Extra 2,000 hospital beds are needed almost immediately, consultants say

An additional 2,000 hospital beds are needed pretty much immediately, medical specialists have said.

The Irish Hospital Consultants Association (IHCA) also said on Monday that capacity in intensive care units should be doubled to 579 beds while an additional 1,300 transitional intermediatory-care step-down beds should be opened before the winter for the year ahead.

It said investment was also required to increase space in hospitals to allow for social distancing.

The IHCA said additional investment in beds and services would only work if the 500 vacant consultant posts in hospitals across the country were filled with sustainable, permanent appointments.

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It said that to do this the Government needed to end immediately the lower pay rates in place for consultants recruited since 2012, when the then government cut the pay of hospital consultants appointed after that date by 30 per cent.

The IHCA said one of the most damaging consequences of the consultant recruitment and retention crisis was “the unacceptable delays in providing care to patients”.

It warned there could soon be one million people on public hospital waiting lists. In August there were over 840,000 people on queues for various forms of hospital care.

IHCA vice president Dr Gabrielle Colleran said for many of her colleagues currently working abroad and who were considering returning to Ireland ending "pay inequality was a red line issue".

The IHCA also wants the Government to Introduce and resource a maximum waiting time of 18 weeks, instead of the current 52 weeks, following a GP referral for a consultant outpatient appointment, and instead of the 64 weeks for inpatient/day-case public hospital treatment.

Speaking at the launch of the IHCA's pre -Budget submission the association's president , Professor Alan Irvine said: "What is needed in the health budget 2021 is to address the stark acute hospital capacity deficits, with clear, fully-funded and time-lined decisions to end the deficits failing our health system. This is not a time for promises or excuses, instead we need delivery on earlier commitments so our hospitals have the capacity they need."

“Prior to the pandemic, our health system was battling with significant consultant and capacity shortages, contributing to mounting waiting lists - a situation that left us vulnerable to a crisis like Covid-19.”

“A return to ‘normal’ is not an option; we need a return to better. Waiting lists, trolley crises, under-staffed services must become a thing of the past not just to provide resilience in the system for any future pandemic - but to provide the timely and quality access to care that our patients need and deserve.

In its submission the IHCA said the 13,228 acute hospital beds that were open at the end of 2019 should not only be maintained and reinstated, as necessary - given new social distancing requirements - but also that capacity must be expanded to facilitate a reduction in the occupancy levels from around 95 per cent to between 80 per cent 85 per cent.

“ To treat patients in a timely manner in the year ahead this would require the opening of an estimated 2,000 acute hospital beds in excess of 2019, including those opened as part of the 2019/20 Winter Plan and the Covid-19 response. “

IHCA secretary general Martin Varley said there were vacancies in consultant posts across all hospital types and across all locations.

“For example in Kerry University Hospital there are five permanent consultant radiology posts. Only one is filled on a permanent basis and the other four have been advertised repeatedly over the last number of years and, at best, are filled on a temporary basis or are carrying vacancies.”

While the lower consultant wage structure introduced in 2012 was subsequently rolled back in part medical organisations say that those appointed after 2012 earn about €50,000 less a year than longer-serving colleagues.

Consultants in Ireland can still earn between €150,000 and more than €200,000 in the public system, with many having lucrative private practices on top.

Medical organisations claim Ireland has become uncompetitive in the English-speaking world for specialist doctors, due to the wage disparity between pre and post 2012 entrants.

The IHCA said in its pre-budget submission on Monday:”In Australia, Canada, and the United States, average salaries are up to 48 per cent above that being paid to Consultants in Ireland appointed prior to 2012 and up to double that paid to new entrants.”