Ageing population‘a time bomb’ for surgical services

Our ageing population is a “demographic time bomb” that will have serious repercussions for surgical services, the president of the Royal College of Surgeons in Ireland, Kenneth Mealy, has warned.

Mr Mealy, who is lead of the national clinical programme in surgery and clinical director of the National Office of Clinical Audit, also called for the variance in surgical services across the country to be addressed

He said: “3,000 beds per day are currently occupied by surgical patients. By 2046 if the system remains as it is and with Ireland’s projected population and age profile, 5,500 beds a day will be required.

“Greater efficiencies are necessary because of the absolute imperative presented by our ageing population.

“We have a choice to make; we can either start building more hospitals or we can make more efficient use of the bed days we currently have. We can see what’s coming down the line here and we can plan for it.”

Mr Mealy was speaking ahead of his address today at the 43rd Sir Peter Freyer Memorial Lecture and Surgical Symposium, the largest Surgical Conference in Ireland, taking place in NUI Galway.

He welcomed the publication of the Sláintecare, the blueprint to overhaul the health service over the next decade, describing it as a positive step forward in providing a more strategic approach to healthcare delivery in Ireland.

However, he found it surprising that there was little in the plan about the huge variance in surgical services across the country.

“When we see that one hospital can deal with gallbladder surgery as a day case whereas other hospitals admit patients overnight, we have to ask why,” said Mr Mealy.

“We need to look at the funding model and make sure that it’s disincentivising inefficient practices. The rollout of an activity-based pricing model over the next number of years would go a long way to incentivise hospitals to manage their beds efficiently.”

Referring to plans for new elective-only hospitals in Cork, Dublin and Galway, Mr Mealy said there was an “inescapable logic” to the separation of acute and elective care.

“Putting the patient exclusively at the centre of our planning means there is no other outcome that makes sense. Patients with life-threatening conditions must be treated by the right team with access to the appropriate equipment and diagnostics.”

Meanwhile, the Irish Nurses and Midwives Organisation said the HSE had yet to come up with a plan to deal with a surge in patients this winter.

The INMO was also disappointed that the health authority had been unable to fill 169 nursing posts in emergency departments across Ireland, despite having funding to do so.

INMO representatives, who met with HSE and Department of Health officials at the Workplace Relations Commission yesterday, said nurses and midwives will go on lunchtime protests next week. Demonstrations will be held at Galway University Hospital on Monday and at Cork University Hospital and Limerick University Hospital on Tuesday.