Irish Medical Organisation launches pre-budget submission
Warns that system is facing a perfect storm and a difficult Winter looms.
Thursday 15th September 2022. The Irish Medical Organisation has warned that the public health services are facing a perfect storm of a growing and aging population, unprecedented numbers on waiting lists, a recruitment and retention crisis amongst doctors in all specialties, a severe bed shortage and a fragile and weakened service due to Covid.
The organisation set out a list of concerns about the health services but chief amongst them was the medical workforce crisis that it warned affects all parts of the health service with:
- Almost 900 consultant posts vacant or filled on a temporary basis
- A shortage of GPs around the country with less than 150 additional GPs in the PCRS system in the last 4 years
- NCHD teams in many hospitals that have significant gaps in rotas meaning they have to work unsafe and illegal hours to keep the service going
These issues have been long identified yet we still have no medical workforce plan. The failed policies of successive governments where investment is simply not matching demand has led to a system that is constantly in a state of crisis with too few beds, too few doctors and ever-increasing waiting lists and challenges in accessing services in a timely manner.
Speaking today, the President of the IMO, Dr. Clive Kilgallen said; “There is a direct correlation between the shockingly high waiting lists and the failure of the health services to recruit and retain sufficient numbers of doctor. We are being asked to stretch ourselves beyond capacity each and every day. Our patients are facing intolerable delays for services, and we know that access to appropriate and timely care is critical to good health outcomes. Unfortunately, with delays in our EDs and waiting lists at the level we are experiencing, the risk of mortality and poor outcomes increases. Each year we are told of the significant budget attached to health, in comparison to previous years, and while all investment is welcome, we must be cognizant of the fact that our population has significantly increased in recent years, and we have a growing older population who need more complex care. Unless and until we plan for a service that has sufficient capacity to meet demand we are going to be in an endless cycle of crisis.”
The IMO has urged the development of a comprehensive medical workforce plan to meet current and future population needs with clear annual targets to increase and align the number of specialist training posts with current and future requirements for doctors.
The IMO submission also focuses on the ED crisis and the beds issue, where the number of hospital beds per 1,000 of the population was just 2.9 (beds) v the EU average of 4.7. There has been a 21% increase in deployments of the HSE Full Capacity Protocol in public hospitals already this year compared to the full year 2021 (deployed 1,343 in the eight months to end August compared to 1,106 times in the 12 months of 2021).
Among its key recommendations the IMO has called for
Investment in medical manpower:
- Urgent measures to attract and retain senior doctors in our public health service and reverse the trend of emigration among our newly qualified doctors.
- Immediately resolve issues of excessive working hours and non-payment of overtime;
- Investment in supports for General Practice – including supports for expansion of Practice teams and further investment in structured programmes of care in General Practice.
- Investment in Prevention and our Public Health and Community Health Services.
Investment in acute bed capacity and infrastructure:
- Immediately invest in modular builds to relieve the capacity strains on our Emergency Departments;
- Resource a multi-annual programme of investment in acute bed capacity to include5,000 additional public acute beds;
- Introduce tax incentives to GPs to encourage the development of GP infrastructure, and engage with the IMO in developing specific supports to help newly qualified GPs to establish as principals;
- Ongoing investment in Health and Social care needs of Older People;
- Invest in Specialist Mental Health Services and Integration of Mental Health Care into the Wider Health Service;
- Ongoing investment in eHealth.