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HIQA report confirms resource and manpower deficits – IMO and IHCA

Both the IMO and the IHCA have said the new HIQA report on health services confirms longstanding issues in the delivery of care.

The report from the Authority provides an overview of its monitoring of healthcare services in 2020 (Healthcare Overview Report for 2020 (hiqa.ie))

According to the IMO, the report shows that the health services are operating at “dangerous capacity” levels and there is a “crisis in medical manpower”, the union said.

Dr Ina Kelly, President of the IMO, warned that doctors are now looking ahead to the winter with a sense of despair and foreboding.

According to the IMO, the problems identified by HIQA have “beset our services long before Covid, which has only served to expose the system deficits which have led to ever increasing waiting lists, inadequate access to timely care, increasing pressures on doctors seeking to provide care in general practice, in the community and in our acute settings.” 

It said the health service will continue to fail to meet the realistic expectations and demands of the Irish public without significant and long-term action, including measures to support doctor recruitment and retention.

The country urgently needed 2,000 medical specialists across acute hospital and psychiatry services.  It also required up to 1,660 additional GPs along with a sustainable career pathway for general practice.

In addition, a further 5,000 beds were required urgently, outlined the Organisation, which said focusing on the minimum requirements of the health capacity review were insufficient.

Dr Kelly said that the HIQA report would be a damning indictment in normal times.

“The report details the long-term damage caused by under investment and poor policy decisions. Tragically these problems have been ongoing for so long that public has learnt to accept the unacceptable when it comes to waiting lists and access to timely care,” according to Dr Kelly.

“This is not something we can or should accept and as Government now considers measures for the budget, we need to see a significant ramping up of sustainable investment in our services that will deliver timely patient care in a system that is well resourced and properly staffed.

Commenting on the overview of HIQA’s monitoring of healthcare services in 2020, Prof Rob Landers, Vice President, Irish Hospital Consultants Association, said:

“While the report details some areas of improvement made in our health service last year, it is clear that we still face the same long-standing issues in our system, namely, workforce shortages, chronic overcrowding and widespread capacity deficits.

“This is before we even consider the impact that COVID-19 has and continues to have – and which has changed the face of healthcare.

“What’s not changed, however, is the unacceptable number of people currently waiting on some form of list to see or be treated by a hospital consultant. Almost 1 million people now face this situation and such record waiting lists existed long before the pandemic exacerbated the problem.

“This pandemic and more recently, the cyberattack have exposed deep fundamental deficiencies in our health system which we always knew were there, but which have now been exposed in a way previously unseen.

“The impact of years of underinvestment and a lack of strategic leadership continues to hamper the provision of timely and efficient care. 1 in 5 hospital consultant posts continue to remain unfilled as needed, with some medical specialties experiencing far greater vacancy rates.

“Meanwhile, 385 patients waited on trolleys in our public hospitals today which is the 21st time since the start of the pandemic last March that the figure has gone over 300, but the second time it has done so this week already. More than half (11) of those breaches of 300 patients or more on trolleys have occurred in the past month – a worrying indicator for the winter ahead.

“Today’s trolley figures are one greater than the 384 described in 2006 by then Minister for Health Mary Harney as a ‘national emergency’ and the lack of meaningful action or urgency today to address this issue demonstrates a complete lack of understanding of just how bad things have gotten. “The continued risk of Covid-19 infection means that any overcrowding in our Emergency Departments is unacceptable and cannot be tolerated. Such overcrowding will also result in the further cancellation of scheduled care, which has already been decimated as a result of the pandemic.

“Our hospitals face a near-insurmountable challenge if urgent action is not taken now to address these issues. It is in the interest of all in the healthcare system to create an environment that medical specialists and wider staff want to work in, and that patients have trust in.

“The ongoing hospital consultant contract negotiations are critical to this and must be successful in finding workable solutions to the root causes of our recruitment and retention crisis.”

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