trainees can be supervised and surgeons can maintain
their own skills. We know there is spare capacity in some of the
private hospitals and we should be working to treat patients in a
planned and regulated fashion and use these resources to their full
capacity, rather than, as in the current system, engaging in feverish,
misdirected activity and referral of patients elsewhere to meet
arbitrary deadlines, rather than patient needs.
When will the Department of Health and the HSE listen to pleas
from surgeons and the College for a common sense approach
utilising designated Elective Surgery wards with the proven
capability to deliver more effective care and improved outputs
while maintaining surgical skills and enhancing surgeon morale? In
addition to mitigating some of the challenges currently facing our
healthcare system, it would be an important first step in countering
the difficulties we face in recruitment and retention.
The plenary session at Charter Day which focused on the theme
`Centralisation vs Regionalisation within a Networked Environment'
proved to be a very worthwhile exploration of the complexity of the
topic and provided a forum for a wide range of views and opinions.
The innovative electronic voting process allowed us to identify areas
of consensus and the session as a whole will help to inform future
policy decisions.
All four expert speakers provided cogent and thought-provoking
presentations, beginning with Mr Paul Blair, Royal Victoria
Hospital, Belfast whose account of strategic changes in vascular
surgery practice in Northern Ireland may prove to be of particular
significance for us here in the South in years to come. Mr Hugh
Flood, Department of Urology, University Hospital, Limerick
provided perceptive insights on the implications of regionalisation
based on his experience of the re-organisation of urology services in
the Mid-West.
Mr Eoin O'Broin, Cork University Hospital (CUH), presented a
detailed, informative account of the effects of centralisation in CUH,
identifying positive and negative impacts. Professor Peter Gillen,
Our Lady of Lourdes Hospital, Drogheda, delivered a biting critique
of centralisation, informed by his experiences of the cancer strategy
implementation and its impact on hospitals such as Our Lady of
With the benefit of having heard the articulate and persuasive views
expressed at the session, in my opinion, the Hospital Groups strategy
has significant potential to deliver better patient care and more
effective surgical services, providing lessons are learned from the
cancer strategy implementation process and providing each Hospital
Group is allowed sufficient autonomy to operate in a manner that is
responsive to specific local needs.
This is my last contribution to The President Writes... and I wish
to compliment all involved with Surgical Scope for their work in
producing an ever-evolving publication for Fellows and Members
that acts as a source of news and informed opinion, as well as
maintaining and strengthening collegiate links. It has been a
privilege to communicate with Fellows and Members through the
column and I hope that my successor Mr Declan Magee will find it
as enjoyable and fulfilling as I have.
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