Infrastructure and capacity issues in the Irish healthcare system are severely limiting doctors’ ability to practise patient-centred, ethical medicine, according to the outgoing IMO President.
Donegal GP Dr Denis McCauley made the remarks during a keynote lecture on the ‘Challenges facing the medical workforce in Ireland’ at the recent RCSI Medical Professionalism Annual Conference 2025 in Dublin.
Dr McCauley told delegates that “healthcare in Irish hospitals is being practised in conditions which are in no way conducive to optimal patient care due to infrastructure and capacity issues”.
He highlighted that a shortfall of 5,000 acute hospital beds exists in the public system at a time when the population had grown by 15 per cent over the last decade and the number of people aged 65 years and older had increased significantly.
“Based on our current population, it is estimated that we need nearly 6,000 consultants to assure a consultant-delivered healthcare service,” Dr McCauley stated.
“We presently have 4,500 approved consultant posts, of which one in five are not filled on a permanent basis. There has been an increase of only 136 GPs holding GMS contracts over the last decade.
“At the same time the number of people treated on trolleys in our [emergency departments] and hospitals risen by 60 per cent.”
Dr McCauley added that the number of people waiting for hospital treatment had almost doubled since 2015.
He argued that, because of these issues, diagnoses were being delayed, and patients were being left languishing on investigative waiting lists.
“Patients who are diagnosed with cancer are having delays in their treatment due to infrastructural and staff deficits,” he stated.
Dr McCauley stated that the management of an acutely ill person involves a coordinated response from medical and nursing staff in an appropriate setting, with proper communication and observation.
“It is increasingly difficult to give this standard of care when patients are receiving ongoing care in an overcrowded emergency department or on a hospital corridor,” he maintained.
“Healthcare is a multifaceted environment, and to achieve optimal outcomes for our patients we need effective teamwork. The principles of any team involve core values, good communication, and having common purpose, with clear knowledge of each other’s roles and responsibilities.”
An important part of this, he stated, was the attitude, culture, and ethos of organisations overseeing healthcare services.
“Medical professionals being valued and respected by the governing organisation is essential in achieving optimal outcomes,” he remarked.
But he said this was not being achieved when NCHDs were being forced to work illegal hours and hospital consultants were being “scapegoated for the inability of hospitals to give a seven-day service”.
He also criticised the new HSE Health App, which he said was planned and introduced without any proper engagement with GPs, despite the fact that it would contain information sourced from a patient’s GP software record.
Dr McCauley asserted that unsustainable workloads and dysfunctional teamwork and leadership ultimately causes healthcare professionals to be “emotionally exhausted, experience de-personalisation and have feelings of low accomplishment and value”, leading to burnout.
“This diminishes their potential and their output and therefore affects patient care,” he said.
He described the medico-legal and regulatory environment in Ireland as “additional stressors”.
Dr McCauley’s term as IMO President ends today as the Organisation’s AGM commences in Killarney, Co Kerry.
The Vice-President, Dr Anne Dee, a public health consultant based in the Mid-West region, will assume the role this evening.
The IMO AGM takes place on 24-26 April.
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