The public health service is facing a perfect storm of an ageing population, long waiting lists, a recruitment and retention crisis among doctors, major bed shortages and continuing Covid-related issues, the Irish Medical Organisation (IMO) has warned in its pre-budget submission.

It pointed out that last weekend marked the 10-year anniversary since the then-Minister for Health, Dr James Reilly, announced that the pay of new consultants was to be cut by 30%. This decision created a two-tier system for consultants working in the public health system and has widely been acknowledged as adding to the recruitment and retention problems of these doctors.

Currently, almost 900 consultant posts are vacant or filled on a temporary basis.

“The consequences of that decision have been entirely negative and are demonstrated most clearly by the fact that we have almost 900 vacant or temporarily filled consultant posts and dangerously long waiting lists which are causing significant risks for patients and negative health outcomes,” commented Prof Matthew Sadlier of the IMO consultant committee.

There are also major issues for other doctors in the health service. For example, there is a shortage of GPs nationwide, while many NCHDs continue to work unsafe and illegal hours due to staff shortages.

However, despite these issues being flagged for some time, there is still no medical workforce plan, the IMO noted. It has called for the development of a comprehensive 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”.

According to IMO president, Dr Clive Kilgallen, there is “a direct correlation between shockingly high waiting lists and the failure of the health services to recruit and retain sufficient numbers of doctors”.

The IMO’s pre-budget submission is calling for a major investment in medical manpower, focusing on measures to attract and retain senior doctors in the public health service and reverse the trend of emigration among newly qualified doctors.

It is also calling for investment in acute bed capacity and infrastructure to include:

-Immediate investment in modular builds to relieve the capacity strains on emergency departments

-The resourcing of a multi-annual programme of investment in acute bed capacity to include 5,000 additional public acute beds

-Ongoing investment in e-health.

“We know that access to appropriate and timely care is  critical to good health outcomes. Unfortunately, with delays in our emergency departments and waiting lists at the levels we are experiencing, the risk of poor outcomes and mortality increases. Unless we plan for a service that has sufficient capacity to meet demand, we are going to be in an endless cycle of crisis,” Dr Kilgallen added.