The possibility for immediate and impactful changes to our health services

The possibility for immediate and impactful changes to our health services

Yesterday, the Government published its Capital Investment Plan for Health Services covering 2019 to 2021. At the same time, the Irish Hospital Consultant Associations was also publishing its Pre-Budget 2020 Submission, writes Martin Varley.

Our Submission is focused on several key recommendations to Government, which, we believe, if implemented as part of Budget 2020 measures can make immediate and impactful changes to our health services.

They will improve access for patients to health services, reducing waiting times and lead to a better and higher quality services for patients.

While the IHCA welcomes any Government investment in our acute hospitals, particularly after a decade of underinvestment, yesterday’s announcement simply does not go far enough. In fact, the level of investment announced is a reduced amount from what was first promised in the National Development Plan (NDP), published in May last.

This is particularly true in the case of acute hospital beds. The number of acute hospital beds across our public hospitals has not been increased to match demand, particularly given a growing and ageing population, but instead has been reduced, compared with 2008 levels.

Ireland has one of the lowest numbers of acute hospital beds across the EU at 2.77 per 1,000 - 31% below the EU average of 4.02.

Unsurprisingly, Ireland also has the highest bed occupancy rates in the developed world at 94%, well above the recommended occupancy rate of 85% and 23% higher than the EU average of 77%.

In February 2018 the new NDP promised 2,600 additional acute hospital beds over ten years, equating to 260 acute hospital beds per year.

However, under yesterday’s Plan an additional 480 acute hospital beds will be opened over the next three years not the 780 promised less than five months ago.

It’s worrying that if we have abandoned 300 acute hospital beds already, a year and half into the NDP, then the signs are not encouraging for the delivery of all 2,600 promised under the NDP.

Beds are just one part of the infrastructure required by our acute hospitals. We need new equipment, services and facilities to urgently replace our creaking infrastructure.

Almost daily our consultant members tell us about the out-of-date equipment they are struggling to treat their patients with.

Our Budget Submission captures some of these issues – the MRI scanner in Sligo General which breaks down constantly, the lack of air conditioning in an ED where temperatures can rise to 35 degrees in summer or equipment for pain management at the Mercy University Hospital in Cork which is more than 14 years old and can no longer be serviced. The list goes on.

The IHCA believes that the following measures must be implemented by the Government immediately to reform our health services:

  • 1. Funding our acute hospitals adequately to maintain existing services and, meet unmet and increasing demand, to end rationing of care, record waiting lists and the unacceptable number of patients being treated on trolleys;
  • 2. Front-loading delivery of the additional 2,600 acute hospital beds promised under the National Development Plan rather than waiting until 2027, as currently planned;
  • 3. Capital expenditure for acute hospitals must be increased to address the physical infrastructure and equipment deficits resulting from a decade of capital cuts and underinvestment. Future overruns with the National Children’s Hospital development must also be funded separately.
  • 4. Restoring pay parity for all consultants appointed since October 2012, to retain and attract consultants back to our health service; and 5. Filling all consultant posts in public hospitals on a permanent basis rather than relying on costly agency or locum consultants.

Martin Varley is Secretary-General of the Irish Hospital Consultants Association.

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