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‘Higher level’ of consultant posts being approved – CAAC 

By David Lynch - 30th Mar 2024


The increase in the number of new consultant posts since 2021 was maintained last year following the introduction of the new contract, according to the consultant applications advisory committee (CAAC).

The CAAC considered 438 applications for posts last year, according to its annual report for 2023. Of these, 434 posts were recommended for approval.

General medicine was the specialty with the highest number of newly approved posts, followed by surgery, anaesthesiology, and pathology.

The annual report noted that the HSE consultants’ division processed a total of 541 applications in 2023. As a result of the introduction of the public-only consultant contract 2023 (POCC23), applications for replacement appointments are now no longer required to be presented directly to the CAAC.

The POCC23 became operational in March 2023. According to the report, there has been an increase of 2,560 in approved consultant posts since 2004.

“Compared to previous years, a substantially higher number of new consultant posts were approved by the CAAC since 2021.”

This “higher level was maintained in 2023”, the report outlined.

The annual report noted that the introduction of POCC23 has seen the membership of the CAAC extended to include specialties, such as public health medicine, that were previously not represented on the committee.

On average, there were 44 applications considered per meeting and there were 10 meetings during 2023. The average turnaround time for the processing of consultant applications in 2023 to issuing of letter of approval was six weeks, according to the CAAC.

A HSE spokesperson told the Medical Independent (MI) the annual report was approved at the February CAAC meeting.

At the end of 2023, 4,254 consultants were employed in the HSE and there were 445 vacant consultant posts. These figures exclude public health.

The IMO and IHCA have previously stated there are over 800 consultant posts unfilled on a permanent basis. The HSE figures exclude posts filled by temporary or locum doctors from the number of vacancies.

Writing in MI in advance of the 2024 IMO AGM, Chair of the Organisation’s consultant committee Prof Matthew Sadlier stated that while consultant recruitment and retention has been one of the barriers to the delivery of healthcare, “it certainly has not been the only one, as this year has consistently shown.”

“The crowding of our emergency departments with admitted patients awaiting beds has gone from a seasonal to a whole-year-round crisis,” according to Prof Sadlier, who highlighted a continued lack of capacity.

“As I write this article, surgery is being cancelled across the mid-west due to this issue (in March which, last time I checked, is not winter). Will the POCC solve this problem? It won’t and it can’t because it actually doesn’t attack the root causes.”

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