Report says 50% more consultants and 32% more GPs needed in coming years

A substantial increase in the number of doctors including hospital consultants and GPs will be needed in the coming years, a Health Service Executive report has forecast.

The report by the HSE national doctor training and planning group on the training pipeline to meet demands to 2028 says the number of consultants in acute hospital specialties could potentially have to rise by 53 per cent.

It suggests that if the Government wants to introduce free GP care for all children and those over 70, then an increase of 32 per cent in the number of family doctors will be required. There will also have to be a substantial rise in the number of specialist training positions.

The report says the Irish medical workforce currently faces recruitment challenges, particularly at consultant level, in mental health services and in smaller hospitals outside of the main urban areas.

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It says many consultant posts have failed to attract any suitable applicants and that there are also ongoing and impending difficulties in the recruitment of general practitioners.

The report has been seen by the Irish Hospital Consultants Association (IHCA), which said it confirmed "the gravity of the current and projected consultant recruitment and retention crisis for patients".

The report notes that there are 3,100 consultants currently in the public system, with an estimated additional 500 working exclusively in the private sector; 3,989 GPs, 88 public health specialists, 91 ophthalmologists, and 79 occupational medicine specialists, working both public and privately; about 4,000 non-consultant hospital doctor trainees and 2,400 non-training non-consultant hospital doctors in the public system.

The HSE report concludes that “there is a need for a considerable increase in the numbers of medical consultants/specialists and trainees”.

“Accounting for stakeholder-informed consultant/specialist demand estimates and the results of modelling supply and demand for these doctors, we potentially need a 42 per cent increase in consultant and specialist numbers by 2028. This estimated increase includes an increase of approximately 53 per cent of consultants working in acute hospital-based specialties.”

“Depending on the successful implementation of Sláintecare and the roll out of ‘universal free GP care’, a 42 per cent increase in GPs may be required. Should free GP be rolled out to all those under the age of 18 and over the age of 70, then a 32 per cent increase in GPs may be required.” In order to meet this level of staffing in the system, an almost 38 per cent increase in trainees across all specialties, excluding general practice, over the next five years will be required.

Free GP care

“General practice numbers are estimated to have a growth requirement from today’s number of 3,989 to a future number of 5,649, to roll out universal free GP care. This would require an increase from approximately 200 to over 500 trainees in general practice over the next five years, not accounting for doctor emigration.”

However it says the provision of more nurse-led care in the community could reduce this estimate.

The IHCA said in comparison with among five other countries – England, Scotland, Australia, New Zealand and Canada – evaluated in the report, Ireland has the lowest number of consultants in most of the specialties including obstetrics and gynaecology, paediatrics, radiology, intensive care and emergency medicine.

IHCA president Dr Donal O’Hanlon said one in five permanent consultant posts were currently unfilled in public hospitals. He said the consequences of the consultant recruitment and retention crisis were “unacceptable delays in providing care to patients and record waiting lists which are getting longer as a result of the pandemic”.

He suggested that the root cause of the crisis was the lower salary levels introduced in 2012 for consultants appointed after that point and that this issue must be addressed immediately by Minister for Health Stephen Donnelly.

Last December the government proposed a new Sláintecare contract for consultants working only in the public system with a salary of up to €252,000 by July 2022 but these plans were delayed by the pandemic.

Mr Donnelly told the Dáil this month that he intended to commence talks on this issue with medical organisations as a priority in the coming weeks.