Chronic shortage of hospital consultants and capacity severely impacting patient care according to the IHCA

Saturday 6th October 2018: The widespread and chronic shortage of hospital consultants, beds and other facilities in public hospitals is severely impacting patient care across the country, according to the Irish Hospital Consultants Association (IHCA). At their Annual Conference in Galway today, the IHCA President, Dr Donal O’Hanlon, said a combination of having one of the lowest numbers of specialist hospital consultants in Europe and having over 500 unfilled posts is resulting in patients not being able to access timely medical care. The IHCA today held its 30th Annual Conference in Galway, which was attended by hospital consultants from across Ireland.

Speaking at the Annual Conference, President of the Association, Dr Donal O’Hanlon, said: “Our public hospitals are in crisis and not enough is being done about it. We have hundreds of thousands of patients who are being treated on trolleys and are on waiting lists because we don’t have enough hospital beds and we have over 500 permanent hospital consultant posts which are unfilled. The root cause of the vacancies is the persistent discrimination by the State against new entrant consultants who are being paid up to 57% less than their colleagues who were appointed prior to October 2012. Patients can ill afford to have nearly one fifth of the permanent consultant posts in our hospitals unfilled, especially in view of the fact that Ireland has 40% fewer hospital consultants than the OECD average.  

“The lack of capacity in our public hospitals and the shortage of consultants is damaging patient care and is having a catastrophic impact on our health service. Some of the numerous examples include:

• In the Dublin Midland Hospital Group there are over 6,500 new patients waiting to see a Consultant Urologist. St James’ Hospital has advertised a Consultant Urologist post twice and failed to recruit.

• In the eye surgery services in Cork around 6,000 patients are awaiting outpatient reviews. Consultants are concerned that some patients will lose vision permanently and irreversibly as a result of the delays.

• Over 6,500 children are waiting for MRI and Ultrasound scans in Crumlin and Temple Street hospitals.

• In Waterford a much needed Consultant Endocrinologist post has failed to fill over the past 5 years.

• In the Louth and Meath area around 2,400 outpatients are awaiting othopaedic surgical appointments.  Waits include around 8 months for 'urgent cases' and 20 months for 'routine' cases.

• In Galway restrictions on the availability of bone density scans has led toa  waiting list of around 6,000 patients.  In addition, Galway University Hospital is suffereing from one in three operating theatre rolling closures which is impacting adversely on the delivery of surgical care to patients.  This is resulting in one of the worst elective surgical waiting lists in the country.

• In Cork University Maternity Hospital there are over 3,600 people awaiting outpatient appointments and 340 awaiting inpatient and day-case appointments. Two of the fifteen permanent Consultant Obstetrician/Gynaecologists in CUMH have emigrated to the UK in the past 18 months and a third is on a career break.

• Over 220 patients with significant brain injuries or stroke are waiting to be admitted to the National Rehabilitation Hospital for treatment. Some patients with brain injury and severe disability from stroke can wait more than a year from referral to the NRH to admission for formal rehabilitation in the hospital.

   

• Over 6,500 children are waiting for MRI and Ultrasound scans in Crumlin and Temple Street hospitals.

Commenting on the lack of hospital beds, theatre operating space and other essential facilities, Dr O’Hanlon said: “Contrary to common perception, our public hospitals are poorly funded compared to other countries in Europe. We spend much less of our total health budget on acute hospitals than other countries. Despite all  the promises from Government, it is already too late for the 100,000 acutely ill patients who are destined to be treated on trolleys this year. It is a major concern that heretofore on average it has taken around eight years from design to opening additional beds in public hospitals compared with less than half that time in private hospitals. While the Department of Health and HSE commissioned Prospectus Report in 2009 recommended that the Intensive Care Unit (ICU) bed capacity in our public hospitals should be increased by 45% within one year and doubled by 2020, there has been no increase in ICU capacity nine years later.

The IHCA President said that there is a distinct lack of urgency in providing the extra beds and other hospital facilities that the Government has committed to and provided funding for in the National Development Plan published earlier this year. He said these beds and facilities are needed without delay.

“Patients are deteriorating on lengthy waiting lists and the State is putting in place sticking plaster solutions of outsourcing through NTPF or facilitating patients to travel abroad for operations that have for decades been provided in our public hospitals. There is clearly an urgent need for a Multi Annual Plan committing precisely when the 2,600 additional acute hospital beds will be put in place so that patients on trolleys and awaiting treatment can be provided an appropriate standard of care.

“Our population is growing at a rate five times higher than the EU average and this has significant implications for our health service. We need to plan for the future and put in place the public hospital capacity that can cater for actual demand for acute care and not ignore predictable growth. The failure of the State to provide needed capacity makes it impossible to provide the care that our patients need and deserve.”

The Public Service Pay Commission report confirms the IHCA position that there is a general difficulty in recruiting Consultants and that action is required to end the particularly severe reductions in pay applied to Consultants since 2012. The Report proposes that the relevant parties should jointly consider further measures to address the pay differential between newly appointed Consultants and their colleagues appointed before 2012.  However, the health service management has not acted on the proposal despite the IHCA’s engagement with them on this urgent issue.

A recent IHCA survey of 300 recently appointed consultants confirms that over 70% are seriously considering resigning from their public hospital posts unless the discriminatory salary terms imposed on them by the State are corrected. “New Entrant Consultants have made it abundantly clear that if this persistent and blatant discrimination continues they are likely to leave in much greater numbers. It is essential to end the discrimination and restore pay parity in order to provide a better service to our patients,” concluded Dr O’Hanlon.

ENDS

For further information contact:

James Dunny, FleishmanHillard 086 388 3903