Health Budget 2021 must fund urgent capacity increases now and not more promises as time is running out

• Irish Hospital Consultants Association launches Pre-Budget Submission; 
• Consultants say Covid-19 pandemic has further exposed the stark reality of longstanding and critical hospital capacity deficits; 
• Urgent need to open 2,000 additional inpatient/day-case beds; double ICU capacity to the recommended 579 beds and open 1,300 additional transitional intermediatory-care step-down beds before the winter for the year ahead to provide essential hospital care to patients; 
• Fill the 500 vacant permanent consultant posts without delay to urgently assess the 610,000 outpatients and treat the growing backlog of patients on waiting lists who need essential care; 
• Irish Government spends some €600m per year less on acute hospitals than European neighbours. 

IHCA President, Professor Alan Irvine: “This Budget must fund pressing acute hospital capacity increases for the Winter and year ahead to deliver essential hospital care in a very challenging Covid-19 environment. What is needed is Health Budget 2021 to address the stark acute hospital capacity deficits, with clear, fully-funded and timelined decisions to end the deficits failing our health system. This is not a time for promises or excuses, instead we need delivery on earlier commitments so our hospitals have the capacity they need.”

The Irish Hospital Consultants Association (IHCA) has said that any additional investment in beds and services will only work if 500 vacant consultant posts are filled with sustainable permanent appointments.

The organisation was commenting today at the launch of its Pre-Budget Submission 2021, where they called on Government to take specific, focussed, and funded actions to address persistent deficits in our public hospitals. 

With record numbers of people on waiting lists to be assessed and treated by a hospital consultant, the organisation said Budget 2021 presents an opportunity to ensure that acute hospital and mental health services will be fully staffed and resourced to deliver timely access to quality care for all patients. 

Highlighting how Covid-19 has further exposed the true scale of the existing deficits in the health system, the IHCA said that for increased investment in beds and services to make a real difference for patients, filling vacant permanent consultant posts is essential as agreed by Minister for Health, Stephen Donnelly and Cabinet colleagues over the past two years. 

The organisation’s submission cites how Ireland has one of the lowest levels of acute hospital funding, with €575.473 million per annum less funding for our hospitals in 2018/2019 than the EU15 average (spend per capita, based on current estimated population of 4.89m).* 

The IHCA is calling for fully-funded practical plans and workable solutions in the health budget, prioritising the urgent opening of 2,000 additional inpatient/day-case hospital beds, in addition to maintaining and/or re-instating the 2019 bed stock, doubling ICU capacity and opening 1,300 additional transitional intermediatory-care step-down beds before the winter to provide essential hospital care. Investment is also required to increase space in hospitals for social distancing in all services. 

Consultants also say the persistent and critical shortage of hospital consultants will continue to impede the health system unless action is taken to urgently fill the 500 vacant permanent posts and expand consultant numbers. The low number of Consultant posts in Ireland is impacting on patient care and contributing significantly to the unacceptable delays that patients experience when they need to see a specialist or receive treatment. 

It is expected that the number of patients needing essential acute hospital care could be far greater than waiting list figures suggest, as those who had care disrupted or delayed have not yet come forward to seek follow-up care or referrals. 

According to the IHCA, the significant decrease in inpatient/day case and outpatient activity in acute hospitals during 2020 as a result of the pandemic will require a corresponding increase in acute hospital appointments and funding in 2021 to address the backlog of patients requiring essential care. 

The organisation has set out 12 key recommendations for Budget 2021, including: 

• Resource and open 2,000 additional inpatient/day-case hospital beds, double ICU capacity to 579 beds and open 1,300 additional transitional intermediatory-care step-down beds before the winter for the year ahead to provide essential hospital care;
• In addition, fast-track in the shortest possible timeframe the opening of the 2,600 acute hospital beds and 4,500 community step-down and rehab beds committed to in the 2018 Capacity Review and provided for in the National Development Plan;
• Open and resource an additional 300 psychiatric beds for acute adult inpatient and child and adolescent cases - ensuring that some of our youngest and most vulnerable patients can be admitted to age-appropriate units; 
• Fill the 500 vacant permanent consultant posts without delay to urgently assess the 610,000 outpatients awaiting appointments and treat the growing backlog of patients awaiting inpatient and day case essential surgical and medical care;
• Immediately end the consultant salary inequity imposed by the Government on appointments since 2012, a policy change supported by the Minister for Health, Stephen Donnelly and his Cabinet colleagues over the past two years. This is essential to restore trust and encourage the recruitment and retention of skilled consultants; 
• Introduce and resource a maximum waiting time of 18 weeks, instead of the current 52 weeks, following a GP referral for a consultant outpatient appointment, and instead of the 64 weeks for inpatient/day-case public hospital treatment.

IHCA President, Professor Alan Irvine said: “This Budget must be founded on the reality of delivering care in a Covid-19 environment, be cognisant of the pre-existing deficits and make clear, fully-funded decisions  addressing the failings in our health system. This is not a time for sweeping promises or excuses. We need specific, focussed, and funded actions that will make a difference for patients. 

“Prior to the pandemic, our health system was battling with significant consultant and capacity shortages, contributing to mounting waiting lists – a situation that left us vulnerable to a crisis like Covid-19. 

“A return to ‘normal’ is not an option; we need a return to better. Waiting lists, trolley crises, under-staffed services must become a thing of the past not just to provide resilience in the system for any future pandemic – but to provide the timely and quality access to care that our patients need and deserve.

“Healthcare is an essential right and must not fall victim to the political bargaining and shifting of spending margins in budget negotiations.” 

ENDS

Notes for editors: 

* OECD.Stat. Government/compulsory schemes excludes voluntary insurance schemes – such as voluntary private health insurance – as well as household out-of-pocket payments. 10/07/2020.

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