HSE warned by board to prepare for increased patient risks due to consultant shortages

Overtime rates frequently make headlines due to the large sums involved. 

The HSE has been warned by its own board that it needs to be prepared for increased risk to patients and staff burnout due to the ongoing shortage of hospital consultants.

Minutes from the June 30 HSE board meeting, seen by the Irish Examiner, also show the board has been warned of the high cost of paying doctors overtime to make up for the lack of staff.

Details of the meeting come as new figures show that up to last week, just 110 new doctors had been recruited since March. 

The HSE has now rolled out a marketing campaign around the world. 

It has been estimated 900 roles are either vacant or filled on a temporary basis.

HSE chief executive Bernard Gloster told the board meeting: “One of the primary drivers behind high earnings in the HSE remains the shortage of consultant staff, particularly in relation to certain specialties [such as radiology, psychiatry, emergency medicine] and in certain geographic areas." 

Overtime rates frequently make headlines due to the large sums involved. 

However, Mr Gloster told the meeting: “The primary reason behind these earnings remains the overriding requirement to maintain essential, critical services where significant vacancies or shortages exist."

In response, the board said: “Consideration should also be given to aspects such as patient safety, staff burnout, compliance with working time directives as well as financial ones.”

Recent critical reports have pointed out that patients are facing waiting lists for urgent services, including psychiatry appointments for children, due to the doctor shortages.

Meanwhile, it has emerged that just 5% of almost 4,000 hospital consultants have so far accepted the new HSE contract since they were made available in March.

Up to June, there were 3,988 consultants working for the HSE. 

Of those just 205 had accepted the contract by the end of last week. 

The 110 new doctors who have since been recruited are automatically put on the new contract.

The contract offers basic pay of €209,915 to €252,150 for a 37-hour week covering 8am to 10pm Monday to Friday and 8am to 6pm Saturdays.

New rosters are expected to mean more doctors in hospitals at weekends rather than mainly on-call.

Members of the Irish Medical Organisation (IMO) essentially rejected the terms earlier this year in a survey, citing lack of clarity around their future location, rostering, and support staff numbers.

Dr Matthew Sadlier, chair of the IMO consultant committee said “it will really be December” before the up-take can be properly assessed. It can take six to eight weeks for each doctor to switch, he said.

HSE HR director Anne Marie Hoey told the Irish Examiner: “At the minute, there is probably an increase of about 40 contracts each week, so it is 315 signed as at last week.

“I’m anticipating by this week that will be around 350 or higher. There is also a lot of interest from existing consultants in finding out more information, and moving across.” 

Social Democrats health spokeswoman Róisín Shortall said the response shows “there is still a long way to go”.

I think it's really important that it’s clear the Government is committed to the reform programme, and that things are going to improve substantially within the Irish health service.

“I think it would be helpful if the Taoiseach was to make a strong appeal to Irish doctors living abroad to return home, and to be part of and to lead the reform programme, and show that he as a leader of the Government is absolutely committed to making it happen.”

In response, a spokesman for the Taoiseach reiterated his support for Sláintecare, adding that as Leo Varadkar has previously said: "Sláintecare is about four things; making healthcare more affordable, improving access to healthcare, improving patient outcomes, and reforming how healthcare is provided with a focus on the community, integration, and prevention."