Government should ‘incentivise’ young medics to return to Ireland

Patients needed elective care being ‘crowded out’ says HSE executive

Colette Cowan, chief executive of the University of Limerick Hospitals Group told the Oireachtas health committee that graduate nurses need to be incentivised before they leave the country. File photograph: Press 22
Colette Cowan, chief executive of the University of Limerick Hospitals Group told the Oireachtas health committee that graduate nurses need to be incentivised before they leave the country. File photograph: Press 22

The Government should incentive young nurses and consultants to encourage them to return and work in the Irish health service, a senior hospital manager has urged.

Colette Cowan, chief executive of the University of Limerick Hospital Group said the most important thing about (securing the services) of graduate nurses was to capture them before they left the country. She said in past years Ireland was slow at doing that and young graduates would go to the UK very quickly.

She told the Oireachtas health committee on Wednesday that from talking to intern students she found they had a real problem around accommodation.

“They can’t get accommodation when they qualify. They can’t afford accommodation.They can’t travel from home because they can’t get access to transport in rural areas or they can’t get a driving test. These are real problems for these young people.”

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She said they needed support and training when they came onto the floor in dealing with real, front line pressures.

“That is what turns them off sometimes and makes them leave the country. They need support to deal with public expectation because they are the front point of contract when people are under pressure and also professional expectation of them.”

Ms Cowan said she really did think “we have to incentivise them to stay around accommodation and transport and such things”.

“That is not just nurses, that is every level and profession in the country. It is the same thing about consultants to attract them back into the country.We need to make some other offering to get them to come back to work in our services .”

“That will solve the waiting lists, theatre problems, the opening of beds and everything else as we will have our own staff retained”, she said.

Non-emergency treatment

Meanwhile, the HSE’s national director for acute hospitals suggested there was evidence that patients seeking elective or non-urgent treatment were being “crowded out” of hospitals.

Liam Woods said pressures on emergency departments caused by increased demand and largely static bed capacity were creating a challenge in terms of access to elective care.

He told the Oireachtas health committee that “notwithstanding the extraordinary measures taken over the winter period to manage emergency activity, there is evidence to suggest that access to elective care is being crowded out”.

He said members of the health committee were well aware of the challenges facing the HSE and, more importantly patients, in accessing out-patient and in-patient/day case services in public hospitals.

He said this was despite the significant volume of activity undertaken in public hospitals which see 3.3 million out-patients and carry out 1.7 million procedures annually.

At the end of June there were 511,415 patients on waiting lists for a first out-patient appointment with a hospital consultant and 78,014 queuing for a surgical procedure, Mr Woods said.

However, he maintained that the HSE had “begun to make progress in this area”.

“This is most evident in the numbers of patients waiting for a hospital in-patient or day case procedure where in July 2017 the numbers waiting stood at a high of 86,100.

The most recent figures represent a fall of more than 8,000 or 9.4 per cent in less than 12 months.

“Latest figures also show that 58 per cent of patients who are on the waiting list for an in-patient or day case procedure are waiting less than 6 months and 83 per cent are waiting less than 12 months.”

Age of patients

Mr Woods also told the committee that the rise in the number of people on trolleys in hospital emergency departments in the first 4 months of 2018 was due to increased attendances and the age and acuity of the patients who presented.

He said more than 2,200 people aged over 65 had to be admitted due to influenza with 85 requiring treatment in intensive care facilities during the 2017/18 flu season.

However he said the trolley numbers had stabilised after April and the figures in May showed a 2.5 per cent improvement on the situation at the same time last year.

Mr Woods said a “key challenge for most hospitals is the lack of sufficient isolation facilities or single rooms required to ensure that infection control issues are managed appropriately”.

“As a result patients can wait for significant periods for suitable accommodation.”

The director of scheduled and unscheduled care performance in the Department of Health, Paul Bolger said "to match the increase in demand for services and to reduce waiting times substantially and sustainably, the implementation of the reform programme set out in Slaintecare is required".

Martin Wall

Martin Wall

Martin Wall is the Public Policy Correspondent of The Irish Times.