The IHCA has expressed its deep concern over what it described as the “damaging closed down approach taken by the Minister for Health”, which has prevented any engagement with hospital consultants over the past 20 months. 

The Association told members attending its Annual Conference in Kilkenny today (17^th October 2026) that it has only met with Minister Jennifer Carroll MacNeill once during her time at the Department of Health, in March 2025. The Association said this was the case despite repeated invitations to attend conferences, open headquarters, and discuss urgent patient-focused reforms.

This, it said, was in contrast to the Government’s adoption of an ‘open-door’ policy towards other unions and representative associations, as it seeks to avert a second nationwide strike.

IHCA President Prof Gabrielle Colleran commented: “If this week’s industrial action has taught us anything, it is that engagement is key to resolving differences, building trust and finding sustainable solutions to our most intractable problems.

“What does it say about the relationship between the leadership of our health service and the medical profession when the organisation representing almost 5,000 hospital consultants cannot secure a discussion with the Minister for Health?” 

Addressing recent comments by the Minister regarding a legal action taken by two consultants over access to the new surgical hubs, the IHCA reiterated that it was not a party to the case. It added that it strongly supported the establishment of these surgical hubs, as well as the long-overdue elective hospitals, which together could significantly address the current record waiting lists and wait times for hospital care.

The Association said the decision of two consultants to seek redress through the courts should not be “used as an excuse” by the Minister to stymie vital engagement with the wider consultant profession, or worse, to prevent other senior health management from interacting with the Association. 

HSE CEO Anne O’Connor, who was due to speak at the IHCA Conference today, was forced to cancel at short notice. HSE Deputy CEO Damien McCallion and former Department of Health Secretary General Robert Watt had also accepted invitations to attend IHCA events this year, only to withdraw their attendance.

“The IHCA stands ready to work constructively with the Minister, bringing forward clinician-led, sustainable solutions to the many challenges facing our health service. But if engagement is being systematically discouraged or prevented, that would be a matter of profound concern,” added Prof Colleran.

The 38th IHCA Annual Conference is addressing many issues facing the health service today, including financial constraints, workforce pressures, and how clinician-led innovation can transform service delivery and improve patient outcomes.

Doctors will attend picket lines at over 30 locations today, according to the IMO. The largest public sector strike in recent years takes place across the country today.

The IMO confirmed that pickets will be in place at over 30 hospital locations in support of the industrial action taking place across the public sector.  

“Doctors who are supporting today’s action are extremely mindful of the challenges the disruption will mean for patients,” the Organisation said in a statement. “In preparing to support this action, the IMO has prioritised patient safety and has taken steps to minimise the impact of the action on patients across the health services and particularly on users of Emergency Departments.” 

The IMO described as “hugely regrettable” that public sector employees “have been pushed” into supporting this day of action. 

“But this is not a crisis of our making.  Responsibility for the matter lies with the Government and we urge the Government to take steps urgently to open talks to resolve this issue and save the public from any further disruption in the coming weeks.”

The expansion of surgical hubs and the opening of additional “hospital and community capacity” will be some of the measures arising from the health funding within Budget 2027 according to the Minister for Health.

The Government announced that €29.1 billion was being “delivered” for health services in the Budget.

“This €29.1 billion allocation is focused on what matters most to patients: earlier access, more care closer to home and better use of our staff, facilities and equipment,” said Minister Jennifer Carroll MacNeill.“We will expand our surgical hubs, open additional hospital and community capacity, strengthen GP and pharmacy services and accelerate digital health.”

According to the Department of Health the funding “continues investment in more care, closer to home” and includes;

• “Additional €1.76 billion will expand capacity, strengthen community services and accelerate reform across the health service”.
• More evening and weekend activity across theatres, outpatient clinics and diagnostics, making better use of existing staff, facilities and equipment.
• Additional hospital, community and mental health capacity will be opened and brought into operation.
• 1.8 million additional home-support hours and €2 million more for Meals on Wheels.
• Continued expansion of healthcare training places “to strengthen the future workforce”.
• Expanded older persons and community supports, including additional home-support hours, dementia services and community-based care.
• Improved access to oral health and orthodontic services for children, including reducing waiting lists in the School Dental Programme and improving access to more complex dental treatment.

