Health services face another chaotic winter and this could lead to trolley figures exceeding 1,000, the Irish Medical Organisation (IMO) has warned.

According to IMO president, Dr Peadar Gilligan, a lack of Emergency Department (ED) resources and beds, along with staff shortages, look set to combine and create a ‘perfect storm' in hospitals over the coming months.

As a result, the number of patients left waiting every day on trolleys in hospitals nationwide could break the 1,000 barrier.

"The IMO has long warned that you cannot have a removal of resources without an impact on services. Successive governments' lack of investment in our health service will be seen in hospitals across the country this winter. We will be told in January that it is a ‘flu crisis' or a ‘winter crisis', but it is not. It is a failure of policy," Dr Gilligan commented.

He insisted that the extra demands placed on hospitals during the winter months could be met if there was more investment in infrastructure and recruitment.

"We cannot expect to have a health service which is meeting the demands of the population when we are training doctors to send them abroad. A sustained campaign of recruitment - backed fully by the Government - is needed to fill existing vacancies and improve services.

"Patients being cared for in dangerously overcrowded EDs are a function of an acute hospital system working beyond its available capacity. The capacity constraints include nearly 500 unfilled consultant posts and 2,650 less beds than we currently require in Irish hospitals, and a need for over 1,000 additional GPs," Dr Gilligan said.

Meanwhile, the issue of staff recruitment has also been highlighted by the Irish Nurses and Midwives Organisation (INMO), which recently revealed that nurses and midwives are being offered 20% higher wages by agencies compared to the public sector, often to work in the same job in the public health service.

It said that this clearly shows that public sector pay in nursing is below the real market rate, which is in turn having an impact on the recruitment and retention of nurses in the public health service.

It pointed out that Xtra Nursing Agency, which offers agency staff to the HSE, pays an hourly rate of at least 20% more than that offered by the public sector. Nurses in their first five years of employment are also bumped up to the fifth increment.

For a newly qualified nurse, this means the annual equivalent of an extra €13,000 per annum (a 46% pay difference). For a senior staff nurse, it would mean close to €10,000 extra (20%).

Agency nurses and midwives are currently costing the HSE over €1.4 million per week.

Some 94% of INMO members recently rejected new Government pay proposals, and according to the organisation's general secretary, Phil Ní Sheaghdha, ‘the market clearly agrees with them'.

"The public sector simply isn't offering the going rate for the job. There is now a pay gap of 20% between staff doing the same work, at the same time, in the same hospital. Is it any wonder that many of Ireland's nurses and midwives are opting for agency or overseas work?

"Taxpayers will fork out over €100 million this year on agency nurses alone and until the Government meet with us directly to negotiate realistic pay rates, our health service will continue to be understaffed and waiting lists will only grow longer," Ms Ní Sheghdha insisted.