Statement by Irish Medical Organisation

• New IMO President warns that medical profession is “under attack’
• Warns that overcrowding in Emergency Departments ‘costs lives”
• Calls for an additional 7,000 hospital beds to deal with rising and aging population.

Sunday 8^th April 2018.  The new President of the Irish Medical Organisation (IMO) has warned that the medical profession in Ireland is “under attack” and the role of doctors was being systematically undervalued.  This, he said, is contributing to an unprecedented shortage of doctors in key positions across the country.

Dr. Peadar Gilligan was delivering his inaugural address as President of the IMO at the organisation’s AGM in Killarney last evening (Saturday).  Dr. Gilligan,  who is a Consultant in Emergency Medicine in Beaumont Hospital in Dublin, said that while Irish society had very significant expectations of those who wish to become doctors, practicing doctors were routinely  dishonoured by having agreed contracts ignored, by having to tolerate different pay rates for similarly qualified doctors doing the same job and by unreasonable delays in restoring cuts imposed during the crisis compared to other groups. 

Dr. Gilligan said; “The fact that new contracts need to be negotiated for General Practitioners, NCHDs, Consultants and Public Health specialists is indicative of the fact that Doctors in Ireland currently do not feel valued.” 

Dr. Gilligan said that this issue fed directly into the unprecedented shortage of doctors in key posts across the country.  Dr. Gilligan recounted a personal experience of a colleague who resigned his post recently saying that he could no longer work in a country where he was embarrassed to tell people he was a consultant.”  He said that the consequences included 400 consultant posts unfilled nationally, GMS lists without a GP and “more resignations from the public hospital system than ever before in the history of the State.’

A Consultant in Emergency Medicine, Dr. Gilligan described the need to board admitted patients on trolleys and chairs in Emergency Departments as “an absolute outrage”.  He said overcrowding in Emergency Departments ‘costs live and must stop”.

Dr. Gilligan said Ireland was an outlier in terms of overcrowding in Emergency Departments internationally.  He called for the introduction of a 6 hour standard between the time a patient arrives in an Emergency Department and the time they are admitted or discharged.  The current average waiting time in EDs in Dublin is 14 hours.

He said; “Such a (6 hour) standard of care requires that Hospitals have adequate capacity in terms of beds, staffing, diagnostics, theatre time, and timely discharge of hospitalized patients to rehabilitation services, convalescence, nursing homes or assisted home care.”

On proposals to increase the number of beds available in the system by just over 2,500, Dr. Gilligan said that the country needs over 7,000 new beds to deal adequately with an increasing and aging population.

Dr. Gilligan said; “the 2,590 bed target is based on a series of very positive assumptions including improving health generally and major investment and reform across the health services; “to plan on the basis of all our plans working out optimally is at best fool hardy and I think we need to plan for the worst but hope for the best not just bank on the best. In short we do not just need 2590 acute hospital beds we need 7000 beds and the associated staffing levels and we need to get started on producing this capacity in our system now. “

Friday 6th April 2018. The new President of the Irish Medical Organisation (IMO) has warned that the 2,500 new hospital beds target will be insufficient to meet demand.  Dr. Peadar Gilligan was speaking at the IMO AGM in Killarney. 

The Health Service Capacity Review was published in January of this year.  That document suggested that a minimum of 2,500 additional beds were necessary over the coming years.  It was based on an analysis of demographics and demand out to 2030.

Dr. Gilligan – who is a Consultant in Emergency Medicine at Beaumont Hospital in Dublin – said that the 2,500 figure was a minimum figure which was based on a “set of generous assumptions” which were unlikely to be fulfilled.  The review makes clear that the figures proposed assume that various other initiatives including a major programme of investment and reform will occur at the same time as the additional beds are brought on stream.

Dr. Gilligan said there were no grounds for confidence in the ability of the Irish political system to successfully introduce the sector wide reforms necessary to support the 2,500 figure; “our experience teaches us that we have to assume that the reforms required to support the 2,500 additional bed figure will not be met.  Sláintecare is less than a year old and already crucial commitments have been missed.”

Dr. Gilligan said that for investment and planning purposes, the Government should use the higher end target of over 7,000 additional beds; “we cannot afford to lose the next five years preparing for a target of additional beds which is simply too low.  We need to be realistic and begin to plan on the basis of the upper end of the range of additional bed requirements set out in the capacity review not the minimum.  Planning for the worst while hoping for the best is the wisest course of action in healthcare.  Planning on the basis of best possible outcomes is unwise and risks on-going patient hardship.”

