An inspection by the Medical Council of Children's Health Ireland (CHI) hospital sites has said there needs to be a clear and accessible process for doctors who are in training to raise and escalate concerns.
It said there needs to be a clear and timely process for incident reporting, including near misses.
It found poor ICT systems which hinder clinical service delivery with potential patient safety implications.
Doctors faced multiple log-ins to complete routine tasks, such as checking test results and investigations and completing discharge letters.
The inspection was conducted over two days, on 24-25 September last year.
The reason for the inspection was to ensure there is quality training for trainee doctors.
The inspection followed concerns raised in an internal CHI report from 2021-22 about alleged issues such as bullying and culture, governance and leadership, as well as waiting list management.
The Medical Council wanted assurance that these matters were not adversely affecting the experience of trainees or impacting patient safety.
Inspectors found trainees were positive about their training experience at all CHI sites.
But some spoke of inappropriate or unprofessional behaviour and would choose to wait it out and not tell the hospital.
The inspection found significantly delayed salary payments and payroll discrepancies.
There were also delays in issuing contracts, and some doctors were working without a contract.
Some Non-Consultant Hospital Doctors were assigned to the incorrect department or post.
The organisation of patient records and file retrieval was difficult due to the IT systems.
These issues caused distress and anxiety to doctors.
Overall, the Medical Council found a supportive and collegiate culture across CHI sites.
CHI welcomes findings
Speaking on RTÉ's News At One, CHI Regional Director Paediatric Education CHI Dr Sineád Murphy said: "We certainly accept the findings."
"We welcomed the Medical Council visit, we in fact invited and instigated the Medical Council visit, based on historical or legacy issues that CHI has had," she said.
She said the issues were centred on "one or at the most two departments - they were absolutely not CHI-wide."
She said that CHI is currently in a "huge state of change".
"There is an enormous project happening and at the same time we are running with business-as-usual.
"And the single biggest priority in our business-as-usual is patient care," Dr Murphy said.
She said that CHI knew the issues were there and it welcomes the Medical Council "calling them [issues] out."
She added: "We know that when we get the chance to move to our wonderful new hospital in which there's been huge investment in things like ICT, that these [issues]will be less."
