The HSE is appointing doctors from outside the EU to work in Irish hospitals without having assurances about their competence in the English language, while Garda vetting and police clearance from abroad was low to moderate – and non-existent – in some cases.
That’s according to HSE internal auditors, in a report yesterday, warned that such deficiencies reduce assurance that all staff engaged met required regulatory and governance standards when they were taken on “and give rise to potential regulatory, patient safety and operational risks.”
The HSE audit examined 40 non-EU consultant and junior doctors recruited since 2024, with 20 doctors examined in the HSE Dublin and Midlands region, and 20 in the HSE Dublin and North East region – covering seven hospitals: the Rotunda Maternity Hospital, and hospitals in Tullamore, Portlaoise, Mullingar, Drogheda, Cavan, and Navan.
Six doctors out of the 40 in the sample did not have evidence of Garda vetting recorded for the audit – something Independent Ireland’s Linda de Courcy described as an “absolute disgrace” .
“Overall compliance was low for mandatory checks relating to evidence of English language competency and occupational health clearance,” the report found.
“Evidence of English language competency was not available for 13 employees across the two regions, including two consultants who were assessed as fluent at time of onboarding but for whom no documented evidence was retained on file.”
“In addition, one site accepted an English language certificate that did not meet the minimum HSE required score and one other site accepted a certificate a year after onboarding.”
“Deficiencies in completion and/or retention of evidence of these mandatory checks reduce assurance that staff meet baseline fitness and competency requirements before commencing duties, creating potential patient and employee safety risks,” the auditors said.
The HSE audit also notes “inconsistent evidence of pre-employment vetting checks”.
“Overall compliance achieved for Garda vetting was moderate while compliance achieved for overseas police clearance was low. Evidence of Garda vetting clearance was not available in one region for two employees (while) for a further five employees, Garda vetting clearance was obtained after commencement of employment.”
“Nearly 28 per cent of doctors in active clinical practice in 2024 held a basic medical degree from outside Ireland, the UK or the EU. More than 2,300 doctors had graduated in Pakistan and 1,200 qualified in Sudan,” reports the Irish Times.
Reacting, Independent Ireland TD Michael Collins said immediate action was needed to address serious failures identified in the audit as he called the findings “deeply concerning.”
Health Spokesman Collins said the findings raise serious questions about the effectiveness of the HSE’s recruitment oversight and that patients must be given confidence that the deficiencies identified are being dealt with immediately.
“These findings are deeply concerning. It is almost inconceivable that there could be such disregard for basic vetting, verification and oversight in the recruitment of doctors who are going directly into patient-facing roles.”
“Patients have every right to expect that anyone treating them in our public hospitals has undergone the necessary checks, that their qualifications and professional history have been properly verified, that their ability to communicate effectively in English has been established and that the appropriate occupational health clearances are in place,” he said.
He said the issue was not about where a doctor came from, but about ensuring the same robust standards apply to every doctor recruited into the Irish health service.
“This is not about nationality. It is about standards, patient safety and accountability. Doctors recruited from overseas make an important contribution to our health service, but every doctor — regardless of where they trained or previously worked — must be subject to rigorous and consistently applied checks before undertaking patient-facing duties.”
The audit found that only two of the seven hospitals reviewed achieved full compliance with English-language competency requirements. It also identified significant regional variation in compliance with Garda vetting and other recruitment controls.
Cllr Linda de Courcey said the situation was “an absolute disgrace”.
“I’ve heard several accounts from people who felt like their nurse/doctor wasn’t fully qualified and/or couldn’t speak English properly,” she said.
“This government seems to be doing its utmost to push our medical graduates overseas and bring in people, not from Europe or other Western countries who we can ensure are vetted, properly qualified and can speak the language, but from further afield and now this is what we end up with.”
Research published by Gript last year found that doctors trained abroad appear to be substantially overrepresented in Fitness to Practise inquiry notifications, according to an analysis of statistics drawn from Medical Council sources.
Gript analysed all published Medical Council reports related to Fitness to Practise (FTP) cases for the last 17 years.
We found that doctors who qualified in non-European Union/non-European Economic Area (EEA) countries, when combined with the UK, EU member states and the broader EEA, accounted for over 80 percent of those doctors for whom a Fitness to Practise (FTP) notification was issued by the Medical Council since 2008.