At least one in every five temporary or locum consultants operating in hospitals last year was employed without ever having to attend an interview, with many also not required to supply a reference, an unpublished HSE survey obtained by the
Sunday Tribune has revealed.

In findings which are likely to prompt renewed concern about standards of care in hospitals around the country, the study by the HSE's Consultant Appointment Unit (CAU) reveals there were 393 doctors employed in temporary or locum consultant positions ranging from three days duration to "indefinite".

But in 85 cases, HSE-run hospitals said an interview for the position was never held, while in a further 87 instances a response to this question was not provided, meaning the final figure could be significantly higher.

References for the doctors in question were also not receiv­ed for 50 appointments, meaning they had not been vetted fully in advance of taking up their work. Again, information was not supplied in relation to a further 87 appointments.

The use of locums is known to pose increased risks to patients due to its potential impact on continuity of care and overall standards.

An internal HSE report into the much-publicised misdiagnosis of Ann Moriarty (53) earlier this year said a locum consultant radiologist had misread as normal a chest X-ray carried out on her in June 2007. Her cancer was missed at Ennis hospital and she died last year.

"These figures are alarming, especially given the cases of the misdiagnosis of cancer which were directly attributable to locum and temporary consultants," said Labour spokeswoman Jan O'Sullivan.

"We have come across cases where doctors are coming to Ireland from different countries where they would already have problems with their home register so to think there are not proper procedures in place to check these issues is worrying... I am mostly concerned about the lack of references however, as these are absolutely vital to deem whether the applicant is suitable for the job."

Fine Gael's health spokes­man James O'Reilly describ­ed the findings of the report as an "absolute disgrace. After all the trauma, and now these figures come to light. We've seen it time and time again that these misdiagnosis scandals arise from inappropriately placed locum and temporary consultants."

At least 112 consultant appointments were not appro­v­ed by the CAU itself, while in four out of 10 cases – 155 appointments – the consultants in question were not members of the medical council's specialist register.

Among the main areas where the consultants were employed were anaesthetics (79 appointments), surgery (37), obstetrics and gynaecology (26), paediatrics (34), radiology (18) and emergency medicine (9).

Just over one-third of those appointed were Irish, with the remainder drawn from countries such as Britain, India and Pakistan, although responses to this question were not received in 23% of cases.