IMO identifies key challenges and recommendations

31 August 2016:  The Irish Medical Organisation (IMO) has said that that the primary strategic goal over the next ten years should be to develop a universal healthcare system that aims to secure access to adequate, quality healthcare for all when they need it and at an affordable cost.   In a submission to the Oireachtas Committee on the Future of Healthcare the IMO presents the evidence to support the best outcomes for patients and which provide value for money for the State, and outlines 14 recommendations which should be included in the Committee’s final report.   

Dr. John Duddy, President of the IMO, said "the health service is complex with legacy issues that need to be sorted out, many of which are a direct result of underfunding. What is required is long-term planning and careful assessment of the  financial and manpower resources required right across the health system. It is critical that any plan prioritises the areas most in need.”  

The IMO has identified three key challenges which must be overcome to deliver on a Universal Health System:

• The requirement for enhanced health services to meet the needs of a growing population
• The current inability to recruit or retain doctors to our health services
• The absence of a planned funding model to support the Health Services

The IMO is making the following recommendations in its submission:

• A detailed assessment of the number of beds is required in the public hospital system to meet current and future demand, as is the development of a demand-led range of social care, long-term residential care, and community care services to cater to the needs of our elderly population. 

Irish hospitals operate at well over 90% capacity, and above the safe occupancy threshold of 85%, beyond which patients are put at greater risk. Approximately 3,500 more in-patient beds are required to raise capacity in this country to that of the current west-European average.    

• That the Department of Health and the HSE agree a new strategy with the IMO for the development of general practice recognising the need for the management of chronic disease in the community, continuity of care for patients, and a greatly expanded number of general practitioners. 

The number of those aged 65 years and over is expected to increase by over 40% during the next ten years, with the prevalence of chronic disease expected to rise by around 5% per annum during that time. Evidence cited by the IMO demonstrates that investment in general practice can lead to lower patient mortality, lower emergency department utilisation, and lower overall health expenditure and it is imperative that we support general practice the front-line of primary care.  

• The development of a new mental health strategy that will put mental health on a par with physical health in terms of community-based an acute services, as well as appropriate funding.

Mental health disorders affect one in four adults in Ireland and are the leading cause of disability worldwide, but less than 50% of people receive professional help and even less receive appropriate care. Ireland currently spends just 6% of its health budget on mental health compared with 10-11% in the UK, France and Germany and 8.24% recommended in A Vision for Change.

• A detailed manpower plan to identify the required staffing to levels in order to provide a high quality health services, delivered in their most appropriate location. 

Measures must be taken immediately to improve training pathways, and recruitment and retention of our medical workforce in Ireland.  A manpower action plan must be put in place to retain skilled medical professionals in Ireland. Ireland has the highest reliance on foreign-trained doctors in the EU; around two-thirds of interns and over one-third of trainees do not see themselves practising in Ireland in the foreseeable future; and approximately 300 consultant posts remain vacant for lack of suitable applicants

Dr. Duddy has called for an open public debate on health service funding to determine what model is most appropriate to achieve universal healthcare.  “We do not want a flawed process to start and then fail. The model and plan for our health service must be destined to succeed.”

Read the full submission here