IHCA End of Year Review
Care Can’t Wait – IHCA Look Back on 2023
Written by Professor Rob Landers, President, IHCA
The Irish Hospital Consultants Association (IHCA) welcomed in the new year by expressing its concern over the continued pressures being faced by Ireland’s acute hospital services as extreme levels of overcrowding in emergency departments and un-safe capacity limits hit record new highs.
Commenting, a spokesperson for the IHCA said, “The Irish health service is once again the focus of public, political and media attention. The level of coverage of individual and collective experiences from within our hospitals over the past number of weeks is only comparable to that of the start of the Covid-19 pandemic. It is not inconceivable that we could see 1,000 admitted patients being treated on trolleys on a single day in the weeks ahead.
“Public hospital staff are working tirelessly attempting to provide appropriate levels of care to patients. Consultants are on call 24/7, often practising over and above recommended levels, but the reality is there simply aren’t enough of us to meet increased demand. We are still working with 40% less Consultant staffing in Ireland, compared to the EU average.”
By February, they warned that the ongoing shortage of Consultants across Cork hospitals and unaddressed bed capacity deficits, were restricting patients from accessing timely, high-quality medical and surgical care. The six hospitals in the Cork region1 saw 2,300 additional people added to their waiting lists for outpatient appointments and procedures in 2022 – a increase of almost 3%.2 This compares with a modest reduction of 5% (-7,800) in the number of people on the three main waiting lists under the Government’s Waiting List Action Plan3 across the wider South/South West Hospital Group (SSWHG), and a 4% (-28,900) fall nationwide, meaning the Plan missed its key targets in the region.
The Association launched a new video this year, as part of their ‘Care Can’t Wait Campaign. Active since June 2022, the campaign highlights the consequences of the shortage of hospital consultants and public acute hospital beds.
In the new video, Airline Captain Niall Downey, a former Cardiothoracic Surgeon, said the Government should implement an aviation style safety model when it comes to healthcare.
Captain Downey said a ‘name, blame, shame, retrain’ culture within our health service is placing extra strain on healthcare workers who are already facing immense pressure. He added that consultants and other healthcare workers should feel safe in identifying risks and where mistakes have been made, in order to develop a system where health service management can assess “what went wrong, not who went wrong.”
“In aviation we assume we are going to get it wrong, and all our systems are designed around that. We expect error, we don’t blame the individual for that. We have reporting systems where we can speak up without the fear of disciplinary action or dismissal. It’s called a Just Culture,” he said.
In a bid to help combat the serious issues being faced by Ireland’s health service, the Association recommended The Government commit the estimated ¤4 billion in capital funding needed to build and open essential hospital improvements already announced by the Minister for Health that promises to significantly increase the number of acute hospital beds and theatre capacity in our hospitals.
In its Pre-Budget Submission 2024, published in July, the Association said a minimum of 5,000 additional public hospital beds should be funded and opened by the end of 2030 – or 700 extra hospital beds each year for the next seven years. This must start with the rapid delivery of the 1,500 acute beds the Minister for Health Stephen Donnelly committed to open across 15 hospital sites in 2023 and 2024 at a cost of ¤1bn.
However, in October, following publication of the Budget 2024, they expressed concern that is has not provided the necessary capital funding to build and open the additional acute hospital beds and theatre capacity in our public hospitals already announced by the Minister for Health.
The Association had estimated that ¤4bn could be required for the long promised four elective hospitals, six surgical hubs, and the 1,500 rapid build public hospital beds that Minister Stephen Donnelly promised to open across 15 acute public hospital sites in 2023 and 2024.
Instead, Budget 2024 has allocated ¤1.23bn in capital funding for Health next year, which is just ¤70m more than the allocation in 2023. Consultants say this will not result in the opening of the 1,500 additional rapid build hospital beds, six surgical hubs and four elective hospitals promised by the Minister for Health, and therefore will not address the demographic factors increasing the demand for care that is growing year on year.
Professor Rob Landers, President of the IHCA, says, “Regrettably Budget 2024 will not adequately address the overwhelming capacity deficits in our acute hospital and mental health services, especially the severe shortage of public hospital beds, theatres, and other frontline facilities, which are urgently needed to provide timely, safe care to patients.
“The four new elective hospitals have been promised since Sláintecare in 2017 but have not been opened or advanced as expected. In addition, the six surgical hubs proposed in December 2022 remain as far away as ever, and the 1,500 rapid build hospital beds announced by the Minister in April are nowhere to be seen.
“Without the required funding to rapidly address the fundamental shortage of acute hospital beds, theatre capacity and other facilities the challenges in delivering timely care will continue to escalate.”
References
1. The six Cork Hospitals are: Cork University Hospital, Cork University Maternity Hospital, Mercy University Hospital, South Infirmary Victoria University Hospital, Bantry General Hospital, and Mallow General Hospital.
2. Latest NTFP data as at end December 2022: https://www. ntpf.ie/home/nwld.htm.
3. Waiting List Action Plan, 25 February 2022: https://www.gov. ie/en/publication/323b5-the2022-waiting-list-action-plan/
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