“More planned care will also be provided in the evenings and at weekends, helping patients to be seen, diagnosed and treated sooner,” said Minister Carroll MacNeill.

“Our priority is to ensure that the investment we are announcing today delivers clear, measurable improvement to services for people.

“Budget 2027 will also support a more responsive and efficient model of care by aligning the workforce with patient demand, reducing reliance on agency staffing and moving care to community, home-based and virtual settings. For people living with and beyond cancer, this will include providing suitable monitoring and follow-up closer to home, making care more convenient while protecting hospital capacity for those who need specialist treatment.”

A new surgical hub in Cork, providing care for HSE South West, was officially opened today.

Once fully operational, the hub will include four-day case operating theatres and supporting spaces, two minor procedure rooms, five outpatient department (OPD)/treatment rooms and a dedicated recovery unit and associated clinical support services and staff facilities.

The hub is located on the Cork University Hospital (CUH) campus. According to the Department of Health, operational activity will commence from tomorrow (29 September), with a “phased introduction” of services. Eventually this hub is expected to deliver additional annual activity of approximately 8,000 day-case procedures, 5,700 minor operations and over 18,400 OPD appointments.

The Taoiseach, Micheál Martin and Minister for Health, Jennifer Carroll MacNeill TD, attended the official opening.  

The Taoiseach said that by “developing new facilities such as this state-of-the-art surgical hub, we are ensuring that Ireland’s healthcare system is fit for the future”.

The Minister for Health said these hubs “are designed so that patients move seamlessly in one direction, from registration to pre-admission to the operating theatre, to the recovery bay, and then, on the same day, are discharged home”.

The Cork surgical hub is part of the wider Sláintecare elective care programme which is delivering surgical hubs and elective treatment centres across the country.

Three hubs are already operational (the Reeves Centre in Tallaght and the surgical hubs in Mount Carmel and Swords). A further three are due to start treating patients in the coming months in Limerick, Waterford and Galway, with two more hubs in Sligo and Letterkenny currently in the design phase.

According to the Department the new Cork hub will deliver “significant additional capacity” with “thousands of day-case procedures, minor operations and outpatient consultations every year”.

The IMO has commenced a ballot of doctors employed across the public health system on industrial action, up to and including strike action.

According to the IMO, the ballot is a response to Government “inaction” on a new public sector pay deal and failure to conclude local bargaining arrangements due under the last agreement. The current public service agreement expired in July 2026 and, to date, the Government has not engaged on a successor agreement.

The IMO is recommending to members that they vote ‘yes’ in the ballot on industrial action, which will close on Monday 21 September.

These members include consultants, NCHDs, and public and community health doctors.

In a statement, the Organisation said that while industrial action and “particularly strike action would be a last resort”, the IMO has made it clear to members that unless there is immediate and serious engagement by Government and the HSE, “it will not hesitate to use it to bring about much-needed agreement.”

After the ballot results, the national specialty committees and council will meet to determine the nature of industrial action.

The Medical Council has launched a public consultation on proposed registration (amendment) rules which are required to support the commencement of the Regulated Professions (Health and Social Care) (Amendment) Acts 2020 and 2023, next year. 

These Acts introduce significant changes to the registration system and require the existing framework to be updated.

Executive Director for registration operations with the Medical Council, Ms Trudy Reid, said “With over 35,000 doctors on the Medical Councils’ register, this public consultation plays an important part in implementing recent legislative changes.”

“These changes which will enhance the way we register doctors, consolidate exiting rules and ultimately support us in contributing to patient safety and public protection.”

She added that this consultation provides an opportunity for doctors, members of the public, individuals and organisations to share their thoughts on these changes.

“I would encourage anyone with an interest in this proposal to take part in consultation.”

The draft rules will be subject to a public consultation and a proportionality assessment before being considered by the Medical Council and progressing through the legislative process.

