HSE vacancy crisis means €350m plan to cut waiting lists unlikely to be attained
Chronic shortage of nurses, GPs and senior consultants as waiting lists continue to grow
HEALTH Minister Stephen Donnelly’s €350m plan to cut waiting lists is under threat from a chronic shortage of nurses, GPs and senior hospital consultants.
Under-pressure hospitals are already struggling to hire nurses after significant numbers quit their posts during the pandemic. And a new study published in the Social Science And Medicine journal has found GP practices across the country are coming increasing under pressure due to a lack of family doctors and growing waiting lists. On foot of the report, Dr Diarmuid Quinlan, medical director of the Irish College of General Practitioners (ICGP), said Ireland is 1,200 GPs short of what is needed to meet the demand.
Separately, documents obtained under Freedom of Information reveal the Public Appointments Service (PAS) is experiencing major difficulties recruiting consultants. Not a single person applied for nine highly paid hospital consultant positions after they were advertised over the course of last year.
The extent of the staffing crisis facing the health service comes after Mr Donnelly on Friday unveiled a €350m investment to reduce waiting lists to their lowest level in five years. And of the 75,000 people waiting for inpatient and day-case procedures, Mr Donnelly said the aim is to have ‘almost all’ treated by the end of the year. The minister said the 2022 Waiting List Action Plan is the first of a ‘multi-annual’ reform programme to reduce waiting times and treat up to 1.7 million patients this year.
With a record 1.5 million people set to join waiting lists this year, he said the planned reduction of 200,000 would bring the backlog down to 2017 levels.
However, the HSE is struggling to cope with a severe shortage of medical personnel across the sector.
A new study has found that visits by children under six to their family doctor shot up by a fifth in the years following the introduction of free care, which has heaped further pressure on GPs.
Commenting on the study’s findings, Dr Quinlan said: ‘This comes at a time when GPs are working at full capacity, with a national shortage of GPs. The ICGP is not surprised at these findings. The 2018 Department of Health Capacity review recommended an expansion of the GP workforce by almost 50%.’
He revealed Ireland has almost 3,500 GPs, which is 30% fewer GPs per head of population than England. ‘We need almost 1,200 more to match English GP workforce numbers,’ he said. ‘We estimate that 20% of our GPs will have retired within five years, creating a further GP deficit of about 700 doctors. We need almost 2,000 more GPs within five years.’
He said the number of family doctors in training has risen from 150 in 2015, to 258 in 2022, and will be 350 by 2025, with HSE support.
Meanwhile, the health service faces an uphill task to attract qualified doctors to regional roles in psychiatry and old-age medicine.
The challenge in recruiting consultants was laid bare in recent months amid the scandal over the
‘20% of GPs will have retired within five years’
poor treatment of some vulnerable children and teens in Child and Adolescent Mental Health Services in south Kerry.
PAS figures reveal that of 100 completed public competitions for consultant or senior public health posts last year, 23 did not result in an appointment.
On nine separate occasions, there wasn’t a single applicant for a consultant job, often after several months of advertising. In the case of Sligo Leitrim Mental Health Services, a consultant child and adolescent psychiatrist was twice sought to fill a vacancy. However, nobody applied for either of the posts after four months of them being advertised. In Donegal, local health services needed a consultant psychiatrist for patients of old age but had no applicants after four months. It was the same story in the Cavan/ Monaghan region where a child and adolescent psychiatrist was being sought to fill a vacancy.
A post in the West, split between University Hospital Galway and Sligo University Hospital, for a consultant clinical neuro-physiologist also attracted no applicants. In many other cases, there was only one candidate applying for a post – leaving health services with little wriggle room over who got appointed.
In response to queries about the failure to fill posts, a HSE spokeswoman said: ‘[We are] recruiting in a very competitive global market for medical consultants… The HSE is investing heavily in
improving the overall recruitment capacity [and] expanding the international reach.’
However, Labour Party leader Alan Kelly said there needs to be a ‘relook’ at how consultants are hired. He said: ‘These figures show there’s a huge issue in filling these key posts. There needs to be a fundamental relook at how we contract consultants with a very targeted approach for areas of difficulty and we need to look at consultant contracts.’
claire.scott@mailonsunday.ie