Surgical hubs and elective hospitals, “will go a long way to address the challenges in elective surgery”, the RCSI President Prof Deborah McNamara told this newspaper.

However, Prof McNamara cautioned that even with this extra infrastructure, there remained “a huge need” for the health service to focus on patients who need a longer stay in hospital.

She said these are patients who require “all of the resources of a bigger hospital in order to get the surgical care that they need”.

“And we have major concern about that, I’ll be honest. So, the elective surgical hubs, and elective hospitals will go a long way to address the challenges in elective surgery. But for some of the most complex, elective operations, they won’t address the totality of what we need.

“That needs to be taken into consideration alongside interventions to protect surgical beds and theatre capacity in our [existing] bigger hospitals that have emergency departments.”

Prof McNamara was speaking to the Medical Independent (MI) at the recent annual Millin Meeting held in the RCSI. (Coverage of the Millin meeting will be carried in the 9 December issue of MI).

Separately the HSE told MI the elective hospitals in Cork and Galway are being progressed first.  The design team are actively working on the design for these hospitals, including carrying out necessary surveys and site investigations to inform the design as it develops toward planning permission applications. 

“A key issue emerging for the Cork site is the road access, and the HSE continues to actively engage with Cork City Council to find a solution,” the spokesperson told MI.

In relation to the two Dublin sites, the demand modelling and validation are underway, along with the assessment of current and planned infrastructure for ambulatory care in the catchment area to underpin the scope and scale required.

A total of nine HSE surgical hubs are also at various stages of development nationally, two of which are operational.

The Medical Council has welcomed the publication of the third One Health National Action Plan to address Antimicrobial Resistance (AMR) 2026-2030, known as iNAP3.

CEO of the Medical Council, Dr Maria O’Kane, said increasing awareness of AMR is critical to protecting patients.

“According to the World Health Organisation, antimicrobial resistance is one of the top ten global threats to human health,” said Dr O’Kane. “Continued planning and action against AMR will be essential for patient safety into the future, and we welcome iNAP3 as an important step forward.” 

“For doctors, reducing AMR means ensuring that antibiotic medicines are only prescribed and administered when they are genuinely needed. Antimicrobial medicines should only be used where they are required to treat serious infections.

“For patients, not every illness requires an antibiotic, and your doctor will advise you on the most effective treatment. Avoiding unnecessary antibiotics helps protect their effectiveness for the future.”

Earlier this week, the Minister for Health, Jennifer Carroll MacNeill and Minister for Agriculture, Food and the Marine, Martin Heydon launched iNAP3.

According to the Department of Health, building “on the strong foundations” laid under iNAP1 (2017-2020) and iNAP2 (2021-2025), iNAP3 (2026-2030) “reinforces Ireland’s commitment” to tackling the growing global threat of AMR through a ;One Health approach; – recognising the interconnection between human health, animal health and the environment.

“This [AMR] threat requires a multisectoral approach across human, animal, and environment health to preserve the effectiveness of antimicrobials for future generations,” said the Health Minister.

“With this National Action Plan, iNAP3, we have demonstrated that Ireland is fully committed to a collective approach to combating antimicrobial resistance. However, its success will depend on continued commitment from every sector and from each one of us.

“Since the publication of our first iNAP plan in 2017, significant progress has been made in tackling antimicrobial resistance in the health sector, and I would like to thank all healthcare workers for their efforts in this regard.”

HIQA found improvements across the health services it inspects in 2024.  

That is according to findings in the Authority’s Overview Report of the Monitoring and Regulation of Healthcare Services in 2024, published today (7 November).

While “good standards” of care were observed by HIQA, healthcare remains a challenging environment and a number of key areas require ongoing improvement. The overview report found that hospitals continue to be challenged with suitable infrastructure to support demand, bed capacity, and sufficient workforce among other issues.  

“Our inspectors have spoken to many patients who have praised the healthcare staff who have cared for them. We regularly observe excellent practice from committed staff working in a challenging environment,” said HIQA’s Director of Healthcare Regulation, Mr Sean Egan.

 “While we are seeing tangible improvements in healthcare services, resourcing and capacity requirements, particularly in acute hospitals, need to be addressed to meet service demand. These shortfalls directly affect both patients and the workforce on a daily basis, and this becomes increasingly crucial as we come into the winter months.”

HIQA inspections have shown examples of improved levels of compliance in healthcare services in 2024. In situations where findings from previous inspections facilitated comparison on re-inspection in 2024, 41 per cent of national standards assessed on re-inspection showed improvements.

In addition, in facilities that provide medical exposure to ionising radiation, the number of regulations assessed as not compliant was five per cent, which is significantly lower than the 12 per cent identified between 2021 and 2023.

