More than 700 consultant posts remain unfilled in Ireland

The IHCA says Ireland has 1.49 medical specialists per 1,000 people, the lowest in Europe and 41% below the EU average of 2.53. File Picture: Peter Byrne/PA Wire

There are now 728 unfilled consultant posts in Ireland, 45% more than previously believed, according to the Irish Hospital Consultants Association (IHCA).

New data from the HSE's National Doctors Training and Planning unit confirms that over a fifth of all permanent consultant posts are vacant or filled on a temporary, locum, or agency basis.

This comes as 612,000 people, or 12% of the population, are waiting for an outpatient appointment with a consultant, according to data analysis conducted by the IHCA on the HSE's figures.

Further analysis reveals that more than a quarter of a million people (255,000) have been waiting longer than a year for an outpatient appointment, which is five times the amount who were waiting in 2014.

A further 75,000 people are awaiting inpatient or day-case treatment.

As of November 4, 554 of the vacant consultant posts are at hospital level and 174 are at community level. 

A total of 237 permanent consultant posts are vacant and two are of unknown status. 

A further 406 permanent consultant posts are filled by temporary and locum consultants, with an additional 83 posts filled on an agency basis. 

It was previously believed approximately 500 consultant posts were vacant or unfilled on a permanent basis.

• The specialty with the largest percentage of unfilled permanent consultant posts, or with temporary/locum/agency staff filling the posts, is psychiatry at 32%, representing 153 posts;
• 33 consultant posts in emergency medicine are vacant or temporarily filled, and 27% of intensive care medicine consultant jobs, or nine posts, are affected; 
• 22% or 176 consultant posts in medicine are not filled on a permanent basis, and the same goes for 21% of paediatric consultant posts, totalling 49 jobs; 
• 20% of consultant pathology posts are either unfilled or filled on a temporary basis, representing 60 posts; 
• 19% of radiology consultant posts are vacant or filled temporarily, equating to 60 posts; 
• 17% of surgery consultant posts (93 posts) are either unfilled or staffed by locums, agency or temporary doctors; 
• Of the 83 approved consultant posts filled by agency staff, 46 of these are in psychiatry, which is over half; 
• Around 1 in 5 posts currently vacant in pathology (23%), psychiatry (23%), and radiology (17%) have been vacant for more than three years.

The IHCA say patients in all parts of the country are impacted, but the South/South West and Western regions have the highest number of unfilled posts.

The South/South West Hospital Group of Cork, Waterford, Kerry, South Tipperary and Kilkenny has 117 unfilled or temporarily filled consultant jobs.

Saolta University Health Care Group, which comprises of Galway, Sligo, Donegal, Mayo, Roscommon has 104. 

However, the University Limerick Hospitals Group has the highest percentage of vacant or permanently unfilled posts, at 29% (52 posts).

As for community healthcare organisations (CHOs), CHO 4 containing Kerry, North Cork, North Lee, South Lee and West Cork has the biggest number of unfilled or temporarily filled consultant posts at 28. 

The IHCA say Ireland has 1.49 medical specialists per 1,000 people, the lowest in Europe and 41%  below the EU average of 2.53. 

The IHCA add that a HSE report published earlier this year found that Ireland has the lowest number of consultants in practically all specialties.

The report also said the number of consultants in hospital-based specialties will have to increase by 53% to address the current shortfall and to meet increased patient demand by 2028.

The IHCA claim that one of the primary causes of the HSE’s worsening waiting list problem is consultant pay disparity. 

The association is calling on the Minister for Health and the Minister for Public Expenditure and Reform to "end the 2012 pay inequity that was imposed unilaterally on consultants who took up HSE contracts after that date."

"This data confirms that Ireland’s ability to provide quality, timely care to patients is worsening," says IHCA President, Professor Alan Irvine.

"Put simply, over 600,000 people require specialist medical treatment but our system is not providing the permanent specialist expertise to care for them.

"A major part of this problem is a direct result of this country’s ongoing consultant recruitment and retention crisis, which is continuing throughout the worst disease pandemic in a century.

"Reduced availability of specialist care means longer stays in hospital beds, which are already in critically short supply."

Prof Irvine said the group welcomed the additional investment in hospital beds, but added that without the permanent specialists to care for these patients, waiting times will get longer. 

"Short-term measures to temporarily fill gaps is both expensive and unreliable. Medical agency costs have doubled," he said.

"Whatever theoretical saving was envisaged in the 2012 cut, it has actually generated a massive, ongoing loss to the taxpayer equivalent to hundreds of millions of euro per year. 

"Irish patients are not getting hospital and mental health services that they need; they are simply being added to an ever-increasing waiting list."