IT WAS unlikely that all nonconsultant hospital doctor vacancies would be filled by the July 11th deadline, Minister for Health Dr James Reilly told the Dáil.

He said that as of this week 221 of the 475 posts had been filled, leaving 254 vacancies.

“Hospital managements are working with clinical directors in a planned way to devise contingency arrangements which can be implemented if required to ensure that any resulting impact on services is minimised and that the safe delivery of services is assured,” said Dr Reilly.

He said the Health Service Executive had conducted an extensive recruitment drive in India and Pakistan in recent months and had succeeded in identifying 439 potential candidates for positions in Ireland.

The drafting of a Bill to amend the Medical Practitioners Act 2007 to enable the Medical Council to register doctors in supervised posts for a defined period was at an advanced stage, he added.

Dr Reilly said he recognised and supported the need to reduce the hours worked by non-consultant hospital doctors.

“If further progress is to be made it is essential that, over time, reliance on non-consultant hospital doctors to deliver services is reduced,” he added.

“An expanded role for nurses and a better skill mix generally in hospitals is one crucial way of achieving this.” The Minister told Sinn Féin health spokesman Caoimhghín Ó Caoláin it was difficult to say precisely which hospitals would suffer if the full complement was not in place by July 11th.

He recalled that he had said on the RTÉ television programme The Frontlinethat for several reasons it would, more than likely, be the smaller hospitals.

Dr Reilly said that doctors who had already applied to the hospitals affected would not be pulled away from them, while those recruited would be sent to the areas of highest need and according to their speciality.

Replying to Fianna Fáil health spokesman Billy Kelleher, the Minister said he did not believe that reports by the Health Information and Quality Authority (Hiqa) should be used to close down smaller hospitals.

“If they highlight problems, these should be addressed as far as possible,” he added.

Roscommon County Hospital currently faced a number of difficulties, he said. “One is a shortage of non-consultant hospital doctors and another is Hiqa patient safety concerns, which arise because of the low volume of patients going through the emergency department, 30 people a day,” he added.

“There is also a difficulty in providing supervised training for doctors, which means these posts are unpopular.”

The biggest problem facing the hospital was safety, said Dr Reilly.

“I say it is unsafe because it deals with undifferentiated multiple trauma cases; undifferentiated medical cases, including heart attacks and strokes; and undifferentiated surgical problems,” he added.

“If people are brought there by an ambulance, they have a right to expect that the skills are available to deal with their problems.”

Dr Reilly said there would be four ambulances covering Roscommon during daytime and three at night. “I can guarantee that,” he said. “There will be extra paramedics available with a car to provide cover if all the ambulances are out of Roscommon at any given time.”

He said he wanted to see a vibrant 24-hour service available through an urgent-care centre for people attending Roscommon hospital. Talks were under way with local GPs to provide cover between 8pm and 8am.

He said the abiding message he wanted to send from the Dáil was that he wanted to replace that which was not safe with something that was safe.

Mr Ó Caoláin said the Minister should accept that what was being proposed for Roscommon represented a significant downgrading of services which local people had treasured over many years and rightly expected to be protected by the new Government.