The Medical Council has condemned the “increasing trend” in targeting of healthcare workers, including “racial abuse of doctors, nurses, and healthcare assistants around the country”, and the deliberate targeting and killing of humanitarian healthcare workers in conflict zones around the world.

Speaking about the rise in racial abuse of healthcare workers in Ireland, Dr Maria O’Kane, CEO of the Medical Council said: “Here in Ireland, we have…seen an increase in reports of racial abuse towards our healthcare workers”.

“Our health service would collapse overnight if it wasn’t for our internationally trained colleagues and friends,” said Dr O’Kane. “It is vitally important that there is a zero-tolerance approach to racial abuse, especially in healthcare settings. I strongly encourage employers to ensure that supports are available and promoted for healthcare professionals who are victims of racial abuse and for those from countries engulfed in conflict.”

According to the Medical Council’s Workforce Intelligence Report 2024, 41.7 per cent of doctors clinically active in Ireland received their primary medical qualification outside of Ireland.

Looking globally, Dr O’Kane said that “we have recently seen blatant breaches of international law in Sudan, Gaza, Lebanon and Ukraine, amongst other countries, with the targeting of healthcare workers and health facilities.”

“Last week, the WHO condemned the killing of 460 patients and their companions in a hospital in El Fasher, Sudan, in addition to the abduction of six healthcare workers. Two days earlier Saudi Maternity Hospital, the only partially functioning hospital in El Fasher, was attacked for the fourth time in a month, killing one nurse and injuring three other healthcare workers. Throughout the conflict in Gaza, hospitals and hospital staff have been regularly targeted, resulting in a situation where healthcare is not accessible for so many due to the destruction of hospitals and clinics.”

According to the Medical Council, there are 1,240 doctors clinically active in Ireland with a primary qualification from Sudan.

“Since the first of January this year, there have been 1,146 attacks on healthcare facilities, healthcare workers, patients, supplies, warehouses and healthcare transport, resulting in 1,785 deaths and 1,014 injuries in 16 countries across the globe, according to the WHO Surveillance System for Attacks on Healthcare,” said Dr O’Kane. “This is simply unacceptable and should be condemned widely.”

“We must be cognisant of doctors from these conflict zones working here in Ireland, caring for us and our families while worrying about their loved ones and families still living in areas impacted by war and aggression, or who have been displaced.”

BowelScreen has announced that it is now offering screening to people aged 58.

This is the third expansion of the screening programme’s offering since October 2023 and makes screening available to men and women aged 58 to 70. Over time, the HSE is expanding the screening programme to people aged 55 to 74.

Around 2,500 people are diagnosed with bowel cancer in Ireland every year. It is the second most common of all cancers in men and the third most common of all cancers in women in Ireland.

BowelScreen Clinical Director Professor Pádraic Mac Mathúna, said that making BowelScreen available to younger people is an important step in preventing and detecting bowel cancer early.

“Our primary goal in BowelScreen is to reduce mortality from bowel cancer. We prevent cancers from developing by finding and removing small growths, which can turn into cancer if left untreated. Every year, around 3,000 people have pre-cancerous growths removed because they did our BowelScreen test.”

He added that a screening test is not a diagnostic test – it looks for a level of blood in your sample.

“Not all cancers or polyps bleed all the time so a normal result does not guarantee that cancer isn’t present. This is why it is so important to be aware of symptoms of bowel cancer and go to your GP immediately, even if you had a recent normal screening result. Do not wait for your next screening test if you have any symptoms of bowel cancer.”

Minister for Health Jennifer Carroll MacNeill said the continued expansion of BowelScreen “is an important step in our ongoing investment in public health and disease prevention”.

“This will ensure that more people across Ireland can benefit from early detection, timely treatment and ultimately better outcomes.”

The Government has announced additional €11 million in recurring funding for drugs and inclusion health services in Budget 2026.

According to the Department of Health, the allocation includes €4m for service enhancement measures and will address regional disparities in availability of drug and inclusion health services, “with a strong focus on the provision of services in disadvantaged and rural areas”. It also aims to enhance prevention measures, including through early intervention measures to improve child health and wellbeing.

“The additional funding I have secured for 2026 will address disparities in the availability of and access to drugs and inclusion health services across the six HSE health regions,” said Minister for Public Health, Wellbeing and the National Drugs Strategy Jennifer Murnane O’Connor.

“We are paving the way for the implementation of our new national drugs strategy, expanding capacity in services all across the country and rolling out successful pilot initiatives to new areas.”

Separately Minister for Older People Kieran O’Donnell announced that there will be an increase of €215 million for older persons services in 2026, representing a rise of over a 7.1 per cent increase on 2025.