According to the Medical Council the proposed rules include five key changes:

1. Consolidation of existing Rules: Seven sets of registration rules will be combined into a single set of registration rules. Professional indemnity rules will remain unchanged.

2. Register of Interns: Interns will no longer be registered in the trainee specialist division, and a separate Register of Interns will now be established. 

3. Recognition of qualifications before registration: Applicants will need to have their medical degree formally recognised before applying for registration.

4. Register of Adapters: A new register of adapters will be established primarily for certain EU/EEA citizens undertaking compensatory measures, including adaptation periods.

5. English language requirements: All first-time applicants will be required to meet English language requirements.

The public consultation is open from 3rd September to 6th October.

There are increasing workload pressures on the “growing and diversifying” medical workforce, according to the newly published Medical Workforce Intelligence Report 2025.

The Medical Council’s report found that in 2025, there were 22,257 clinically active doctors practising medicine in Ireland. The proportion of clinically active female doctors rose to 47.6 per cent, representing a slight but steady increase in recent years.

The mean age of doctors was 43.6 years, with approximately one in five (20.1 per cent) aged 55 or older and approaching typical retirement age. The gender split was almost even across all age groups except the 55 or older cohort, where 66 per cent were male.

There were 5,017 doctors self-reporting as GPs, an increase of 5.3 per cent compared to the previous year. Some 78.9 per cent of GPs were on the specialist division, and 19.3 were per cent on the general division.

Some 22.1 per cent of doctors self-reported working more than 48 hours a week on average, a slight improvement on 2024.

In relation to services provided, the report found “persistent barriers to safe patient care”.

Only one-third of doctors (30.7 per cent) reported never experiencing difficulties providing patients with sufficient levels of care. More than one-quarter (27.6 per cent) experienced such difficulties at least once a week or more often.

In response to the report, the IHCA noted that one in 12 doctors (9 per cent) told the Council that they experience difficulties providing patients with sufficient care at least once a day.

“It is not surprising to learn that [so many] doctors report experiencing difficulties at least once a day providing a patient with the sufficient level of care needed. This is the lived experience of so many of my specialist colleagues,” said IHCA President Prof Gabrielle Colleran.

“While ‘pressure on workloads’ was the single most frequently quoted barrier, the fact that ‘time spent on bureaucracy/administration’ was a close second highlights yet again the need to accelerate the roll-out of electronic health records across the health system as a matter of urgency. The current fragmented nature of our digital technology in the health service continues to impact directly on patient care, and the roll-out of the national [electronic health record] cannot come soon enough.”

Prof Colleran said the IHCA is particularly concerned with the finding that 41 per cent of all doctors who report working more than 48 hours on average per week are spending more than 48 hours in direct patient care.

“This means these doctors are not only working excessive hours, but are doing so in intensely pressurised conditions, and are not being given adequate time by their employer to keep up with the necessary administrative tasks that are required to make the job both sustainable and safe for patients.”

Also commenting on the report, Dr Pallavi Bradshaw, Medical Director, Medical Protection, said: “It is encouraging to see continued growth in Ireland’s medical workforce and increasing numbers of GPs. However, it is concerning that so many doctors continue to report barriers to providing patients with a sufficient level of care, with workload pressure, bureaucracy, and overcrowding continuing to have an impact on healthcare professionals.”

 “These findings highlight the need for continued action to reduce these barriers, improve workforce retention, and ensure doctors have the time and resources they need to deliver safe, high-quality care.”

Dr Bradshaw also pointed out the report highlights Ireland’s growing reliance on international medical graduates.

“As this trend continues, it is essential that international medical graduates receive comprehensive induction and ongoing professional support throughout their careers. Ensuring doctors are well supported to navigate a new healthcare system is not only important for their wellbeing and career development, but also for patient safety and the long-term sustainability of the workforce.”

The IMO has called claims that consultants are not working enough weekend shifts in public hospitals a “fallacy”. In a statement today, the Organisation also highlighted what it called the “sustained shortfall” in doctors in the health system.

