Recent events may suggest there will be no let-up in the near future in the medical workforce shortage crisis, and thus the hospital waiting lists debacle, writes Lloyd Mudiwa
Monday last week (March 12) saw 714 patients waiting on hospital trolleys — the worst ever recorded by the voice of Irish nurses and midwives. This figure was despite the fact that the Health Service Executive (HSE) had received more than enough notice of a backlog of appointments, as normal hospital services resumed following the extreme weather conditions of the previous week, which had resulted in many hospital appointments being cancelled.
But, of even more concern, was that — according to the latest National Treatment Purchase Fund’s waiting list figures — a worrying trend might be developing. For the third month in a row, more than 500,000 people nationally were awaiting outpatients appointments.
“The situation will deteriorate and worsen”, in relation to record numbers of patients on troll–eys and the ongoing hospital crowding, the Irish Medical Organisation (IMO) has predicted.
Commenting on last week’s unacceptable trolley list, the Organisation’s Vice President and Emergency Department (ED) Consultant, Dr Peadar Gilligan, cited three factors for the problems in hospital EDs and the Irish health service as a whole. He said there were insufficient beds to meet patient demand in the acute and community sectors; insufficient specialists for a consultant-delivered service and a GP service that was not resourced to deal with complex care.
But while some of the costs involved could be met through identifying inefficiencies within the system, there is no doubt whatsoever that significant investment both in staffing (particularly that of medical practitioners) and infrastructure is needed to ensure health and social services are resourced to effectively manage and respond to the healthcare needs of our rapidly increasing older population.
In the case of staffing, this was clearly demonstrated by two things.
Firstly, in the week that the Irish rugby team answered Ireland’s call by wrapping up the Grand Slam in dominating style in no better venue than Twickenham, the HSE confirmed to Irish Medical Times that while its much-publicised social and digital media recruitment awareness campaign ‘New Year, New Career 2018’, received a total of 2,914 responses, by group only 90 were from doctors. The campaign ran from December 18, 2017 to January 31, 2018.
This is despite the fact that HSE employees that availed of the Voluntary Redundancy Scheme (VRS), introduced in the public health service at the end of 2010, were now eligible for re-employment after the seven-year prohibition on their re-employment expired on December 30, 2017.
This was even after the Department of Health had confirmed that following consideration of the issue given the current conditions, the Minister for Public Expenditure and Reform had agreed to remove a requirement for ministerial consent (from the Minister for Finance) for re-employment after the seven-year ban.
In that regard, Hawkins House also confirmed that no other consent was required, other than the relevant subsequent employing authority ensuring that a person who availed of the VRS adhered to the scheme’s requirements during the prohibition period.
Targeted at interested professionals, especially those returning to Ireland over the Christmas period, the campaign had been touted as “a great opportunity for people thinking of taking up a career in the Irish health service to let the Executive know they are out there and wish to join or re-join it”.
I can distinctly remember the then Minister for Health, Dr James Reilly, pledging to the Seanad back in February 2012 to make a similar ‘Ireland’s call’ to doctors working abroad to come back to this country, before unilaterally cutting consultants’ salaries by more than a 40 per cent — the largest cut in the public sector — later that year.
While I cannot remember whether Dr Reilly ever issued his call, it will be interesting to see how many doctors actually end up joining the HSE as a direct result of this latest campaign.
Secondly, IMT this week reports that the number of applications to study medicine in undergraduate or graduate-entry medicine courses for 2018-2019 is down this year on 2017 figures, meaning unless radical action is taken this medical workforce shortage is likely to remain a crisis for the foreseeable future.