An additional 2,000 hospital consultant and 1,000 junior doctor posts should be created by the end of the decade, a Government-appointed taskforce has recommended.
There is a “clear need” to improve the working environment of junior doctors through the provision of rest, showering and changing facilities, providing food and drink, improved IT services and other supports, its report advises.
Though the number of consultant posts has been increased, the health service continues to be highly dependent on doctors who are not in training posts, it points out. This dependency is increasing despite recommendations from previous medical reports.
There is also a continued over-reliance on doctors to provide care that other healthcare professionals are better placed to deliver “in a more patient-centric and efficient manner”, according to the taskforce.
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“The Irish healthcare workforce must be configured such that the most efficient, sustainable, and cost-effective models are developed, and non-consultant hospital doctor (NCHD) reliance is reduced.”
The National Taskforce on the NCHD workforce was established by Minister for Health Stephen Donnelly with the brief to put in place sustainable workforce planning strategies to improve the working experience of junior doctors and help to retain them in the health service.The HSE’s difficulty in recruiting and retaining sufficient numbers of medical and other staff is recognised as one of the main causes of hospital overcrowding. Ireland has proportionately lower numbers of consultants than other health services.
In interim recommendations the taskforce says annualised targets for increasing consultant and NCHD numbers should be agreed. The number of consultant posts should be increased to 6,000 by 2030, from 4,152 last December – a target ratio of 110 consultants per 100,000 of the population.
The number of NCHDs in training should be increased to 5,800-6,000, and there should be one consultant for every 1.3 NCHDs by 2030. At the end of last year there were 8,269 NCHDs, but only 5,000 of them were in training posts.
Of the 4,152 approved consultant posts last December, only 3,230 were filled permanently and 478 were filled by locums. Of the 444 vacancies, 76 per cent had been vacant for less than one year.
A mismatch exists between the number of specialists exiting postgraduate training over the last year (687) against the 1,195 consultant posts that were newly-approved or replaced, the report points out. It says this is one of the contributing factors to the vacancy rate for consultant posts.
“I recognise that significant change is required to ensure that we improve the NCHD experience and work-life balance through the development and implementation of improved structures and supports in hospital sites,” Mr Donnelly said. “They are a critical part of our workforce and need to be supported to ensure they are retained in our health service.”
The Minister said he has written to HSE chief executive officer Bernard Gloster seeking full implementation of the recommendations as a priority.
The report also recommends standardised induction for all new NCHDs, and additional induction of the 500 or so international medical graduates starting each year in Irish hospitals.
Doctors should have access to healthy food 24/7 and those on overnight shifts should have access to a private space for rest, including a bedroom for shifts over 12 hours.