“The reality of this situation is that every weekend, consultants up and down the country are working on call, carrying out ward rounds, reviewing and discharging patients, and responding to emergencies,” said Prof Mick Molloy, Chair of the Consultants’ Committee of the IMO.

“This is in addition to working their core hours on a Monday to Friday. This work is critical to the functioning of our hospitals but is often absent from discussions about consultant availability and weekend working.”

The IMO said it was responding to media reports of a HSE briefing to Minister to Health Jennifer Carroll MacNeill, suggesting consultant weekend work in three regions of the country was still too low.

“Rostering consultants for core hours on a Saturday means that they must take another day off during the week or this additional work day to be classed as overtime which is not financially effective in the current constraints,” continued Prof Molloy.

“In order for weekend core hour rostering and extended day core hour rostering to be effective, a whole of hospital approach is required. Using a consultant’s core hours for an out patient clinic on a Saturday, rather than inpatient work on a Monday, is a poor use of resources.”

He noted that the Department of Health has stated that Ireland needs to have 110 consultants per 100,000 population. In terms of whole-time equivalents, Ireland is currently at 87.6 per 100,000, he added.

“In a situation where a consultant can have a full team, services and infrastructure available on a Monday, but not on a Saturday, it does not make sense to roster the consultant on a Saturday as there is less productivity. This is why hospitals are in some cases slower to roster consultants on a Saturday. The public-only consultants’ contract allows such rostering but there is no recognition of the additional staff required to make a comprehensive six-day health service a practical reality.”

He added: “The IMO supports any move that will facilitate better and more accessible care for patients throughout the week, but it is a fallacy to think this can happen without firstly having the correct numbers of consultant and healthcare staffing in place.”

The IHCA is seeking “urgent clarity” on how the abolition of insourcing in the HSE will impact patient capacity.

The Association called on the Minister for Health and the HSE to outline what replacement capacity will be provided and set a “clear timeline for delivery”.

In a statement the Association noted that insourcing has now ended across all HSE regions. Citing a report in today’s Irish Times, the IHCA noted that an internal HSE report warned that the abolition of insourcing could create a “significant risk of unintended harm to patients”. The confidential HSE report examined the impact on the HSE West and North West region.

The IHCA said that while this report relates to only one region, insourcing was used across the country and has now ended nationally.

“Insourcing was helping patients,” said IHCA President Professor Gabrielle Colleran.  

“That is the starting point for this conversation and a fact that has been almost entirely lost in the political and media debate of recent months. Consultants were coming in on their own time, outside contracted hours, to see patients who had already been waiting too long for care.”

She noted that the HSE’s “own internal report warned in writing that ending insourcing without replacement capacity would create a significant risk of unintended harm to patients”.

“The question patients now need answered is simple: what is the plan? What replaces this capacity, and by when?”

According to the IHCA President, Ireland continues to have too few consultants and insufficient protected capacity across outpatient clinics, diagnostics and operating theatres.

“We also continue to face inadequate investment in hospital infrastructure. Until these underlying issues are addressed, patients will continue to experience unacceptable delays, regardless of which short-term initiatives are introduced or withdrawn.”

The IMO has said it is “unrealistic and unhelpful” to assume weekend rostering for consultants in hospitals can be introduced in an “effective manner” without all other hospital staff being rostered in the same way.

The Organisation was responding to an HSE internal audit on the implementation of the public-only consultant contract (POCC).

The audit stated there was inadequate oversight of increased rostering of consultants at weekends and evenings.

According to RTÉ, the audit found the contract did not have a significant impact on the number of consultants available to work weekends or evenings. Of the 2,954 consultants on the POCC in February 2025, 80 per cent were rostered Monday to Friday, 12 per cent on weekday evenings, 11 per cent on Saturday daytime and 56 per cent were on call on a Saturday.

The IMO said it “welcomed” the fact that the audit “dispelled the myth that consultants don’t work on weekends”, as it showed over half (56 per cent) work on call on a Saturday.  

Prof Matthew Sadlier, President of the IMO and Consultant in Old Age Psychiatry, said that it made “little sense” for consultants to be rostered on weekends in isolation. “We welcome the fact that this audit shows consultants regularly work on-call at weekends, so working weekends in and of itself is not a problem.”

