SATURDAY ROSTERING WITHOUT SUPPORT SERVICES IS "CLINICAL AND ECONOMIC INSANITY" AND WILL WORSEN WAITING LISTS CRISIS

Critical lack of staff and support services make weekend rostering ‘unworkable’Shifting scarce consultants to low-support Saturdays dismantles high-productivity Monday operations 

The Irish Hospital Consultants Association (IHCA) has warned the Minister for Health Jennifer Carroll MacNeill: "You cannot roster your way out of a capacity deficit".

The IHCA insists Ministerial demands to push hospital consultants onto weekend rosters without providing essential supporting staff, diagnostics, or bed capacity will actively damage patient care and deepen the waiting list crisis. 

As approximately 70% of consultants have signed the new Public-Only Consultant Contract (POCC), which includes Saturday work, the Association said there is a willingness on the part of hospital consultants to work weekends. However, the rostering of consultants to provide normal scheduled care at weekends is unworkable without additional staff within the system. 

"A consultant working on a Saturday without an operational radiology team, full laboratory support, or available step-down beds cannot discharge patients or run complex clinics," Professor Gabrielle Colleran explained. "It simply shifts senior decision-makers into an empty room while stripping essential cover from Mondays, when the full hospital machine is actually built to run.”

The real bottleneck in the health service is the severe and chronic shortage of consultants, diagnostics and beds, the Association points out. The Government itself recognises that Ireland has a significantly below average number of specialist doctors, which remains one third below the EU average despite recent increases in consultant staffing. 

Responding to recent comments from the Minister for Health on consultant working patterns, IHCA President Professor Colleran stated that insisting on the provision of forced weekend routine care in an under-resourced system represents a ‘politically driven illusion of progress’.

"You cannot roster your way out of a capacity deficit," said Professor Colleran, in a frank message to the Minister. "Shifting a severely scarce clinical workforce from high-productivity Mondays to low-support Saturdays, where basic access to diagnostics, allied health, and community step-down beds is virtually non-existent, is bordering on clinical and economic insanity."

The IHCA notes that while proper healthcare is ‘team-based’, a recent members’ survey showed 78% of consultants "never" or "rarely" have access to sufficient support staff (including pharmacists, phlebotomists, radiographers, administrators, and hospital management) outside normal hours, at weekends, and on bank holidays at the same level as standard weekdays.

These cumulative issues result in the situation that a consultant working on Saturday is a consultant missing on Monday, when patient demand is historically highest and the full hospital infrastructure is running.

This is the basic reality of a system operating at capacity. Consultant cover in Ireland is like a blanket on a hospital bed: if you pull the blanket up to cover the shoulders on Saturday, you leave the feet exposed on Monday, the IHCA warned.

Citing her own example, as a consultant in paediatric radiology, Professor Colleran said that operating alone on a Saturday to perform ultrasound scans, she can scan 16 children at a maximum.

While on Monday, with a full multidisciplinary team on site, three sonographers, scanning 16 children each, can together achieve an output of around 50 patients. 

Furthermore, while the Minister aggressively audits frontline doctors, the internal reality of the health service tells a different story, the IHCA says.

Some 86% of consultants are already working above their contracted hours, with 41% providing at least seven hours of uncompensated, discretionary work every single week. 

The health service would collapse overnight without this voluntary effort. Ignoring this, while refusing to formally engage with the IHCA representative body since March 2025, is a staggering failure of political leadership. 

The credibility of the Minister's contract audits is further undermined by the state's own outdated IT infrastructure which struggles to capture multi-week rotas, making it a poor tool for accurately measuring the hours consultants are already fulfilling.

"If the Minister wants a functional six- or seven-day health service, she must first provide the beds, the diagnostics, and the support staff required to run it. Forcing frontline clinicians into unworkable weekend schedules is a political distraction that treats patient safety as an afterthought,” she said.

Ends 

For further information on this press release, please contact:

Claire O’Flynn claire@communicationsclinic.ie, 085 8001275

Nicola Anderson, nicola@communicationsclinic.ie,  086 2009691

Eoin Murphy eoin@communicationsclinic.ie,  085 8524979