More than 100 consultant positions are currently vacant in Northern Ireland hospitals – sparking new concerns over a senior workforce crisis in the health service.
The latest figures that show hundreds of unfilled medical posts have reignited calls for the government to take urgent action to reduce our reliance on temporary or agency staff.
In addition, almost 500 nursing, midwifery and health visitor posts are still to be filled by health trusts.
According to the statistics, the largest number of current vacancies was among the nursing, midwifery and health visiting area, with 478 jobs.
But most concern will be over the revelation that 114 consultant posts were still unfilled with 66 having been advertised on or before December 31 last year.
The details were included in the Northern Ireland Health and Social Care (HSC) Workforce Vacancies survey.
It examined the vacancies up until March 31 this year.
It comes as the number of doctors applying to the GMC for Certificates of Good Standing, a document which enables them to register with an overseas regulatory body or employer, has remained at a constant of more than 4,700 per year for the past two years in the UK.
And the DUP's Jim Wells believes this has been an ongoing key factor in being unable to fill the posts in Northern Ireland.
"Many doctors are choosing to leave and resettle in Australia or Canada," he said.
"There is no such thing as a golden handcuff deal.
"We have very talented doctors being trained here, but if they are offered the chance to go to work in sunnier climbs for better pay and shorter hours, it is hard to compete.
"This is a problem that is affecting the whole of the UK."
Mr Wells, a member of the Stormont Health Committee, says one approach to try to tackle issue is to bring more doctors in from eastern Europe.
"There is of course a language issue that has to be addressed but I believe that is one way that could help ease the staffing problem."
Meanwhile, the RCN says the figures fail to reveal the true extent of agency staff being used.
Spending on agency or 'bank' staff is expected to top £70m this year, having soared by 60% over the last four years.
Janice Smyth, Director of the Royal College of Nursing (RCN) in Northern Ireland, said the way the vacancies were defined prevented the real number of posts being held as 'cost-saving measures' being revealed.
"We know there is an over-reliance on bank and agency staff, and in particular bank staff.
"These figures do not show the posts being held as cost-saving measures."
Ms Smyth also said there was "anecdotal evidence" that a number of nursing posts were becoming difficult to fill within the HSC.
"There is a body of evidence that the independent sector cannot fill nursing vacancies, and are being forced to recruit nurses from Europe," she said.
"While we will always need bank and agency staff to fill unexpected vacancies, if patient experience is to be improved, more must be done to ensure adequate nurse staffing."
A DHSSPS spokeswoman said the HSC trusts were responsible for managing the recruitment of staff.
"The department's role is to ensure that there are sufficient staff trained at the right level and speciality to meet our healthcare needs.
"This is a complex and important area of work for the department and as such, a number of exercises are under way, including reviews by medical speciality and an overarching review of the medical workforce. In addition, a nursing workforce review is also under way.
"Medical workforce plans for primary and secondary care will be developed, which will make recommendations to ensure effective medical workforce planning.
"An overarching review of the medical workforce is currently under way which will look at all areas of the medical workforce, including undergraduate intake levels. This review will highlight any issues to be addressed and provide a picture of how the medical workforce is evolving in Northern Ireland compared to England."
Hundreds of posts unfilled, even with six-figure salaries
Take a look through the public sector job vacancies in the Belfast Telegraph and there is one sector which dominates the pages.
In capital letters and big print there are multiple advertisements for vital positions within the health service waiting to be filled.
Just a quick glance at Tuesday’s paper and there are dozens of high-profile posts available for the already over-stretched and under-strain health service in Northern Ireland.
And what’s more, the positions up for grabs are some of the most highly paid and respected jobs achievable within the medical world — with many offering six-figure salaries.
Rows of senior jobs ranging from a consultant physician to a temporary speciality doctor in acute medicine are lying vacant. And it’s not just a demand for doctors — as recent figures released by the Department of Heath highlighted, there are almost 500 nursing, midwifery and health visitor posts still to be filled by health trusts.
According to the statistics, the largest number of current vacancies was among the nursing, midwifery and health visiting areas, with 478 jobs.
But log on to any of the trusts’ recruitment websites and the job advertisements continue.
There are vacancies for a series of consultants in different areas including cardiology and dozens for speciality doctors including one for the care of the elderly and for emergency medicine.
And there are many theories as to why the posts are not being filled.
Dr Paul Darragh, the chair of the British Medical Association in Northern Ireland, said it wasn’t just a problem of recruitment but also of retention. He told the Belfast Telegraph that the recent problems which have plagued our emergency departments had seen people turning away from a career in that department.
He indicated that some were retiring early due to the stress while others were continuing to work but opting for other countries like Australia.
The DUP’s Jim Wells believes the key factor in not fulfiling the positions is the relocation of doctors to other countries and that one way to tackle the issue is to bring doctors in from eastern Europe.
The Belfast Trust indicated that the statutory instructions for recruiting medical consultants had recently been reviewed and that it can take between three-to-six months to appoint a consultant.
It also suggested that as the demand for speciality doctors grows there is a longer time-frame within medical training and they had worked with recruitment agencies to target recruitment in Europe.
A spokesman for the Belfast Trust’s human resources department said: “You want to be treated by someone capable of working within the NHS and has been able to satisfy the General Medical Council entry requirements.
“There is a lot of hoops to go through, it’s not just put a job in the paper today and it’s filled within a month.
“It doesn't work that way for consultants — normally it can take within three and six months.
“The public needs to be assured in that regard that the necessary checks are in place, but that equally because of the demand for service we are trying to be as responsive and innovative as we can.”
A spokeswoman for the Health Department said: “Posts are advertised both online on the HSC recruitment site and in local newspapers. This vacancy rate represents a normal workforce turnover rate. That is why it is similar to last year. It allows for people leaving their posts for a variety of reasons and takes account of the length of time it takes to refill the post.”
CURRENT CONSULTANT VACANCIES
20 at Royal Victoria Hospital
10 at the Belfast City Hospital
9 at Musgrave Park Hospital
8 at Antrim Area Hospital
1 at the Ulster Hospital
15 at Craigavon Area Hospital
16 at Altnagelvin Hospital
2 at Daisy Hill in Newry
33 at other locations