The failure of the Department of Health to begin recruiting extra staff to cover for junior doctors, whose hours will have to be dramatically cut under new EU legislation coming into force within the next year, may close small hospitals, members of the Irish Hospital Consultants Association have warned.
Under the directive, the hours of non-consultant hospital doctors will be limited to a maximum of 58 hours a week from August 1st next. At present, they can work more than 100 hours a week. While the Department hopes to make up for the shortfall in manpower by appointing extra consultants, to deliver a consultant-provided rather than consultant-led service, no effort has been made to date to recruit any. It can take years to make such appointments.
Dr Colman O'Leary, an accident and emergency consultant at Limerick Regional Hospital, told the IHCA annual conference the EU directive would have a "lethal" effect on small hospitals, which depend on junior doctors to provide 24-hour services.
The president of the IHCA, Dr Colm Quigley, said the Department's inaction suggested it would not be too unhappy if the directive had a lethal effect on small hospitals.
Another worrying factor, the conference heard, was that the State would be liable for fines of up to €10,000 a day for each day the directive was breached.
The Minister for Health, Mr Martin, insists he is preparing for the directive. This was why he commissioned the Hanly report on medical staffing and that report, which if implemented, will result in the closing of emergency and maternity services at smaller hospitals. It will be published later this month.
Addressing delegates, he indicated he favoured Hanly's proposals. "Evidence shows that patients receive better treatment in hospitals that have the required numbers of specialist staff, high volumes of activity and access to appropriate diagnostic and treatment facilities. It is therefore justified on evidence-based criteria to concentrate emergency care in our major hospitals," he said.
"I believe that a number of smaller hospitals have the potential to provide an increasing volume of elective procedures and the kind of multi-specialist day and outpatient care that is currently performed in the larger hospitals," he added.
He said the case for a general hospital with emergency services would be explored for some regions where "for geographic or demographic reasons, access to emergency hospital care would be problematic".