Welcome for commitments given to the AGM by Minister for Health  and HSE CEO to improve the working conditions of NCHDs

Sunday 7^th April 2024.   The new President of the Irish Medical Organisation, Dr. Denis McCauley, said that health services continued to be undermined by shortages of beds, consultants and GPs leading to waiting lists which are “frighteningly long”.

Dr. McCauley was making his inaugural address at the IMO AGM in Killarney (Saturday evening 19:30).

In terms of various problems in the services Dr. McCauley highlighted the following issues:

Shortage of beds.

He said; “The ESRI anticipate that we need over 5,000 new beds in public hospitals.  Absent those extra beds, our bed occupancy rates run at 88% (11% over the recommended upper limit) and our  full capacity protocols are now often operative year-round.”

Shortage of consultants.

He said: “1 in 5 Consultants posts aren't filled and there are gaps in key specialties across the country.  So yes, we have a new contract and many consultants have signed up to it but the shortages remain and are acute.”

“We also need to build trust – we need an acknowledgement from the system that consultants already provide care 24/7 through the on-call system. And we have to ensure that we properly support the consultants working on weekends so that we don’t simply move work from the middle of the week to the weekend.  Let’s make sure that weekend work adds to the volume of work undertaken across the week rather than simply replaces the work done on other days currently”.  

Shortage of GPs

He said: “We welcome the increase in training posts for GPs but we have a huge need to substantially increase the number of GPs across the country and we must ensure that continuity of care is at the heart of how we approach General Practice into the future.”

NCHDs.

On NCHDs, Dr. McCauley welcomed the fact that both the Minister for Health, Stephen Donnelly and the CEO of the HSE, Bernard Gloster, spoke to the AGM to give strong support to reforming the working environement for NCHDs. 

Dr. McCauley said the survey of NCHD attitudes which was published by the IMO earlier this week had highlighted the urgency of reform in this area.  At present, he said, “Being an NCHD just means being under constant pressure, working illegal and unsafe hours and having no work/life balance.  “If you don't respect them”, he said, “they won’t stay”.  

Medical Negligence Litigation

Dr. McCauley also identified other obstacles which made it more difficult for doctors to practice medicine including medical negligence litigation. 

He said; “ Medical negligence litigation is having a detrimental effect on how doctors practice medicine.”

“Medical negligence is proven when a doctor deviates from the standard which is actually applied by competent professionals of similar specialty in an area.”

“But case law is moving beyond that.  In Dunne v The National Maternity Ward 1989, it was found that even if a doctor is shown to have followed the standard practise that a competent professional would apply, negligence may still apply if a “a plaintiff can establish that such a practice has inherent defects”.

“Legal practitioners and the judiciary which assess these cases must fully understand the models of care which each specialty follow and they must recognise that in a hospital setting that the clinical staff are essentially working with one hand tied behind her back due to staff shortages and infrastructural deficiencies.”

“A failure to do this is leading to Ireland being an outlier in medical litigation, it is encouraging the exodus of well-trained competent medical staff from our shores to other health systems where this is not an issue.  More importantly it is leading to altered patterns of medical practice which is leading to increased investigations and referrals from primary care  to a secondary service that will soon collapse under this  legally induced demand”.