“I am delighted to have secured significant additional for older persons services,” said Minister O’Donnell. “This makes Budget 2026 the largest ever budget for older persons services with over €3 billion allocated to maintain and further enhance older persons services in 2026”. 

The College of Psychiatrists of Ireland (COPI) welcomed the announcement in Budget 2026 of increased staffing and expansion of mental health services but warned this must happen as an urgent priority while increasing the mental health budget.

Minister for Mental Health Mary Butler announced 300 new staff for mental health services in Budget 2026.

The total allocation for mental health for 2026 will be almost €1.6 billion, which is an increase for the sixth year in a row. Mental health funding has increased by over 50 per cent since 2020, the Department of Health said in a statement.  

The College said that the speed of implementing these new measures will be key to gauging their success. Given the increase in costs associated with delivering services in recent years, the decisions made yesterday “will be meaningless without continued focus and sustained, improved funding,” according to the College.  

 The College also cautioned that its allocation of the overall health budget remains too low and should be brought up to, at minimum, 12 per cent of the overall allocated budget for health.

“We thank Minister Butler for her work on this Budget and the improvements that will hopefully be made to mental health services as a result,” said Dr Lorcan Martin, President of COPI. “That said the College believes more can be done to bring mental health services in this country up to the standard it should be at.”

“The mental health portion of the overall health budget should be at 12 per cent. Despite the pledge of €27.4 billion for health, we are still a long way away from hitting this target. We await measures that will make a permanent difference to the mental health of Irish people.”

In its pre-Budget submission, the IMO has called for the establishment of a cross-departmental group to respond to the “chronic problem” of health inequality.

The Organisation said the establishment of a cross-departmental group was critically important to address the fact that people from deprived areas have “far worse” health outcomes that those from affluent areas.

It noted that over half the population who cannot afford private health insurance and rely on the public health system continue to “endure long waiting times to access hospital care”, while five per cent of the population report unmet medical need because of waiting lists.

Dr Anne Dee, IMO President and a public health consultant, said “a person’s health outcomes are based on a range of social and economic factors, with poverty one of the key contributors to poor health”.

“Health inequality is a chronic problem in Ireland, and requires an urgent and significant response from the Government to ensure that children have the best start in life and those in greatest need receive optimal public healthcare.”

She added that “successive governments have failed to sufficiently invest in both bed capacity and our medical workforce, resulting in year-round trolley and waiting list crises as we look to cater for a growing and ageing population with increasingly complex needs. The Government cannot continue to do the bare minimum when it comes to meeting that urgent demand.”

Other recommendations made by union, include a call for an increase in the number of new inpatient beds from 3,438 to 5,000, and the development and funding a comprehensive medical workforce plan with actions laid out to increase the number of consultants and training posts in line with workforce requirements.

The IMO also called for support for the reconstruction of the health service for the population of Gaza with dedicated funding. Dr Dee said the humanitarian catastrophe in Gaza has had a number of appalling effects, “not least the collapse of its healthcare system. The Government must set aside funding to help reconstruct that healthcare system.”

The HSE Health App has been downloaded over 145,000 times since its launch in February, according to statistics from the HSE.

From today, more than 900,000 patients across 31 hospitals will be able to see their appointments in the app. The QUIT stop smoking service will also be available in the app. People can sign up in the app for a free, personalised Quit plan to help them stop smoking and get one-to-one support from a trained advisor.

‘“I am delighted that so many more patients can now view their appointments in the HSE Health App from today,” said Minister for Health, Jennifer Carroll MacNeill.

“This will make it easier for them to keep track of their appointments when they download and log in to the app, and I would encourage everyone to do so.”

The Minister added that work is underway to add more appointments over time.

“This phased introduction of appointment notifications is the first step to enabling patients to book, reschedule or cancel certain appointments in the app. It enables us to ensure that more patients are provided with easily accessible health information that is accurate and trustworthy.’’

The Executive added that future app features will be guided by ongoing research and engagement with patients, staff, advocacy organisations, and the public. 

Mr Damien McCallion, HSE Chief Technology and Transformation Officer, said that the additions to the app “represents significant progress” in the HSE’s journey to a more digital and user-friendly health service. “We will continue to build on this success and will work with our voluntary hospitals, to ensure our patients, wherever they are receiving care, will have all their appointments in one app.”

The Irish Society of Specialists in Public Health Medicine (ISSPHM) has called on the Taoiseach and Government to intensify efforts help alleviate the suffering of people in Gaza.

In a letter dated 7 August, ISSPHM Chair Dr Kenneth Beatty said public health doctors are “once again” urging the Taoiseach to “do more for the people of Gaza as a matter of grave urgency”.