“However, it is unrealistic and unhelpful to assume this can happen effectively without all other staff in a hospital being rostered in a similar manner so consultants can practice safely with a full team present.”

He said that moving to weekend rostering must include an assessment on how this will affect mid-week services and continuity of care.

“While the POCC has been successful in attracting new consultants to posts that previously could not be filled, we are still critically below OECD averages for numbers of consultants per head of population and have no safe staffing framework in an environment of rising demand,” he said.

“In this context, it makes little sense to introduce weekend rostering if it detracts from mid-week services. If the right resources were available, this could be easily introduced but unfortunately, we are not at that stage yet.”

Prof Sadlier noted that consultants were rostered on a work plan agreed with management, and that while more consultants were now working on weekend discharges, a whole-of-hospital approach was needed to extend this to elective services.

Unrealistic budgeting is having a “hugely negative” effect on the health system, according to the IMO.

In a statement, the Organisation said it was “unreasonable” to expect the system to run on figures that did not reflect the demand of a growing and ageing population, with increasingly complex treatment needs.

The IMO welcomed the publication of a Fiscal Advisory Council analysis earlier this week which “identified bad budgeting” as a key reason for overspending in the health system.

“No health system can balance the books if the financial targets it sets for itself are completely unrealistic,” said Prof Matthew Sadlier, IMO President.

“We are in a bizarre situation now whereby the Government is setting itself up to fail by delaying the introduction of multi-annual funding and setting targets that can never be met.”

He said that it appeared that the Government was unwilling to accept the reality of the needs of a growing and ageing population. “If we want to create a world-class health system, we need to properly resource the system with the right amount of beds and doctors, and we cannot be slaves to farcical yearly targets that everyone who works in the system knows we cannot hope to achieve.”

He noted a recent IMO survey which suggested that 98 per cent of doctors believe cost-cutting measures recently announced by the HSE will negatively impact patient care.

“The IMO has consistently said that if we are to promise a health service that delivers for patients, we must fund it, or else be honest with the public and say what cannot be done within the fiscal restraints.”

He added that the removal of private practice from public hospitals had created a gap in funding. Prof Sadlier said the Government had promised to replace that funding but said it was unclear as to the process for identifying and replacing the lost income upon which the health system relied.

The commitment to a 180-day timeline for reimbursement decisions by the first quarter of 2029 will require more resources, the Clinical Director of the National Centre for Pharmacoeconomics (NCPE) has told this newspaper.

The commitment is part of the framework agreements for the supply and pricing of medicines the Government recently signed with Medicines for Ireland and the Irish Pharmaceutical Healthcare Association.

The agreement promises a structured process towards achieving a 180-day timeline for reimbursement decisions by the first quarter of 2029.

According to the Government, this will accelerate patient access to new treatments.

“The real challenge will be about getting the assessments done, to get the price negotiations done in that narrow time frame,” Prof Michael Barry told the Medical Independent (MI) at the recent AXIS conference on access to medications at the RDS in Dublin.

“But look, we’re moving towards it [the 180-day target]. It’s planned to be introduced by quarter one in 2029. We will do everything we possibly can to make sure we reach that.”

He welcomed the fact that the HSE drugs group and the HSE Corporate Pharmaceutical Unit (CPU) have received increased resources in recent years.

But the new target would require further funding.

“It will require resourcing, not only for the NCPE, but also for the HSE [CPU] and indeed the [HSE] drugs group,” according to Prof Barry. “For all components of the reimbursement chain.”

Separately, MI asked the Minister for Health Jennifer Carroll MacNeill about the 180-day commitment and resources at the recent Irish Nurses and Midwives Organisation’s Annual Delegate Conference in Dundalk, Co Louth.

The Minister pointed out the NCPE team has approximately doubled over the past two years.

“So already huge resources have gone into that,” the Minister told MI. “And we have to continue to work towards the 180 days.”

See news feature, Accessing medicine in a time of global uncertainty – Medical Independent