The man who really runs the Department of Health has acknowledged top doctors are “demanding outrageous salaries [to] work in Derry rather than Belfast.”
Dr Richard Pengelly accepted this was the “reality” when it was put to him by East Londonderry MLA John Dallat at a meeting of the Stormont Public Accounts Committee (PAC) within the past fortnight.
Dr Pengelly, an accountant by profession and the Permanent Secretary at the Department, referred to the seemingly irresolvable difficulty in getting enough specialist doctors to come and live and work in the North West.
“A particular issue for the Western Trust...is that the geographical remoteness of some of its facilities means that it has a much higher level of spend on locum staff, which is necessary to fill vacancies in order to provide a high-quality and safe service to the public,” he told the Committee.
“That is a unique characteristic of the Western Trust. If it suffers an unanticipated level of absence, the options are either to incur the cost of bringing in locum staff to keep a quality service open or to close the service to the public.
“That means that we cannot simply say that you must spend what you have, and no more. That will always be a challenge,” he said.
Dr Pengelly was briefing the PAC on a Northern Ireland Audit Office (NIAO) report published earlier this year, which concluded that emergency monitoring round bail outs from the Executive were merely papering over severe funding pressures at the Western Trust.
Referring to the intractable overreliance on locums in the west, Mr Dallat asked if the Department was “addressing the problem of people cherry-picking where they work?”
Mr Dallat said: “I say that as a taxpayer who probably contributed to their training and everything else. Is it right that people in powerful positions such as that should be demanding outrageous salaries because they work in Derry rather than Belfast?”
Mr Pengelly went on to concede: “It is the reality. I do not think that we can dictate to people where they work. If we had a model in which all medical staff were employed at a regional level and deployed based on the needs of the Northern Ireland health and social care sector, that would be a different case from what we have at the moment, where the staff are employed by trusts.
“It is entirely open to all individual members of staff if they happen to be working in the Western Trust and see a job that they find attractive in the Belfast Trust to apply for it. I do not think that it would ever be right for us to try to stop that. I know that that is not what you are suggesting. It is a difficult issue.”