HSE paid €1m compensation to hospital doctors working illegal long hours

Dr Rachel McNamara: Patients can face exhausted doctors working 72-hour shifts. Picture: Stephen Collins/Collins

HSE hospitals have paid more than €1m in compensation to doctors illegally working long hours without rest days — with further payments expected instead of hiring more staff.

A tense Oireachtas health committee heard the Irish Medical Organisation (IMO) tell TDs and senators the recruitment freeze was leading to burnout and emigration rates as high as 80% in one year’s cohort of interns.

Although it does not hold the Government responsible for the climate difference between Cork and Bondi Beach, working conditions are driving emigration, IMO chief executive Susan Clyne said.

Hiring of non-consultant hospital doctors that are not in approved training posts is paused.

She told Sinn Féin’s David Cullinane rest periods linked to 10 days worked in a row were agreed with the HSE in 2022.

“Sixty eight per cent of non-consultant hospital doctor (NCHDs) report they are regularly working beyond 10 consecutive days — without compensatory pay or additional rest days in almost half of these cases,” she said.

“Since the agreement was reached, the HSE has paid out over €1m in compensatory rest payments, and we know that only 50% of doctors have actually got their payments. So this is now embedded in the system," she said.

In a meeting last year, the HSE advised the union that “targeted recruitment of up to 800 additional NCHDs” was needed. The hiring freeze was announced the next day.

Now they are “gaslighting” doctors into doing overtime, Ms Clyne claimed.

Dr Rachel McNamara, chair of the IMO’s NCHD committee, said patients can face exhausted doctors working 72-hour shifts.

She described a typical interaction between a hospital and a doctor:

“They’ve already been rostered above and beyond what is legal and safe limits. Then the text comes through in the evening, the night [saying]: ‘We’ve no options, we are not going to get a locum additional cover, it’s down to you to fill this shift or your colleagues will be put under enormous pressure’."

Senator Martin Conway called the situation “bleak”.

He asked the IMO why it does not have a view on where new emergency care capacity should go around University Hospital Limerick (UHL).

Dr Peader Gillilgan, a consultant in emergency medicine on the IMO’s consultant committee, said from speaking with UHL staff, there was a sense "they need at least an additional 400 beds within the acute hospital system in the Limerick area to serve the population that is there”. 

He said overcrowding in the emergency department is linked to bed shortages.

Dr Matthew Sadlier, IMO’s consultant committee chair, said: “We do have a view and the view is there should be safe emergency care for the people for the country and the people of the Mid-West.

“Where we don’t have a view is which hospital that is and how it is configured, that is a HSE question.” 

Medicine has become more complex, with huge improvements in survival rates but this means emergency departments must be supported by specialist care, he said.

Fianna Fáil TD John Lahart questioned why the union was “hostile” in its approach, and why it did not acknowledge the “huge increases” in staffing since 2020.

He claimed the IMO was taking a political approach, which Ms Clyne denied. 

She said consultant roles were not affected by the recruitment freeze but hospitals could not recruit admin staff, radiographers and other roles.

“I know of one consultant waiting three years for an office,” she said.