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Concerns mount among Consultants as Irish hospital services continue to bear brunt of healthcare pressures;  Hospitals could see 1,000 admitted patients being treated on trolleys on a single day in the weeks ahead; As peak of winter illness hits, 51 additional Emergency Medicine Consultant post have yet to be delivered under HSE Winter Plan 2022/23; IHCA: “To move away from this constant wheel of crises, the Government must put in place the capacity expansion that is needed and the HSE must empower hospitals and community services to make decisions and take the actions needed to provide timely and safe care to their patients.”   Today (04 January 2023), the Irish Hospital Consultants Association (IHCA) has expressed its concern over the continued pressures being faced by Ireland’s acute hospital services as extreme levels of overcrowding in our emergency departments and un-safe capacity limits hit record new highs.

52,200 people on NTPF waiting lists in UL Hospital Group and an additional 25,100 waiting for urgent diagnostic scans; Almost 1,600 patients admitted to UHL Emergency Department treated on trolleys last month – the worst November on record – and 17,500 this year;  Consultant recruitment crisis and worsening capacity deficits in region’s hospitals is root cause of delays in providing care, with record 1 in 3 permanent Consultant posts vacant or not filled as needed; At least an additional 302 inpatient beds and 63 day case beds needed by 2036 to address current shortfalls and meet increased patient demand. IHCA President Prof Robert Landers: “The extreme shortage of Consultants and worsening capacity deficits across the UL Hospitals Group are the main contributors to the unacceptable delays in providing care to patients in the Mid-West region.” 

€70 million allocated to Waiting List Action Plan left unspent as one-fifth of the population remain on waiting lists  

Commenting on the agreement by Government of the proposed new Consultant contract today, the President of the Irish Hospital Consultants Association (IHCA), Professor Rob Landers, said:   “We have communicated our views on Minister Donnelly’s proposal consistently to both the Minister himself and the Secretary General of the Department of Health.   “Currently, over 900,000 people are on a waiting list to see a hospital consultant. Over 900 permanent Consultant posts are unfilled. For a decade, we have been calling on Government to constructively engage so as to address these stark realities.    “Despite progress in discussions over the recent period, the Minister and Government have moved on and ended talks with representative bodies.   “There remain a number of critically important issues that need to be addressed to ensure any proposed contract will reduce patient waiting times and address the Consultant recruitment and retention crisis.    “The Donnelly proposal must stand up against international standards in order to make Ireland’s health service a place that medical and surgical specialist want to work. This is the lens through which our members will evaluate this proposal.   “We will also be looking at this from the perspective of the almost 1 million people currently waiting for essential care across the country, to assess whether the core objective of providing patients with timely essential care can be achieved through this proposed contract.     “We have a detailed consultation process to undertake with our membership now, including those currently working abroad, to determine Consultants’ final view on the Donnelly proposal.”   ENDS  

1 in 12 children are on some form of hospital waiting list due to growing Consultant vacancies and worsening capacity deficits, says IHCA  98,000 children on some form of NTPF waiting list; more than 1 in 4 (27,000) waiting longer than a year for treatment or assessment in public hospitals, due to capacity deficits and an extreme shortage of Consultants; Additional 8,000 children awaiting diagnostic scans at the three Dublin children’s hospitals not included in NTPF waiting lists;  21 additional children (+9%) added to waiting lists for scoliosis related surgeries since start of the year; Record 918 permanent Consultant posts not filled as needed at end of September, 23% of the total approved posts; an increase of 190 unfilled Consultant posts (+26%) in past two years; New Consultant contract must provide attractive working conditions to persuade Irish trained specialists to return home from abroad, fill the vacant Consultant posts and address unacceptable waiting lists. IHCA President Prof Robert Landers: “The monthly NTPF figures have recorded 98,000 children on waiting lists for hospital care, with more than one in four of these children waiting longer than a year to be treated or assessed in public hospitals due to capacity deficits and an extreme shortage of Consultants. This is resulting in thousands of children not getting the care they need in a timely way, and the real possibility that they will suffer health and developmental issues that could have been reversed or mitigated against if only they were seen in time.”   The Irish Hospital Consultants Association (IHCA) has today (Friday, 11 November 2022) expressed its extreme concern at the number of children now waiting for an appointment to be treated or assessed in public hospitals.

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