Irish Hospital Consultants Association (IHCA) respond to comments made by Minister for Health Simon Harris before the Oireachtas Health Committee on Wednesday 11 December 2019

IHCA welcome the commitment from Minister Harris to further engagement in order to address the ongoing consultant recruitment crisis. The Government’s discrimination against consultants since October 2012 has resulted in one-in-five, or 500 permanent consultant posts, being unfilled in public hospitals across Ireland. This has exacerbated the delays in providing care to patients and led to record waiting lists. Consultants have been repeatedly calling on the Government, but to no avail, to provide us with the capacity to treat all public hospital patients in a timely manner without delays.

“Consultants provide care to patients each day in public hospitals with extreme capacity deficits that are deteriorating by the month. This is evidenced by the cancellations of all but emergency and urgent surgery for months, the increasing number of patients being treated on trolleys year-round and the one million people on waiting lists to access hospital care.

“Consultants have grave concerns about the absence of real commitment to put the required public hospital capacity in place so that timely, safe, high quality care can be provided as needed to our growing and ageing population.

“In the absence of real, funded capacity commitments, the government is focussed on the symptoms of the capacity problem and rejecting the valuable public hospital income stream from health insurers equivalent of €6.5 billion over a decade, which will never be replaced based on the rationing of care being introduced each Autumn and Winter.

“Unless addressed, the Government’s proposals will starve public hospitals of required investment and annual funding, further exacerbating the capacity deficits and delays in providing care to patients.

“There are many questions yet to be answered by the Government and the Minister for Health such as:

  • Why doesn’t the Government and the Minister for Health first put in place the increased capacity that is essential to provide timely care to end the inappropriate treatment of patients on trolleys and unacceptable waiting lists. To do this the Government needs to commit multiannual funding for the next 7 years. This is urgently required to put in place the additional 2,600 public hospital beds and related hospital diagnostic, theatre and other facilities – plus the additional 4,500 community step down beds as outlined in the 2018 Capacity Review and the National Development Plan.  There is currently a very high need for capital investment in public hospital capacity and resultant annual running cost increases. It would be strategically and practically damaging to reject €6.5 billion over a decade in hospital income from insurance companies for patients who will continue to need care in public hospitals,


  • How many additional public hospital beds will be freed up by removing health insurance income in public hospitals? The Department of Health was recently reported as saying it would be 2,100 beds. In contrast, the IHCA has concluded that this is only possible if the existing portion of public hospital patients with health insurance won’t need public hospital care in future. This is very unlikely as such patients will need to be treated in public hospitals for cancer, trauma, complex surgery and other treatments not available in private hospitals. On that basis the number of public hospital beds that could be freed up will be miniscule at best. This view is supported by the secretary to the independent review group (chaired by Dr Donal de Buitléir) tasked with looking at this issue. He is reported as saying “the removal of private activity is unlikely to free-up significant capacity and therefore does not free-up any beds”.


“The IHCA and hospital consultants are committed to working with the Minister for Health, Government and HSE to improve access and the quality of care delivered to all public hospital patients. We urge Minister Harris to engage with the IHCA to address the issues of capacity and fill the 20% unfilled consultant posts so that patients in Ireland can avail of timely specialist care.

“However, consultants cannot support measures which will fail to address the overwhelming capacity deficits that are the root cause of the delays in providing timely, quality patient care, and will further destabilise our crumbling acute, public hospital system”.

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