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Irrefutable evidence on the scale and depth of the consultant recruitment and retention crisis

[ Friday, 25th May 2018 ]

25 May, 2018: An Irish Hospital Consultants Association delegation, led by Dr Tom Ryan, President of the IHCA, recently met with the Public Service Pay Commission to present irrefutable evidence that the prolonged consultant recruitment and retention crisis is deteriorating and undermining the provision of care to patients. The discussions supplemented and reinforced the contents of the Association’s submission to the Commission in November 2017 on the extent of the crisis.

The IHCA outlined in detail why our acute hospital and mental health services are increasingly uncompetitive in recruiting and retaining the number of consultants required to provide timely, high quality, safe care to patients. There are approximately 450 approved consultant posts, a full 15% of the total, which cannot be filled on a permanent basis. About half of the posts are vacant and some are filled on an agency basis, at costs which are up to three times the discriminatory salaries being paid to new entrant consultants.

Around 75 doctors appointed since March 2008 are currently occupying public hospital consultant posts but are not on the Medical Council Specialist Register. This is in clear breach of the basic requirements to hold a consultant post and practise as a specialist, in accordance with the Medical Practitioners Act 2007.

Speaking about the delegations’ recent meetings, Dr Tom Ryan, President of the IHCA, said: “The IHCA has advised the Commission and the Oireachtas Joint Health Committee that the failure to fill consultant posts on a permanent basis with doctors on the specialist register, represents a false economy from a financial perspective and one of patient care, with ever increasing waiting lists due to a shortage of consultants and growing medical agency costs which exceed €100 million per year. Figures from Public Appointments Service for recent years confirm that about a quarter of the advertised consultant posts failed to attract a single suitable applicant and about one third of the advertised consultant posts failed to fill.  In addition, the IHCA provided the Commission with a list of over 60 permanent consultant posts where the consultant had resigned early to practise in the private sector or abroad.”

The IHCA delegation also informed the Commission that the State made a serious mistake a decade ago when it breached the terms of the 2008 Consultant Contract.  The State compounded that considerable breach of trust when it unilaterally imposed a 30% discriminatory salary cut in 2012 on New Entrant Consultants, in addition to FEMPI cuts. Dr Ryan stated that “As a result of this breach of trust, there is now a very substantial risk that a generation of highly trained specialist consultants will be lost to the Irish health service if the decade-long exodus of specialists to practise medicine abroad is not addressed.”

The IHCA explained to the Pay Commission that the State needs to urgently restore trust by honouring the terms 2008 Consultant Contract and ending the discrimination against New Entrant Consultants, as we are not competitive given growing global shortage of specialist consultants.  The Association awaits the publication of the Commission’s report in July in the expectation that it will provide much needed guidance for the Government to address the health services’ increasing lack of competitiveness in recruiting and retaining hospital consultants, as this is undermining the quality and safety of our health services.


For further information contact:

James Dunny, FleishmanHillard + 353 86 388 3903

Fiona Murphy, FleishmanHillard +353 87 819 4464