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.”

IMO members have voted in favour of industrial action, up to and including strike.

Some 94 per cent of doctors who were balloted supported industrial action. These included consultants, NCHDs, and public and community health doctors.

GPs were not balloted as they are independent contractors and not directly employed by the HSE.

According to the IMO: “The ballot was held in line with other public service unions and 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 said that it was “deeply regrettable” this step had been taken but it was “inevitable given the Government’s failure to engage constructively”.

IMO national committees will meet today (Tuesday) to consider the nature of the industrial action. It will then serve three weeks’ notice to the HSE and voluntary hospitals, with action set to commence on Wednesday, 14 October.

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 IMO has called for the introduction of a multi-annual approach to funding healthcare in its pre-Budget submission.

The Organisation warned that Ireland’s growing and ageing population is poorly served by the “current annual cycle of under-budgeting”. The IMO said this leads to “overspending” in a service that is facing increasing demand and “inevitable, extreme cost-cutting measures” which are damaging to the health service.

The IMO launched its pre-Budget submission today. According to the Organisation, it is “imperative” that the “health system adopt a realistic allocation of resources based on population need, and for priority to be given to developing a safe medical staffing framework across HSE settings to deliver safe, quality care to patients”.

It said this would also help to address burnout among the medical workforce, and improve morale and retention among this cohort.

The IMO added that the Pay and Numbers Strategy – which lays out the recruitment targets and staff ceilings – must take into account safe medical staffing levels, predicted increases in patient demand, and strategic priorities for reform.

Other recommendations from the IMO include:

• Safe medical staffing and workforce planning to ensure that there is an adequate amount of medical staff serving a growing population.
• Increase the number of new inpatient beds from 3,438 to at least 5,000 under the Acute Hospital Bed Capacity Expansion Plan 2024-2031.
• Amend the Critical Infrastructure Act 2026 to include public healthcare facilities as critical infrastructure and to streamline the development and building of vital healthcare infrastructure.
• Introduce tax incentives for investment in general practice infrastructure which would allow individual GPs (as opposed to corporate entities) who invest in their infrastructure to write-off the cost of such investment against tax over a defined period of time.
• A rapid expansion of postgraduate medical training places to meet the needs of the current and future workforce needs across Ireland.

Prof Matthew Sadlier, President of the IMO and Consultant Psychiatrist, said: “The Government must use this opportunity to finally put an end to the annual charade of setting an unrealistically low budget which will inevitably lead to overspending and the unfair castigation of the medical workforce who are working themselves to burnout in a system that is completely unfit for purpose.

“To do this, we must eliminate annual budgetary targets and, for once and all, adopt a multi-annual approach to funding that is realistic and, by extension, provides the foundations for a well-resourced and funding health system. If we do not do this, then nothing will ever change; doctors will continue to work in an inefficient system, budgets will continue to be overrun, and patients will bear the consequences.”

He added that safe staffing and increased bed capacity were key issues. “Without the requisite number of doctors and beds, our health system will be stuck in neutral without any chance of improvement. If we want a better health system, then the basics need have to be addressed first.”

Prof Sadlier added that investment in general practice infrastructure was a priority. “It is prohibitively expensive for GPs to invest in practice infrastructure and they must be supported through tax incentives and through dedicated funding for rural and deprived areas.”

He added that the Chronic Disease Management Programme in General Practice should be expanded on a universal basis to all patients with specified chronic conditions over 18 years old.

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.”

Major investment in general practice is needed to enable GPs to expand capacity and infrastructure, according to the IMO.

The organisation was responding to figures confirming that almost 6,000 people have contacted the HSE so far this year seeking help in finding a GP. 

The IMO said the State had not invested sufficiently in GP infrastructure to date and recommended that supports must be introduced on two fronts. The first to enable established practices to take on more GPs. The second to support newly qualified GPs with dedicated supports to set up new practices.

Speaking today, Prof Tadhg Crowley, Chair of the GP Committee of the IMO, acknowledged that the State had invested in additional GP training places, but said there were no supports for GPs beyond their training.

“We have a cohort of highly trained professionals and we must ensure they are enabled to meet the needs of patients through pathways to partnerships in existing practices or through targeted supports in establishing new practices. It is hugely difficult for newly-graduated GPs to set up their own practices, which contributes to our significant recruitment and retention problem.”

Prof Crowley said that he was concerned that the numbers of people contacting the HSE did not reflect the true scale of the problem.

“The number of people without a GP around the country is likely to be much higher than 6,000 and the danger is that these patients source healthcare with online providers or other services which may not always be appropriate and do not deliver the continuity of care a GP offers.”

He said that GPs were operating at full capacity and many could not take on new patients. “GPs cannot just take on new patients endlessly. Each doctor must assess their patient base to ensure they can all be treated safely.”

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.

There was an increase in the number of positions processed by the consultant applications advisory committee (CAAC) last year compared to 2024, according to the CAAC’s 2025 annual report.

