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Dr Brian Turner compares health service capacity challenges to “climbing Skellig Michael”  Ireland has one of the lowest number of public hospital beds on a population basis and the fewest specialist doctors per capita – both around 40% less than the EU average; Proportion of medical graduates vs foreign-trained doctors in the health service points to serious recruitment and retention failings when it comes to home-grown medical and surgical talent; 1,400 specialists have voluntarily withdrawn their registration from the Medical Council since the pay inequity was imposed by Government on Consultants appointed since October 2012; Dr Turner: “It’s going to be a very challenging climb to get to where we need to be. Focus must remain on improving the health service...we need to make sure the Government keeps on track.” A leading Economist and Lecturer at Cork University Business School has said the Irish health service is effectively having to “ration care” through long waiting lists and wait times for care, as a result of serious capacity and resourcing deficits. 

Almost a quarter of a million people on outpatient waiting lists at Dublin hospitals (243,255); an increase of 9,500 people this year alone; Number of patients waiting longer than a year for hospital treatment has increased by 18% since 2015, with a massive 3-fold increase in children waiting longer than 12 months for care; Consultant vacancies in Dublin’s acute hospital and mental health services now account for a third of all Consultant posts unfilled on permanent basis nationally. IHCA President Prof Robert Landers: “Our health service, hospital management and medical teams in the capital need to fill the almost 300 vacant permanent Consultant posts across Dublin’s acute hospital and mental health services and significantly increase hospital capacity, ahead of yet another challenging autumn and winter for patients in desperate need of timely care.” 

Latest waiting list figures expose real impact of Government’s decision in 2012 to cut new Consultant pay Outpatient waiting lists have surged by 240,000 (62%) and Inpatient/day case waiting lists have increased by almost 30,000 (60%) over the past decade; More than a 100-fold increase in patients waiting longer than a year for hospital treatment; Number of permanent Consultant posts not filled as need has increased exponentially in past decade to more than 900, 22% of the total approved posts;  New Consultant contract must provide attractive working conditions for existing Consultants, doctors in training and specialists abroad required to fill vacant posts in our public hospitals. IHCA President Prof Robert Landers: “Irish patients have suffered a decade of despair because they are continually denied the timely hospital treatment that they need due to the increasing shortage of hospital Consultants. Since the salary inequity was imposed the number of permanent Consultant posts not filled as needed has increased exponentially to more than 1 in 5. Government policy is driving Consultants abroad, where they are welcomed with adequate staffing levels, funded services and better conditions.”

‘Twindemic’ of flu and Covid has potential to overwhelm our public hospital and their EDs this autumn and winter; Severe capacity problems in public hospitals continue to go unaddressed, with promised hospital beds yet to be opened; Significant doubt over plan to recruit 51 additional ED Consultants given current recruitment timelines of over 500 days and the ongoing exodus of medical and surgical specialists, says IHCA. Commenting on the publication of the HSE Winter Plan 2022-23 today (Tuesday 11 October 2022), Professor Robert Landers, President of the Irish Hospital Consultants Association (IHCA) said: 

Waiting lists, staff vacancies and burnout levels among Consultants all continue to grow •    Ireland’s hospital Consultants meet to discuss the causes and impacts of 910,000 people waiting to be assessed and treated; •    Over 900 permanent hospital Consultant posts vacant or not filled as needed; •    Almost 8 in every 10 Consultants are screening positive for burnout; •    “Getting contract discussions right a watershed moment for those patients waiting too long for care.” – Prof. Rob Landers

Irish Hospital Consultants Association – Statement on Budget 2023 Announcement  The Irish Hospital Consultants Association (IHCA) today, Tuesday 27 September 2022, acknowledged the provisions in Budget 2023, but it warns that it does not address the decade-long public hospital capacity deficits that are the root causes of the unacceptable public hospital waiting lists, which now stand at almost 1 million people awaiting assessment and treatment.  

Prof Robert Landers appointed as President of Consultant body The Irish Hospital Consultants Association (IHCA) has announced that Professor Robert Landers, Consultant Histopathologist at University Hospital Waterford, has been appointed as the new President of the Association.

No waiting list plan will ever work without addressing shortage of Consultants Waiting lists may increase by over 20,000 in 2022 instead of target reduction of 132,000 (18%) despite €350 million Waiting List Action Plan;  Record 910,000 people on some form of public hospital waiting list – surpassing previous high set in September 2021; up more than 68,000 (8%) since August 2020; 49,500 people removed from waiting lists without any treatment in first six months of 2022 through ‘validation’ of lists at a cost of €3m;  Number of unfilled Consultant posts rises to over 900 for first time as spend on medical agency staff increases by 25% in first half of 2022 compared with same period in 2021; Urgent action needed to address public hospital capacity deficits and Consultant vacancies. IHCA President Prof Alan Irvine: “Not one of the 45 actions listed in the 2022 Waiting List Action Plan addresses the fundamental issue of the overwhelming shortage of Consultants, public hospital beds, theatre and other frontline resources. The Government and health service management needs to engage with the IHCA and agree a realistic and properly funded plan with ambitious waiting lists targets. This can only be achieved by addressing the ongoing and deteriorating Consultant recruitment and retention crisis and ending the pay discrimination imposed on Consultants appointed since October 2012.”

