Medical Council trainee doctor report confirms recruitment crisis, warns IHCA
- 44% of trainee specialist doctors indicate intention to go abroad to practise medicine;
- 86% of doctors in training consistently working over 40 hours a week; 46% work over 48 hours;
- Ireland has lowest number of specialist doctors in EU;
- “At a time when we need more doctors, we’re losing them” — IHCA President, Alan Irvine
The Irish health system is losing its future Hospital Consultants at an alarming rate despite the huge need for them here, the Irish Hospital Consultants Association has warned.
The IHCA was commenting following the publication by the Medical Council of its ‘Your Training Counts Report for 2019 - 2020’* which shows that 44% of trainees intend to go abroad to practise medicine, at a huge loss to our acute hospital services.
The IHCA said that this report was further evidence of the recruitment and retention crisis of doctors and consultants in the Irish health system. It added that the poor working conditions and other factors highted in the Medical Council’s report was feeding the cycle of poor retention and impacting on recruitment at Consultant level.
The report worryingly found that 86% of trainee specialist doctors were working more than 40 hours per week with 46% regularly working over 48 hours.
The Medical Council report highlights the critical need for a considerable increase in the numbers of medical specialists and trainees across the entire health system to meet the projected demand for additional Hospital Consultants and match the increasing need for acute hospital services.
Ireland has the lowest number of medical specialists per 1,000 population in Europe at 1.48, 42% below the EU average of 2.54. In addition, around one in five permanent Consultant posts in Ireland are either vacant or filled on a temporary or agency basis, some of which are not specialist registered.
The Council’s recommendations on the supply and demand of medical specialists echoes the recently released strategic framework report on medical training from the Forum of Irish Postgraduate Medical Training Bodies, which has also called for greater alignment between postgraduate medical training and the workforce planning needs of our health service.
Commenting on today’s Medical Council report, IHCA President Prof Alan Irvine, said:
“This report is a much needed ‘wake-up call’ for the Minister for Health and the health service management. At a time when we need more specialist consultants and doctors, we are losing them. The loss of these highly trained specialists to the health service, together with the continued overreliance on non-training posts and agency or locum staff, is a core reason why we have lengthening patient waiting lists and around one in five approved permanent consultant posts unfilled on a permanent basis.
“Despite Ireland producing the highest number of medical graduates in the OECD, we are still experiencing significant vacancies.
“We have yet to see the required leadership and direction from the HSE and Department of Health on plans to meet the need for an estimated 53% increase in the number of Consultants working in acute hospital-based specialties by 2028, let alone any concrete solutions to fill the one in five permanent approved posts that are currently vacant or filled on a temporary basis.
“A comprehensive gap analysis needs to be undertaken to identify the true mismatch between the future demand for Consultants and the current number of doctors in specialist training. A report from 2020** suggested a 38% increase in trainees was required across all specialties over the subsequent five years if the demand for consultants was to be met. This expansion in training has not happened and the deficits have again been highted in the Medical Council’s report.
“A recent study*** of trainee doctors found that 87% were unlikely to consider the Sláintecare public-only contract being offered, with 94% indicating that they would consider working abroad rather than accepting its terms. It is therefore highly unlikely that the proposed contract in its current form would retain these desperately needed specialists in the Irish system.
“The required gap analysis also needs to factor in the high level of emigration among newly qualified specialists due to the pay inequity imposed on Consultants contracted since 2012, which is the root cause of Ireland’s Consultant recruitment and retention crisis and the unacceptable numbers of people on record waiting lists.
“It is essential that the ongoing Consultant contract discussions deliver on the ‘unambiguous commitment’ made by the Minister for Health to resolve this pay inequity issue. This is crucial if we are to restore trust in the system and attract and recruit the highly trained specialists needed to fill the one in five permanent hospital consultant posts across the country that are either vacant or filled on a temporary basis and meet the increase in demand for care over the next decade.”
* Medical Council ‘Your Training Counts Report for 2019 - 2020’ available at https://www.medicalcouncil.ie/news-and-publications/reports/your-training-counts-19-20.pdf.
** Demand for Medical Consultants and Specialists to 2028, HSE NDTP, 2020, https://www.hse.ie/eng/staff/leadership-education-development/met/plan/demand-for-medical-consultants-and-specialists-to-2028-november-updates-v2.pdf
*** ‘Perceptions of Higher Specialist Trainees and Fellows of the Proposed Sláintecare Consultant Contract and Implications for Workforce Planning in Ireland’, Croghan SM, Murphy EP, Madden A, Murphy RP, Manecksha RP, Journal of Medical and Health Studies 2(2), 45-54, https://doi.org/10.32996/jmhs.2021.2.2.5.
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