Dr. Matthew Sadlier, Chairman of the Consultant Committee of the IMO has issued the following statement in respect of the ongoing crisis conditions in Irish hospitals.

 

 The latest iteration of the permanent crisis in our health services has highlighted:

1. the structural fragility of the Irish health services.  Years of underinvestment in both hospital and community healthcare infrastructure has left us a service which is  dangerous for patients and for those who work within it
2. the inevitability of recurring crises is guaranteed in the absence of a radical increase in public hospital beds and physical infrastructure
3. the inability of Ireland to compete in a global healthcare market for adequate numbers of medical and other healthcare staff
4. The dangerous misunderstanding around the lack of capacity within our GP services

There is a very real likelihood that some patients will have died as a result of avoidable delays in the system in recent weeks.  There is an even stronger likelihood that we will see further increased deaths and delayed diagnosis because some people who should present at our Emergency Departments in the coming weeks will not now do so because of fears of what they have recently seen.

There is also already evidence that having worked in the war-zone like conditions of the past few weeks, many of our younger medics – the future GPs and Consultants of the health services – will be more likely to quit the Irish health services and go abroad to work - with the obvious knock-on effects which that will have on patient care.

It is critical that people understand that the current emergency is not simply a temporary winter crisis or a result of a perfect storm of Covid, Flu and Respiratory illnesses; these are merely the proximate causes of this latest crisis. Nor is this crisis limited to Emergency Departments or Trolley numbers – these are simply a reflection of a wider problem with the health services.

The real issue is that successive governments have accepted as “good enough” a health service which was - and is - demonstrably unfit-for-purpose; where almost a million patients are stuck on waiting lists, where vacancies exist for almost 1,000 consultant posts (which fail even to attract applicants) and where chaotic scenes in Emergency Departments and hundreds of patients on trolleys are now routine and where staff face unprecedented levels of burnout, stress and low morale as they once again listen to politicians making excuses for our woefully inadequate health services.

Such a health service is always vulnerable to any uptick in demand caused by external factors, so it is hardly surprising that our system, which struggles on a day-to-day basis, is thrown into extraordinary levels of dysfunction as soon as challenges arise.

Since Christmas, the only thing that has prevented the health services from tipping over into complete chaos was the herculean efforts of our doctors and other health care professionals.  We saw that again last weekend with the increased number of discharges from hospitals which in turn freed up beds to allow new patients to be admitted.  Some have argued that experience confirms the benefit of having consultants working at weekends.  However, consultants always work weekends.   The difference last weekend was that the Government made funding available to source step-down facilities for discharged patients and whole teams of people were available in the hospital network to facilitate the discharge of those patients.  The ongoing myth of consultants not being available is just that – a myth. Unfortunately, with staffing numbers as constrained as they currently are, the type of once-off-response we saw last weekend cannot be relied upon on an ongoing basis.

It also remains to be clarified as to what impact recent events will have on the budget for healthcare in the coming year.  We ask the Government to make it clear that the recent exceptional measures will be financed independently of the normal budgetary process for healthcare.

The health service is already demanding too much from front-line staff; it has a long history of forcing NCHDs to work illegal and unsafe hours – often 80 hours or more a week; it can’t fill almost 1,000 consultant posts because  it refuses to compete in the worldwide market for such sought-after talent and it will soon be facing the reality of a scarcity of GPs because it has treated GPs as a workhorse on which endlessly increasing demands can be foisted rather than a valuable resources that needs support and investment.

The sad reality is that without radical action, the only certainty is that the chaos of January 2023 will recur and perhaps sooner than anyone would expect.