Dr. Gilligan also warned that as additional beds were brought on stream, the shortage of Consultants in the system would become more acute; “we have a Consultant recruitment crisis as it is.  We need a comprehensive plan on how we are going to train, recruit and retain the hundreds of additional Consultants that will be required to support the patients being treated in these additional beds.”

Ends.

IMO Disputes Department of Health claims in respect of cuts to fees paid to GPs to deliver services

True Number is 38% Cuts

Thursday 5 April 2018. It was reported on Morning Ireland that a Department of Health briefing paper, supplied to RTE, stated that the cuts to GP fees under FEMPI amounted to 24% while the IMO has stated that the series of cuts amounted to 38%.

Since 2009 GPs providing services to patients who have a medical card or a doctor only visit card have suffered three cuts to fees and supports under FEMPI and reductions to fees to care for those over 70.  These cuts have had varying affects depending on the type of practice and the location of practice, for example in rural areas or those GPs with a high number of nursing home patients the cuts are actually over 40%.  The average cut across all GP services is 38%. 

In 2014 total GMS payments were €424,646,000 and cuts imposed to that date totalled €160m which equates to a 37.7% cut.  While since that date new services for Under 6s and Diabetic Patients have been introduced this new funding does not negate the impact of FEMPI cuts as it was for new work not existing services.

These cuts were made under FEMPI and have never been restored, despite the restoration of FEMPI having been agreed with all public servants.

The cumulative effects of these cuts, as highlighted by the IMO are:

-          GPs unable to take on new patients

-          Patients having to wait for longer to be seen

-          Practices closing down and communities being left without a GP

-          No new practices establishing as younger GPs choose to emigrate to systems that support modern practice

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IMO AGM starts in Killarney

Conference theme is Valuing Doctors 

Incoming President, Dr. Peadar Gilligan says the Doctors of Ireland want to provide the best of care to their patients and the system must facilitate them in so doing. Valuing Doctors means providing them with the resources they need to care for patients. A government that has an antagonistic relationship with its medical professionals is not going to be an employer of choice. 

Thursday 5th April 2018.  Doctors in the Irish Medical Organisation (IMO) will begin their Annual General Meeting today in Killarney, Co. Kerry.  The event kicks off at 2pm and will run through the weekend.  The theme of this year’s AGM is Valuing Doctors and incoming President, Dr. Peadar Gilligan, has warned that doctors across the various medical disciplines are facing grave challenges.

Speaking today, Dr. Gilligan said that doctors in Ireland were under significant pressure and that the medical manpower crisis was now reflected in 

• Record levels of emigration amongst recently qualified and working doctors,

• Record numbers of resignations from Consultant posts 

• A failure to attract applicants to key positions as Consultants and General Practitioners 

Dr. Gilligan said; Ireland has very significant expectations of it’s Doctors in terms of knowledge, skills, expertise, compassion and caring. Doctors reasonably expect that their contracts will reflect this level of expectation. Since the founding of the trade union movement a guiding principle has been that people holding the same qualification, with the same expertise, having the same level of responsibility, doing the same job will be paid the same pay. New entrant Doctors cannot continue to be treated unfairly.

Until the 30% pay cut to Consultants is fully addressed we will have challenges recruiting the almost 500 unfilled Consultant posts. Until the FEMPI cuts, which have hit at the heart of the viability of General Practice, are addressed we will have insufficient GPs to take up GMS lists. Until NCHD contracts are honoured in their entirety we will have unfilled NCHD posts. Until specialists in Public Health are treated the same as other specialists we will have challenges in recruiting to this important specialty.

Capacity constraints in the Irish health system are the reason for waiting lists and crowded Emergency Departments and until there is real progress in this regard Ireland will find it challenging to recruit and retain Doctors. 

The Sláintecare Report recognized that the Irish health system needs to become an employer of choice in the international market that is medical recruitment. We have a long way to go to achieve this but the road is clear and the IMO is ready to play it’s part.

The Minister for Health, Simon Harris TD, will attend the AGM on Saturday evening and will make a keynote address.

The AGM will feature discussions on a range of topics including Sláintecare, the economics of new medicines and treatments, fake news and vaccines and the growing use of anti-depressants.

Dr. Gilligan succeeds Dr. Ann Hogan as President and will formally take up the role later today (Thursday).  He is a Consultant in Emergency Medicine in Beaumont Hospital in Dublin. 

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