Agreeing with a top-level inquiry panel report - by the Resident Medical Officer (RMO) Commission that instructed district health boards to work towards making permanent medico jobs more attractive - the union representing junior doctors has upheld the decision for urgent changes to the apprenticeship model.

Directing the public hospitals to let go of their "unsustainable" and "potentially dangerous" heavy reliance on casual employees for filling doctor vacancies, the report has called for a change in the training and employment arrangements for new-graduate doctors and trainee specialists.

Presenting RMOs as a dispirited workforce that opines it has been unvalued by the health system, the report put forth a supposedly contentious recommendation, suggesting the creation of a new national agency replacing the health boards as the employer of most of the country's 2500 house officers and registrars.

Led by the former state services commissioner, Don Hunn, the commission referred to the diversion of medical graduates into the locum market as a grave threat to the long-term sustainability of the medical workforce.

The report noted: "In a time of workforce shortage, locum work, which offers better remuneration and flexibility, appeals to an increasing number of RMOs, diverting them away from vocational training programmes, and thereby reducing the number of specialists in the longer term."