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IHCA statement on New Year hospital crisis

[ Monday, 7th January 2019 ]

Monday 7th January 2019: The Irish Hospital Consultants Association (IHCA) has said that it is very concerned about the complacency in addressing the overwhelming capacity deficits in our public hospital and mental health services.   

Dr Donal O’Hanlon, IHCA President, said he is concerned that the reduction in the number of patients being treated on trolleys in the past week compared with the start of 2018 is being presented as something akin to significant progress. “It is unacceptable that, in a developed economy such as Ireland, hundreds of critically-ill patients who are admitted to hospitals on a daily basis cannot be provided with a bed and are being treated on trolleys. In 2018 over 108,000 ill patients were admitted to hospital yet had to wait on a hospital trolley for an acute bed to become available. This is the highest number ever.”

He said that the significant number of patients being treated on trolleys must be assessed in the light that elective but essential surgery appointments have been deferred in most hospitals for part or all of January because of the extreme capacity deficits, despite there being 70,000 patients on surgical waiting lists.

The IHCA President said that there are two main capacity deficits in our public hospitals which are restricting timely delivery of patient care; the severe shortage of hospital beds and the large number of permanent consultant posts that cannot be filled.

He said the extent of the public hospital deficits means that essential surgery is being cancelled in many hospitals. For example:

i)                    In St James’s Hospital, the largest cancer hospital in the country, 4 of the 13 operating theatres are closed because of bed and staff shortages. Apart from emergency operations and essential cancer surgery the hospital cannot provide elective surgical services.

ii)                   In Cork University Hospital other than for emergency operations, theatres were closed for two weeks.

iii)                 In University Hospital Limerick all elective surgical operations were stopped from 21 December to 7 January. Further extensive curtailment is likely after 7 January due to the severe bed shortage.

iv)                 Galway University Hospital has suffered from a theatre rolling closure policy of 1:3 even prior to the winter emergency plan, so it has been running at two thirds of its theatre capacity. This is impacting not only on the scheduling of essential elective surgery but also on urgent cancer surgery. The result is long waiting lists for elective surgery and increased numbers presenting as emergencies because of delays.

v)                   In the Midland Regional Hospital Tullamore the elective ward was curtailed from 10 December and closed on the 18 December and there is no set date for reopening.

The IHCA President said that the failure to replace the 1,400 inpatient beds, which were closed since 2006 is a major problem. He said the absence of a realistic plan to commission the additional 2,600 acute beds recommended in the Capacity Review a year ago does not augur well given the ongoing increases in demand for hospital care.

The population depending on our health service has increased by 12% in the years from 2006 to 2016 and is still growing steadily. In addition the proportion of the population that are older and so tend to need more medical care has grown at a higher rate.

Dr O’Hanlon said that a realistic plan needs to be put in place to expand our public hospital bed capacity within 5 years by 2,600 beds.

With over 500,000 adults and children awaiting consultant outpatient appointments, there is a pressing need to fill the one-in-five unfilled permanent consultant posts without delay.

Dr O’Hanlon said that the Government’s current policy, which blatantly discriminates against new consultants, is driving highly trained specialists abroad and exacerbating the consultant recruitment and retention crisis. He said it is unacceptable that the Minister for Health and his officials have not engaged in discussions with the IHCA on the solution to the crisis, despite the commitment to do so given over two months ago in the Dail by An Taoiseach, Leo Varadkar.

Dr O’Hanlon concluded that the Government’s discriminatory policy against new entrant consultants is seriously undermining the capacity to provide timely hospital and mental health care to patients.

 He said if the policy is not addressed now, by restoring parity for new consultants and international competitiveness in filling posts, it will cause irreparable damage that will affect patient care for decades.

For further information contact James Dunny, FleishmanHillard, 086 3883903

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