Irish Medical Organisation

IMO Statement on de Buitléir Report

Monday, 26th August, 2019.  The Irish Medical Organisation (IMO) notes the launch of the Government-commissioned de Buitléir Report today.

The Report reiterates the main issues on which the IMO have been campaigning for a number of years:

  1. The difficulty in recruiting consultants to our public hospitals and the need to address the pay inequity for those consultants appointed since 2012. Currently we require 1,600 additional consultants to implement the recommendations of the Hanly report, by 2026 we will need 1,900 additional consultants.
  1. This recruitment crisis was brought about by a political decision, and it will require a political decision to remedy it.


  1. The need to increase capacity in our public health system through the introduction of between 2,600 and 7,150 beds in line with Health Capacity Report, depending on the level of investment in delivering care in the community through general practice and primary care.

The Report also acknowledges that in the context of any policy decision to remove private care from public hospitals there will be serious consequences:


  1. It is going to be hugely expensive to remove private care from public acute hospitals.  The report speculates on a figure of approximately €6bn or more over the coming decade of implementation. 


  1. There is no evidence that capacity will improve or that waiting lists will be alleviated by such a move.


  1. Complex contractual issues will need to be addressed to attract consultants to work in Ireland as the working environment, terms and conditions are much more attractive in other health systems abroad.


Today’s report is significant in that it highlights the consequences of that fateful decision in October 2012 and the importance of resolving recruitment crisis before undertaking such wide ranging reform of the system.


Commenting on the publication of the report, President of the IMO Dr Padraig McGarry said: “This report acknowledges that taking private care away from our public hospitals will cost over €6 billion over ten years, but as high as that figure is, an even more pressing issue is that the Government will not be able to implement any meaningful change without enough doctors to deliver care to patients. The Government can commission all the reports it likes, but the reality is that if we do not see better working conditions and an end to the gaping pay inequality between consultants as a matter of urgency, then we will never come close to any real reform in the system. Our doctors are understandably fleeing our health system in their thousands while the Government looks the other way and patients suffer. This cannot continue.” 


The IMO said that the Government cannot use this report as another delaying tactic, and that it was positive to see that the report’s authors acknowledge that additional resources were needed.


“We have the lowest rate of medical specialists per capita in the EU and we currently have over 520 consultant posts that are unfilled or staffed on a temporary basis – this is completely unsustainable and unacceptable. This detailed report reaches conclusions that anyone working in the health service can confirm: that far more resources, and far more doctors, are needed if we are to offer patients what they need and build the foundations on which our health system can thrive in years to come.”

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