Warning of NHS meltdown if shortage of hospital and family doctors not tackled
PATIENTS in Northern Ireland face a decade of misery while health professionals struggle to keep the NHS running, it has been warned.
Doctors’ leaders have said urgent action is essential to protect the future of the health service and ensure the safety of patients here.
The warning comes after an official study of the medical workforce revealed that of 1,908 specialist doctor posts locally, 110 are currently vacant.
The Medical School Places Review, commissioned by the Department of Health, said that 2,488 senior doctors will be required to work in our hospitals by 2026.
This means an extra 580 doctors will have to be found to take up specialist posts in the next seven years.
The report also referred to the shortage of GPs, and has made a series of recommendations on the best way to address the medical workforce crisis.
Key proposals include moving ahead with the proposed medical school in Londonderry and increasing the number of training posts.
However, it warned that it could be at least a decade before this results in additional GPs, and 18 years before specialties such as surgery benefit.
Dr Tom Black, chair of the British Medical Association’s (BMA) Northern Ireland Council, said: “It’s going to be so incredibly difficult over the next 10 years.
“It’s very clear we have the longest waiting lists for outpatient and routine surgery that we’ve ever had.
“We have waiting lists so long they may as well not exist.
“If you’re waiting more than eight years for a hip or a knee replacement, that’s worse than an absent service.
“We also have very long waits for GP appointments, we have rota gaps within hospitals and within GP practices.
“We’re already struggling to meet the needs of patients in the west and south and things are only going to get worse if we don’t act to address what is happening.
“Staff are really struggling at the moment to meet the demands and a very hostile enviworkforce ronment is developing within the service.
“It’s no surprise that emergency medicine and general practice are experiencing the biggest problems because both are the first stop for patients, they protect the rest of the NHS.
“For example, in general practice we’re seeing more and more areas where there are more than 3,000 patients per GP, and that simply isn’t sustainable.”
Dr Ian Crawford, vice president of the Royal College of Emergency Medicine (NI), said: “The reality is that there is an urgent requirement to grow, support and develop not just the emergency medicine medical workforce, but the wider emergency medicine clinical in Northern Ireland.” The report has been published against a backdrop of an emerging workforce crisis in the NHS.
The Royal College of Nursing has warned that patient safety is being compromised amid a shortage of more than 1,800 nurses in hospitals alone.
Meanwhile, the doctor shortage has resulted in the closure of GP surgeries and has also contributed to spiralling hospital waiting lists and thousands of patients spending countless hours on trolleys in emergency departments.
Responding to the report, the Department of Health said implementing the proposals would cost £30m a year — money which would have to be diverted from funding other services. In addition, the proposed medical school would require approval by a Health Minister.
However, the Royal College of GPs (RCGP) said the report highlighted the “stark realities” facing patients and doctors every day and called for health officials to act urgently.
RCGP NI chair D r G r a i n n e Doran ( left) said: “The Department of Health’s response to the review of medical school places once again highlights how the political stalemate continues to thwart some of the essential elements of healthcare transformation and it is clear that more must be done to prepare for the future and support the current struggling workforce.
“Last year the HSC Workforce Strategy was published and the recommendations from today’s report mainly lie within its remit.
“To date, there has been minimal transparency around the development of any action plans for taking this strategy forward and we call on the department to urgently put plans in place to address the serious challenges we are facing.” WHILE there are shortages right across medicine including within the hospital doctor group, there is a particular issue with general practice, where GP numbers continue to fall and training places can be hard to fill. There are a number of reasons why this is the case.
Firstly, the increasing workload of GPs has been well documented. We know there are long waiting lists but a GP is still the first port of call for anyone who needs medical help — unless it’s an absolute emergency — and we are continuing to see demand rise. This also means as a doctor you can be presented with a very wide range of medical problems, so there is an ongoing challenge to keep abreast of medical developments and ensure you continually update your skills.
GPs are also small businesses as each practice is independently run — this side of the work as an employer, accountant, caretaker and IT manager can be daunting for anyone thinking of coming into the profession. This means the traditional career model where you become a partner in the practice will have to be flexible and responsive to the new generation of young doctors.
So, the stresses of being a GP can appear to outweigh the benefits of what is actually a fantastically rewarding career, and one the we still highly recommend to young doctors and students. The variety, the continuity and the flexibility can also provide some of the real positives to a career as a GP.
Dr Alan Stout is a GP partner at Greenway Practice in east Belfast and the chair of the British Medical Association’s GP committee in Northern Ireland