The Irish Hospital Consultants Association (IHCA) claimed that over the last decade, budget balancing has taken precedent over patient safety, asserting that the time had come for this attitude to change as they announced details of their 2018 Pre-Budget Submission on Thursday 20th July.
Dr Tom Ryan, President of the IHCA, said: “We’re at the point where we probably have a robust economy again, our debt this year is only going to be 0.7 per cent in GDP. While we’ve fixed the economy, we can’t say that we’ve fixed the healthcare system.
“There are about 400,000 people in the state who are waiting to see a consultant and another 80,000 people have seen a consultant but are waiting for an elective surgery, that’s almost half a million people and it’s more than the State can support.
“Last year we cared for 94,000 people on trolleys when there wasn’t a hospital bed available for these mostly frail and elderly patients and while this was going on over the last four years, the number of elective surgeries in our hospitals has decreased from 180,000 to just under 90,000. Our capacity to deliver elective surgery in the republic was cut by 54 per cent and that was because we didn’t have enough hospital beds.
“Over the last ten years our population went up by 12 per cent while our hospital beds decreased by about 12 per cent, and at the same our population in Ireland of those aged over 65 increased by a third and we know that this portion of the population are using the majority of our healthcare resources”.
He referenced the “repeated breaches” of consultant contracts that are occurring throughout the country. The HSE’s admission that 70 non-specialist doctors have been appointed to specialist consultant posts since 2008 demonstrates the failure of the health services to quell the ongoing exodus of highly trained consultants.
The IHCA stated that there has been an “unprecedented” number of consultants resigning, retiring, or going part time which is ultimately affecting patients.
“The ongoing discrimination against new entrant consultants, and the failure to reverse the FEMPI salary cuts, has created an environment where the health services cannot recruit and retain a sufficient number of high calibre consultants. “It is unacceptable that over 400 approved hospital consultant posts are either vacant or filled on a temporary/agency basis. This false economy must be ended as patients are being deprived of care while medical agency costs are exceeding €115m per year”.
The IHCA president alluded to the country’s deteriorating infastructure: “The cumulative cuts of nearly €1.9 billion in the current Health Capital Plan for 2016 to 2021, compared with 2008, is rapidly leading to a crumbling health service infrastructure, with acute hospitals attempting to treat patients with equipment that is increasingly obsolete.
“The current levels of funding do not even meet the cost of maintaining and replacing existing equipment never mind providing for much needed additional capacity.
“Furthermore, when the new capital investment projects, including the Children’s Hospital and the plans to relocate maternity hospitals, are funded the existing Capital Plan of €3 billion will not have sufficient funding to replace obsolete equipment or develop additional capacity to provide care.”
Mr Ryan continued “Our waiting lists are going to accumulate and the private hospitals are expanding. If the state doesn’t invest in our public healthcare system then inevitably we’ll end up privatising our healthcare system, as a consequence of lack of action by the government”.
The IHCA’s general secretary, Martin Varley, called for a return of attention on basic resources to treat patients, warning that otherwise: “you run into a brick wall and in effect that is what’s happening here. It’s the same message year after year except we’re looking at not a static or improving situation, but a deteriorating problem.
“That’s the shocking message coming out of our analysis; throughout the whole system we don’t have the capacity. We have had a decade of underfunding and even prior to that time we were not receiving investment to the same tune as other countries.
“If you underinvest in a system for decades, the cost of maintaining that system will actually be higher. It is back to the basic reality that if a patient requires care and there isn’t a bed there for them, then that level of care can’t be provided”.
Ireland has one of the lowest numbers of acute hospital beds in the OECD, at 2.4 per 1,000 of population, compared to the average of 3.6 per 1,000 in 2015.
Mr Valey claimed: “We’re going backwards rather than forwards, yes we’re treating more patients but the numbers waiting for care is also increasing. In the first half of this year there were 51,000 patients on trolleys.
In 2008, having 59,000 patients on trolleys was considered unacceptable so why have we continued like this and why is it not a crisis? The stats are actually shocking and I question why no one is putting the capacity in place. I don’t see a plan”, he concluded.
Recent figures indicate that there are over 589,000 people on waiting lists in Ireland’s public hospitals.