Brain drain warning over work conditions for consultants

Hospital consultants have warned of a medical brain drain created by deteriorating hospital working conditions and “unrelenting” budget cuts.

The Irish Hospital Consultants’ Association says these trends have forced some of the country’s best consultants to leave the country and seek work overseas.

Doctors often go overseas when training to improve their skills, but the IHCA says it is virtually unprecedented for mid-career senior consultants with positions in Irish hospitals to emigrate again, as they are now.

Consultants have suffered a succession of pay cuts in recent years while pay levels for those filling new consultant posts have been cut by 25 per cent.

One in five consultancy posts in the public system are either vacant or filled on a temporary basis, the association pointed out.

Speaking today at the association's annual conference in Maynooth, Co Kildare, president Denis Evoy said the continued degradation of consultants' working conditions and contracts was changing the medical landscape in Ireland and creating a system that cannot cater for its patients.

“Ireland’s health service is being run with a focus on the implementation of declining annual budget rather than encouraging excellence across the system and making patients the priority.”

Mr Evoy said as Ireland competed globally for medical staff it could not recruit and retain the most talented doctors and consultants. "The brightest and best graduates, having finished prestigious fellowships, are accepting well-resourced and well-remunerated posts in America, Australia and New Zealand.

“The prolonged expectation of the HSE that consultants will endure declining working conditions, uncompetitive contracts and systems failures that result in compromised patient care cannot continue,” he added.

“The inability to appoint permanent consultants with appropriate contracts is impacting on patients directly through growing waiting lists, longer waiting times and cancellations of elective surgery.”

The system was dealing with an additional 230,000 patients a year while budgets were about 25 per cent lower, he pointed out. Frontline staff could not continue delivering the services expected of them while maintaining “acceptable” levels of patient care.

He suggested a "re-alignment" of resources, to include the closure at night of half the country's 28 24-hour emergency departments. He acknowledged the proposals was politically controversial but added that "we just can't go on" staffing emergency departments in close proximity to each other. Kilkenny and Waterford, which both have 24-hour facilities, are just 20 minutes apart, while Loughlinstown was six miles away from St Vincent's in Dublin, he said.

The consolidation of cancer care into eight centres from an original 31 had greatly improved outcomes for patients, he pointed out.