This January, Simon Harris, the Minister for Higher Education, unveiled a new initiative to subsidise students from the Republic of Ireland studying medicine in Northern Ireland. This move is part of a broader strategy to increase the number of medical professionals within the HSE and to address the existing (and projected to worsen) shortage of doctors in Ireland.

Under this initiative, students from the Republic will be eligible for subsidies to offset the higher tuition fees present in Northern Ireland. The subsidy will cover the difference between the tuition fees in the Republic (€3,000) and the higher fees in Northern Ireland, which can reach up to £9,250 (approx. €10,724). To benefit from this subsidy, students must commit to working for the HSE for a specified period upon completion of their studies.

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The program is an expansion of previous efforts that focused on nursing and therapy places in Northern Ireland for students from the Republic. It aligns with Ireland’s broader goal to double the number of medical training places in the country. As the population continues to grow and age, doctors will be more necessary than ever, as evidenced by a recent ERSI study which indicated that Ireland would require at least 2,600 more doctors in hospitals alone by the year 2035.

Meetings between officials from the Republic’s Department of Health and their counterparts in the departments for the economy and health in Northern Ireland are scheduled to finalize the details of the arrangement and Minister Harris is expected to make an official announcement regarding the number of places covered by the subsidy shortly.

Now that the facts of the matter have been addressed it is time to pontificate. I take very little issue with this specific initiative (it seems entirely fair to not disadvantage students studying in the North by straddling them with higher fees, committing to work for the HSE is far better than the NHS anyway, it encourages cross border cooperation etc. etc. all good stuff!) and I think should 100% go ahead.

I do, however, wonder whether the presentation of this scheme as a tonic for Ireland’s issues with staffing medical posts is indicative of the flawed thinking that has gotten us into the doctor shortage in the first place. For those who don’t know, Ireland actually already trains a high number of doctors per capita (in 2016, Ireland had the highest number of medical graduates per population of all OECD and EU countries, 24.4 per 100 000 population – twice the figure in the United Kingdom (12.9) and the OECD average (12.5)) and the vast majority of those graduates go straight on to work for the HSE.

Brain Drain:

Why then, you ask, is there a doctor staffing shortage? It is an issue of retention, not one of training. Ask any doctor or medical student you know and I’m positive that they have at least considered taking the well-trodden path from Belfield to Perth, tempted by better pay, fewer hours and a less stressful working environment.

The brain drain of Irish doctors has led to the scenario we find ourselves in presently, one where, in 2019, over 40% of medics in Ireland were hired from overseas! Now, in fairness to Mr Harris, the inclusion of a clause stipulating that those who avail of this scheme will have to commit to working for the HSE is wise, but the length of this commitment is important as it will only have a meaningful effect on the churn of Irish doctors if it extends beyond the customary one year post-graduation that most graduates commit to the HSE already.

As a GradMed™ student myself I wonder whether a similar scheme (i.e. one which subsides the similar substantial graduate entry fees in exchange for a commitment to working for the HSE) would be another pertinent way to bump up the retention of Irish-qualified docs. It would certainly make the graduate entry route more accessible, and it should be palatable for the medical schools as it would have no bearing on their favourite pastime, price-gouging non-EU students!

Conor Power – Politics Editor