Not enough consultants in A&Es if salaries cut

There won’t be enough senior doctors to run the country’s emergency departments if the Government implements its plan to cut new consultants’ salaries by 30%, according to the Irish Committee for Emergency Medicine Training.

In a hard-hitting letter to the Department of Health, consultants speak of the “perilous state of emergency care” and warn “the future of emergency medicine in this country is in jeopardy”.

They predict that existing emergency departments at the country’s bigger hospitals will face closure if there aren’t enough doctors who want to run them.

The committee has long complained that emergency medicine is not attractive to non-consultant hospital doctors (NCHDs). They say the number of applications to become consultants in the speciality has dropped four-fold in recent years.

In the correspondence, seen by the Irish Examiner, they warn the planned cuts to new consultants’ salaries will further exacerbate this problem as it “will increase the disparity in earning potential” between emergency and other consultants who work better hours and have greater potential for private practice.

They say that difficulties in getting NCHDs to work in emergency departments are “directly related” to how unattractive emergency medicine “is perceived to be at senior career level”.

Health Minister James Reilly wants consultants to work longer hours and emergency medicine (EM) consultants to be available at departments 24 hours a day.

However the emergency doctors’ letter states: “The staffing levels required to provide further extended hours and 24/7 consultant in EM working will never be achieved. It is questionable whether or not there will be sufficient numbers of consultants in emergency medicine to replace natural attrition due to retirement. The current cohort which provides a continuous on call EM service is 66 people representing 2.7% of all consultants in the country.”

They also describe the “current over-reliance on agency and temporary staff” in emergency departments as “a real and present danger” to patient care and safety and warn that the country still doesn’t have enough emergency consultants compared to international norms.

The Department of Health has confirmed that it has received the letter and is investigating it.

The letter is signed by chairman of the Irish Committee for Emergency Medicine Training, Dr Gareth Quin, clinical lead at the National Emergency Medicine Programme, Dr Una Geary, president of the Irish Association of Emergency Medicine, Mr Mark Doyle, and chair of the National Board of the College of Emergency Medicine, Mr Gerard McCarthy.