The Ongoing Crisis in the Irish Health Service
Testimony to the Joint Oireachtas Committee on Health (9th February 2021). describes the ongoing capacity crisis in the Irish Health Service:
There is a severe shortage of hospital consultants in Irish hospitals. Ireland has the lowest number of medical specialists on a population basis in the EU with 41% below the EU average. There is a serious recruitment and retention crisis, with more than 700 permanent hospital consultant posts vacant or not filled as needed. This in large part has been caused by a flawed Government decision in 2012 to cut the pay of newly appointed consultants.
* Recruitment Crisis:
The Government failure to address the recruitment crisis and restore pay parity is 'bordering on negligence and only serves to exacerbate the extremely challenging task in dealing post Covid with the massive backlogs and waiting lists that are accumulating across all specialties.'
* More than half staff members reported:
Moderate or high staff absentee levels are having an adverse impact on service. Of the medical and dental staff, there is an absence rate of just 2.3%, a quarter of the rate of other staff categories. However, more than half of the absences were due to Covid, the largest proportion for any staff category. The closure of schools is impacting on the availability for work of healthcare workers.
* Covid transmission within hospitals:
Improvements are needed to increase the number of single-occupancy rooms and beds in dedicated isolation wards. There is a lack of regular testing and screening of staff, in the nine weeks to the end of January, more than 12,000 healthcare workers had been infected with the virus, including more than 560 doctors.
* Hospital Outbreaks:
A total of over 1,400 confirmed cases are linked with hospital outbreaks in the same period with four in ten of those infected in the hospital outbreaks healthcare workers. For infection control purposes the pre-Covid bed occupancy rate of around 95% needs to be reduced to between 80% and 85%. This will require approximately 2,000 additional hospital beds to maintain current service levels. -
In this respect the Irish Nurses and Midwives Organisation stated on 23rd January 2021 that Hospital infection rates were out of control:
Upgraded safety standards are needed immediately to get COVID hospital infections under control, the INMO has said. Nearly 2,000 healthcare workers have caught the virus over two weeks in outbreaks directly traced to their workplaces.
Urgent Upgrades to Safety Measures Necessary:
* A national requirement that high-standard FFP2 masks be used in all healthcare settings – not just basic surgical masks;
* Distance between beds is increased from the current one metre minimum to two metres * Regular testing for all staff in healthcare settings on a rolling basis
* Safety review in each hospital, in particular to reduce footfall and improve decontamination practices
* Some hospitals (such as Cork University Hospital) have already introduced FFP2 masks as standard, practices vary across the country. “Hospital infection rates are out of control: This is directly harming frontline staff and depleting rosters. “The HSE need to take control and issue strong national guidance to increase safety standards.
“Our members are furious that while many wait to get even their first vaccine, HSE policy is leaving them exposed to the virus.”
INMO General Secretary, Phil Ní Sheaghdha.
One year after the virus hit, mandatory safety measures have still not been implemented by the HSE in Irish hospitals to prevent infection.
Low numbers of consultants available to deliver care will have a moderate or severe adverse impact on the capacity to deal with the backlog in non-Covid care. More than 840,000 people are on some form of hospital waiting list. There are 700 permanent consultant posts vacant.
* COVID Anniversary:
Almost one year since the first case of Covid-19 was diagnosed in Ireland, 'no substantial and systemic action has been taken to date to address the crises in recruitment and retention of medical expertise across our health system.'
* Public Health Specialists: Ireland has 60 public health specialists compared to 180 in Scotland and New Zealand with and dispersed population.
* Hospital Waiting Lists:
In the past year, hospital waiting lists have grown by approximately 70,000 or 9% and now stand at 838,000,
* Vacant Posts:
The number of vacant consultant posts or posts filled on a temporary or non-substantive basis has risen to 730. The supply of medical specialists simply fails to meet demand. The HSE itself estimates a minimum of 1,600 additional hospital consultants to meet demand. If Psychiatry and public health specialists are included, the shortfall is closer to 2,000. -
At least 2,000 additional beds are required, the majority of facilities need to be single-room accommodation (which has obvious implications for controlling the spread of the virus).
1. Joint Committee on Health debate - Tuesday, 9 Feb 2021 - https://www.oireachtas.ie/en/debates/debate/joint_committee_on_health/2021-02-09/3/
2. Hospital infection rates “out of control” – INMO demands strict new measures - https://www.inmo.ie/Home/Index/217/13668