IMO: Chronic shortage of doctors will have devastating implications if not addressed

The IMO has called on the Government to urgently address Ireland’s crisis in medical workforce resourcing, saying that our health system will collapse leading to devastating implication for patients if more doctors are not recruited on a properly sustained basis.

Addressing the Oireachtas Joint Committee on Health on medical workforce planning, the IMO said that despite recent widespread attention on the health system’s chronic shortage of doctors and the advent of Covid-19, the situation had deteriorated in the last year.

It said that, without sustained investment and funding, it was obvious we will have too few doctors to meet the demands of the population in terms of Covid and non-Covid care.

The IMO said that chronic shortages were evident across the health system.

• We have 500 vacant consultant posts leading to growing waiting lists (now at over 840,000) which in turn has a detrimental effect on patients. Ireland has the lowest number of specialists per head of population in the EU and there is not a single specialty that has the required number actually working in the system. 
• The HSE National Doctors Training and Planning (NDTP) division suggests that the HSE has a deficit of 1,600 hospital consultants. If we include the shortage in consultant psychiatrists that figure rises to around 2,000.
• Each year just over 700 doctors enter basic specialist training – that number falls to about 500 doctors entering higher specialist training.  HSE NDTP estimates that a minimum of 648 additional training posts across hospital-based specialties are needed in the coming years to meet the future consultant post requirements.
• The HSE NDTP estimates we will need an additional 1,260 GPs over the next decade. We need to fund up to 350 GP training posts a year to meet our future needs.
• We have only 60 Public Health medicine specialists. Half of our already understaffed public health specialists are due to retire in the next the next five years and there are insufficient trainees to replace this workforce let alone expand it.

Speaking today, Prof Matthew Sadlier, a member of the Consultant Committee of the IMO, said: “The Covid-19 emergency has emphasised just how badly our health system needs sustained funding and investment. This is not a new problem but the virus has rapidly increased the need for urgent action if our health system is to survive. Our health system is chronically understaffed across all specialties.

“We presently cannot recruit enough doctors and we cannot keep hold of many of the doctors that we do have. We have seen increasing trends of high emigration by doctors for the past number of years and we can say with some degree of certainty that that trend will continue. Doctors will leave to enhance their skills with additional training but unfortunately are not returning to Ireland. Doctors want to work in a system that enables them to deliver care to patients and where they are respected and for many that means going abroad.”

The IMO said that a number of demands had to be met by the Government:

• We need to resolve the disastrous two-tier pay system for consultants, which is having a direct effect on recruitment. This politically motivated pay cut has had very damaging impact on our health services. 
• While the commitment to hire an additional 300 consultants in 2021 is welcome it will not even address the current shortage and we need to be much more ambitious in terms of our recruitment targets to support our clinical programmes and models of care.
• Public health specialists must be awarded consultant contracts as a matter of urgency and that we must significantly and rapidly increase the number of training posts across the specialties.
• We must properly support GPs in any transfer of work from the acute to community setting.  We welcome delivery of care in the community but it must be appropriate care that is properly supported and resourced.  We must also, given the demographics of our GP base, deliver supports to GPs establishing in General Practice.