Education (Miscellaneous Provisions) Bill

[Speaking in the Seanad during Second Stage of the Education (Miscellaneous Provisions) Bill 2014]

I thank the Minister for his contributions to the education portfolio. I would like to state that one of the joys of my brief career here to date has been the opportunity to interact with the Minister. He has done, and hopefully will continue to do, very important work in the educational arena.

I completely understand the technical requirements for this Bill and the disadvantage that its absence would confer on certain institutions in the international educational arena, where several Irish organisations have punched way above their weight and done disproportionately and appropriately well. I would like to make three points about the reputation of Irish educational institutions. The international league tables and other league tables may be an irritation, but there is something to them. Those of us who live in the education world and look at the structure of our universities understand there are absolutely profound problems which need to be addressed.

I can speak with the greatest authority in the area of the medical schools. The reality is that we labour under the handicap of the strange demographic of having six medical schools for 4.5 million people, which is twice the European average, while, parenthetically – I know this is not the Minister’s doing – having the lowest number of career-level doctors per head of population of any country in the OECD. That is quite an extraordinary juxtaposition of records to find in one jurisdiction. One would nearly think it required an effort to simultaneously achieve those two, although I believe there are historical reasons why that situation arose. Partly, but not entirely, as a result of that, we have a very serious structural problem in the Irish medical schools. I feel a little like the people who did not like talking too much of their concerns about the economy prior to the meltdown lest they be seen as not wearing the jersey and perhaps causing a problem through scrutiny, which could create its own reality. All I would say is that those who are in charge of education in this country really need to look at the structure of our medical schools internally, and I do not just mean the number of medical schools. If we could sustain six medical schools – and we have enough patients in hospitals to do that – and if we had enough money to appoint the faculty and could attract high-quality students from home and abroad to fill the benches, I would have no problem with that. However, the reality is that we have under-provisioned medical schools which are unprecedentedly understaffed in a way that bears an eerie parallel to the situation with respect to the mainstream health service.

While I do not have the exact figure, we have something in the order of 70 to 90 career-level, full-time faculty clinicians at consultant level, in aggregate, appointed across our six medical schools, whereas Harvard Medical School has 1,500. Whole departments, whole divisions, whole specialties have no full-time academic. I am honoured that two universities in this country, one with a medical school and one an institution with a fine biotechnology and science base – UCD and DCU, respectively – have seen fit to honour me with the title of professor. However, I must stress that they honoured me with it. The professorship, and 50 cent, gets me coffee. There is no division, no department and no formal faculty of medical oncology in any of the Irish medical schools, nor is there for any of the other mainstream specialties. This is a highly unusual situation. I do not believe certain of these structures would bear a great deal of scrutiny, and there is an urgent need to reform them. The reform, I believe, will likely have to be undertaken in parallel with a fundamental and structural reform of the health service itself.

It must be acknowledged that much of the education that takes place in our medical schools takes place according to a principle of voluntarism by those who are primarily employed in the health service. I would have a certain modest reputation for having organised research and helped to organise a certain strand of cancer research in this country, although I would not over-hype my achievements in that area compared to other utterly brilliant people who are doing wonderful research here. However, I have not one minute of protected time for research in my contract, nor does pretty much any other Irish doctor. We are employed, by and large, by the health service and if we do educational research activities, this has to come out of time apportioned for other activities – or, indeed, for life.

I would like the Minister to set out his stall as a reformer and to look at this issue proactively, positively and creatively. I do not believe we are in the business of trying to close medical schools, but we need to be in the business of incentivising the medical schools to look inside themselves, see the fundamental problems they have and to try to remedy them. If we do not, at some stage, somebody may cast a harsh light of criticism on the structures of our medical schools and decide that perhaps there are implications due to a lack of adequate faculty numbers assigned to them.

Finally, I am a huge supporter of the wonderful educational activity of the Royal College of Surgeons and of our other medical schools at home and abroad. I cannot let this opportunity pass without mentioning the names of three doctors, Dr. Ali Al-Ekri, Dr. Ghassan Daif and Dr. Basim Daif, three graduates who committed their young lives to studying medicine with a qualification that had the word “Ireland” on it. To the best of our knowledge, they are living up to the highest principles of our medical profession, providing in an unbiased, uncritical, professional fashion medical care to people who need it. These people, who are politically inconvenient, have found themselves, several years later, still incarcerated and facing very uncertain futures.

I urge the Minister, the Irish educational establishment and particularly the Royal College of Surgeons to come out in forthright support of the rights of these young doctors and other health workers who make the decision to look after their patients rather than to do what might be personally, politically expedient. I thank the Minister and wish him all the very best in this office, hopefully for the next several years.

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