Commenting on today’s publication of the Medical Council’s ‘Medical Workforce Intelligence Report 2021’, the Irish Hospital Consultants (IHCA) said that the Irish health system is losing its highly trained specialists and future Hospital Consultants at an alarming rate, after the report revealed a quarter of all doctors who voluntarily withdrew their registration last year were specialists. 

Over six million people received care in the public hospital system last year by a Consultant, with 907,617 people still waiting to be seen;  IHCA says if Budget 2023 does not provide sufficient resources and deliver them in full, it could take some 15 years to clear backlog of deferred care.  Meanwhile, hospital Consultant vacancies at an all-time high of 882 permanent posts not filled as needed; At least 300 hospital beds not delivered under previous Budget, leaving people waiting longer for critical procedures and treatment; an estimated 5,000 additional beds are required by 2030.   IHCA President, Professor Alan Irvine: “Motivation to fix the problems in Ireland’s health system is waning, at a time when energy should be firmly behind implementing the solutions, which frontline hospital staff have repeatedly called for over the years. Our ask of the Government for Budget 2023 therefore is simple: deliver it. Give us the essential resources, the capacity and the Consultants to treat our patients on time.”   Speaking today (Monday 29 August 2022) at the publication of its pre-Budget submission, the Irish Hospital Consultants Association (IHCA) said that the frontline knowledge and operational learnings from the Covid crisis are not being capitalised upon, while the extreme shortage of hospital Consultants and beds mean rising patient waiting lists will continue.    Publishing analysis today, the IHCA highlighted that the consistent failure to deliver on plans, budgets and Ministerial promises is leading to the continued exodus of medical and surgical talent abroad and increased waiting times, with over 907,000 people now on some form of hospital waiting list across Ireland.  These numbers come at a time when more than 880 permanent hospital Consultant posts are not filled as needed.    The IHCA has previously pointed to the false economy created by the unilateral pay cut imposed by Government on Consultants appointed after 2012. They say that this discrimination, coupled with capacity and investment deficits in the system, has created unattractive working conditions and led to a recruitment crisis resulting in delayed care, poorer patient outcomes, and hundreds of millions in increased State compensation payments for clinical claims and higher agency/locum costs to partially fill vacant Consultant posts.    On beds, the IHCA pointed to promises to add an additional 1,146 beds by the end of last year have also fallen short, with an estimated 317 of these beds yet to materialise. In addition, an estimated 5,000 additional beds will be required by 2030 to provide timely care.   Some Consultants have pointed to what these serious capacity deficits mean for their ability to deliver critical services. Citing examples, of the adverse effect of vacant Consultant posts on patients, such as South Kerry CAMHs services and in hospitals throughout the country.   The IHCA highlighted how one Surgical Oncologist was appointed without access to an operating list or outpatient clinic for almost a year; while theatre capacity for a number of surgeons in another hospital was reduced to 50% compared to pre-Covid levels and has not been restored yet.    The Association projects that even with increased hospital activity compared with pre-pandemic levels, it may still take some 15 years to clear the backlog of deferred care built up during the pandemic.   Commenting, IHCA President, Professor Alan Irvine said: “Over six million people were provided with medical and surgical care in our public hospital system last year by hospital Consultants – we are stretched like never before. Despite the immense pressures placed on those on the frontline at the height of Covid, there was a semblance of hope that its impact would be a catalyst to finally tackle the obvious problems.    “Instead, motivation to fix the problems in Ireland’s health system is waning, at a time when energy should be firmly behind implementing the solutions.   “A year’s worth of time and momentum has been lost, resulting in worsening patient waiting times.    “We know what the problems are and we know what is required to fix them – we can indeed fix them. But we need the beds and the Consultants to treat the patients in a timely manner. There is nothing new here. We all know what is necessary. These core elements have been committed to in successive plans, budgets and Ministerial promises, but not delivered. The stressful, overstretched business-as-usual approach is not an option. It is time for the Government to stop expecting frontline medical and other staff and their patients to put up with unworkable conditions that don’t exist in public hospital services in developed countries.    “Our ask of the Government for Budget 2023 therefore is simple: deliver it. Give us the essential resources, the capacity and the Consultants to treat our patients on time.”   ENDS   For media enquiries, contact 360, A FINN Partners Company: Gerard O’Shea | gerard.oshea@finnpartners.com | +353 (0)87 413 7471 Niamh Kinsella | niamh.kinsella@finnpartners.com | +353 (0)87 921 9711