[Ms. Susan Clyne, CEO of the IMO]

 The IMO is the trade union and representative body for all doctors in Ireland who are delivering care to patients across the health services; consultants, public health doctors, community health doctors, GPs and NCHDs.

 The fundamental problem within our health services is one of capacity and this predates COVID.  We have restricted patient care to match the deficits of our services rather than investing in those services to meet patient need and demand.  The Health Service Capacity Report was published in 2018 but little or no progress has been made since.

 COVID has resulted in extreme pressure on our health services.  Our response should not be to limit all other care but to proactively increase capacity to allow for non Covid care pathways and to create capacity for any Covid surge.  To do otherwise will only compound the problem.  It is inevitable that patients whose care has been delayed will present with more complex needs as they deteriorate and they will suffer negative health outcomes.  Mortality rates will increase.

 We now have a situation where capacity will be reduced by up to 50% at the same time as they are:

Over 800,000 people waiting for an outpatient appointment or inpatient care.

Mounting pressures on our Emergency Departments

Extremely limited referral pathways for GPs and increased pressure on GP services when patients cannot access secondary care, diagnostics, mental health services and other community supports.

 Every year, for far too many years, now, we have severe overcrowding in our Emergency Departments with patients languishing on trollies, elective procedures cancelled, lengthening waiting lists and hospitals operating at dangerous levels of capacity.

 This year will be worse with the additional impact of COVID.

 In summary:

 We have too few beds and need to plan for an additional 5,000 public acute beds and 300 additional ICU beds.  In this context we must immediately embark on a temporary build programme in tandem with longer term builds.

We have over 500 vacant consultant posts and for many years the system has not been capable of attracting sufficient numbers of consultants due to inequitable pay policies.

General Practice and the much needed shift of care to the community must be planned and resourced.  There is little additional capacity in general practice currently.

We must strengthen public health capacity – Public Health is understaffed and undervalued within our system.

Care of the vulnerable and elderly in our society requires urgent attention with significantly more resources deployed to allow people to remain at home.

We need to continue to invest in prevention with appropriate resourcing of our vaccination programmes and investment in diagnostics and treatment pathways to support our screening programmes.

And we need to invest in eHealth across all hospitals and community health settings.

 Since the commencement of the pandemic, Doctors and all other health care workers have shown dedication to patients, professionalism and agility in adapting to new ways of working.  We now appeal to you, members of the Committee and the new Government to respond in kind and support us by investing immediately.

This is a health crisis and we must respond accordingly and prioritise investment in our health services.

Thank you.