Dr Beatty wrote that over “the last 22 months, we have watched helplessly as this catastrophic, man-made public health emergency has unfolded”.

“The civilian population in Gaza has been subject to military assault, bombings, repeated forced displacement, the destruction of housing, food and water supplies, and the relentless/repeated dismantling of healthcare services and infrastructure.”

He noted that there is evidence that starvation “is being used systematically as a weapon of war” by the state of Israel.

“The life-long public health impact of physical and psychological trauma, along with starvation particularly for the children who survive cannot be underestimated.”

Dr Beatty added that many healthcare workers in Gaza have been killed or injured in this conflict.

A total of 917 were killed in attacks as of May 2025, with 1406 injured, according to the World Health Organisation.

The ISSPHM said the Irish Government should use every diplomatic and political channel available to press for a permanent ceasefire and to ensure life-saving humanitarian aid can flow freely through established relief networks.

The letter also calls on the Government to advocate for “large-scale EU economic sanctions on the state of Israel”, as well as ceasing the issuing of licences “for the export of dual use goods to Israel”.

The Society states it is important to ensure “that procurement policies across all Government departments are aligned with human rights/International Court of Justice ruling perspectives.”

ISSPHM members have also been encouraged to send the letter to their local TDs on the issue.

The Government’s decision to delay the planned rollout of alcohol health information labelling, is a “serious threat to public health”, according to the IMO President.  

Dr Anne Dee, a Consultant in Public Health, said the delay “until 2028 at the earliest”, places corporate interests ahead of the health and wellbeing of Irish people.

The Government’s action would result in preventable incidences of cancer, increased incidences of liver disease, and harm to children “because of a refusal to fully enact a bill signed into law seven years ago”.

Dr Dee added that the labelling provisions under the Public Health (Alcohol) Act 2018 are a critical tool in reducing alcohol-related harm, particularly when Ireland “continues to experience worsening rates of liver disease, alcohol-related cancers, and foetal alcohol spectrum disorder”.

“This is about giving people the basic information that alcohol causes cancer, liver damage, and harm during pregnancy. These are irrefutable facts. There is no excuse for keeping them off the label,” she said. “The longer this Government delays, the more irreversible damage is done.”

The IMO President further criticised the influence of “vested interests” in opposing the measure.

“We welcome the fact that the Government recently reiterated its refusal to meet with representatives of the tobacco industry in keeping with Ireland’s obligations under international frameworks that recognise health-harming industries. But why is the alcohol industry, which produces a substance that results in the deaths of up to 1,500 people in Ireland every year, treated differently?”

Dr Dee reiterated that the full implementation of all measures in the Public Health (Alcohol) Act “must happen” without any further delay.

The full roll-out of electronic health records (EHRs) will be a “once in a generation opportunity” to transform the Irish health services’ digital infrastructure and dramatically improve patient care, according to the IHCA President.

Prof Gabrielle Colleran was reacting to Government commitments in the updated National Development Plan for 2026 to 2035 on the digitalisation of the health service.

“We fully endorse and support the decision in the National Development Plan to prioritise health digitalisation. This would be transformational in nature and a once-in-a-generation opportunity to catch up on other countries where digital health records are the norm, enhancing productivity, healthcare outcomes, and service experience for citizens.” 

Prof Colleran noted that the health system continues to rely on an “antiquated records model which is desperately inefficient”.

“It also means healthcare professionals are unable to access and assess patient records in a joined-up, real time fashion. This is at a time when governments around the world are turning their attention to how generative artificial intelligence can transform health systems, improving patient outcomes and overall productivity. The gap from where we are to where we need to be is stark,” said Prof Colleran.

The National Development Plan, which will see €102.4bn in capital investment provided over the next five years, with an overall investment of €275.4bn out to 2035, has allocated €9.25bn to health for the period 2026-2030.

The IHCA has urged the Minister for Health Ms Jennifer Carroll MacNeill to ringfence the required funding for EHRs and prioritise the rapid expansion of current hospital capacity to address the growing demand for care from a growing population.

The IHCA added that a “proper procurement and implementation plan” is now required to accompany this investment in health digitalisation, to ensure value for money, avoid delays, and manage any risks presented by the current fragmented EHR landscape, “which is a reflection of the incremental approach taken to date”.

“The IHCA acknowledges that the recent increases in our health budget is a significant step toward addressing such long-standing deficits,” added Prof Colleran. “However, additional capital investment is still needed to build and open all of the required additional hospital beds, theatres, diagnostics and other facilities across our public hospital base in order to reduce bed occupancy rates, address the numbers of admitted patients being treated on trolleys, and reduce the cancellation of appointments and lengthy waiting times for treatment.”