The HSE National Doctors Training and Planning ‘consultants’ division’, which is the secretariat to the CAAC, processed a total of 400 applications in 2025.

These applications include new post applications, requests to restructure existing approved consultant posts, direct replacement applications, and change of contract type requests.

The volume of applications processed increased by 53 applications, or 15 per cent, compared to 2024.

Of the 400 applications, 275 were considered by the CAAC, which was an increase from 225 in 2024.

The remaining 125 applications were direct replacement requests and were processed directly by the consultants’ division.

Of the 275 applications considered by the CAAC, 272 applications were recommended for approval, while three were deferred for further consideration.

The posts recommended for approval by the CAAC included 92 in general medicine, 42 in surgery, 31 in psychiatry, 30 in radiology, 23 in emergency medicine, 21 in pathology, and 17 in anaesthesiology.

The 125 direct replacement post approvals processed directly by the consultants’ division included 33 in psychiatry, 28 in general medicine, 15 in surgery, 10 in pathology, and 10 in obstetrics and gynaecology.

This year’s report highlighted the “significant evolution” of the CAAC’s work since the introduction of the public-only consultant contract (POCC).

The report states that following the introduction of the POCC in 2023, applications in respect of replacement consultant posts are no longer required to be presented to CAAC.

However, posts requiring restructuring from original approval still require committee approval.

“This procedural change represents a significant evolution in the committee’s workload and oversight responsibilities,” according to the report.

As a result, the CAAC’s role regarding replacement posts has shifted from high-volume, administrative scrutiny toward a more “targeted and strategic oversight” function.

“The committee’s focus is now concentrated on posts that involve restructuring, service redesign, or material deviation from original approval – areas where its evaluative and governance expertise adds greatest value,” according to the report.

“This enables deeper consideration of workforce alignment, service reform objectives, and compliance with national policy, rather than routine confirmation of established approvals.”

See news feature in the 5 May edition of the Medical Independent

The new IMO President has called for a major investment programme in new hospitals to address the “estimated shortfall of 5,000 hospital beds” in the country.

Professor Matthew Sadlier was speaking during his inaugural address at the organisations AGM, in Hotel Europe in Killarney, Co Kerry.

Professor Sadlier, who is a Consultant Psychiatrist, said that the shortage of hospital beds was “directly contributing” to the crisis with both waiting lists and hospital emergency departments.

Professor Sadlier also praised the contribution made by “international doctors and all our international colleagues” in healthcare and criticised recent incidents of verbal and even physical abuse against health service staff based on their race, religion or ethnicity.

“The Irish health services and the people of this country are utterly dependent on the contribution of international doctors, nurses and support staff”, he said.  “The thugs who shout obscenities and physically threaten these colleagues bring shame to this country and their behaviour must never be tolerated or accepted.”

Professor Sadlier also emphasised the importance of contract negotiations currently underway with NCHDs; “it was encouraging to hear Ann O’Connor’s (HSE CEO) words of respect for NCHDs earlier today [at the AGM on Saturday] but we have heard similarly warm words in the past without making the progress necessary”. 

“Many years ago, I was part of the team that launched legal proceedings against the HSE over the European Working Time Directive – now the Organisation of Working Time Act.  I am truly saddened that NCHD working hours are still above legal working limits which is not only about the employer breaking the law but also unsafe for patients and doctors.”

The decision of An Coimisiún Pleanála to reject plans for a €100 million extension to the Rotunda Hospital in Dublin, is “short-sighted and regrettable”, according to the IMO.

Prof Matthew Sadlier, IMO Vice President and chair of the organisation’s consultants’ committee, added that the decision will “jeopardise the wellbeing” of many women and their infant children.

“The Government has rightly given special status to energy, water and transport in its latest critical infrastructure plan, but it is clear that healthcare infrastructure needs to be added to the list,” he said.

“For too long, patients and the healthcare staff who treat them have been forced to endure inadequate conditions in archaic facilities around the country, and this latest decision will perpetuate this dangerous reality for patients of the Rotunda Hospital.

“Our perennial inability to adequately fund and resource our health system has led to a multitude of chronic problems, of which infrastructure is just one. The Government must take action to address the issue of planning in the context of building much needed healthcare infrastructure.”

Separately in a joint statement released on Friday, the Rotunda Board and Executive Management Team said they were “bitterly disappointed”.

“This decision will have devastating consequences for the women and infants who trust us with their care,” according to the statement.

“Most affected will be the tiny fragile premature infants who require prolonged, safe intensive care which should be provided in a modern 21st century neonatal intensive care unit.  As Ireland’s busiest maternity hospital providing care to a quarter of the state’s premature and critically ill babies it is essential that we address the infrastructural deficits and spatial constraints in a timely fashion.

“This decision will not only create clinical risk for the most vulnerable cohort of patients in the health system but may have a national impact in terms of neonatal capacity.”

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.”