A FULLY FUNDED staffing plan for hospitals across the country is needed for the Government’s new “accelerated hospital bed-building plan” to work, the Irish Hospital Consultants Association (IHCA) has said. 

Health Minister Stephen Donnelly this week said that the Government is looking to push ahead with plans for 1,500 new beds across 15 hospital sites over the course of this year and next. 

The IHCA welcomed the promise of new beds, however it added that they are “long overdue”, and that in reality, 5,000 additional hospital beds are needed by 2030, alongside 2,000 additional consultants in order to bring down “unacceptable waiting lists and address population changes”. 

“Delivery of basic infrastructure alone is not enough,” an IHCA spokesperson said, adding that without an adequate staffing plan in place, any efforts to tackle the rising number of people on trolleys may “fall flat at the first hurdle”. 

The spokesperson pointed out that just “196 additional approved permanent Consultant posts were filled last year, despite there being around 900 approved permanent posts that are not filled as needed.”

IHCA President Robert Landers said that this bed-building initiative will need to be paired with a time-bound staffing plan, so that when the new beds come on stream, there will be staff in place to care for the additional patients “from day one”. 

He further warned that the Government needs to take a “whole of service approach” to increasing hospital capacity. 

“These beds are long overdue and stem from the 2018 Capacity Review and two subsequent National Development Plans for 2018-2027 and 2021-2023.

“However, we know these plans are outdated and bed projection figures are underestimated. While the 1,500 rapid build beds are badly needed, we also believe the Minister for Health must plan now to deliver 5,000 beds by 2030,” he said. 

 Landers said to ensure that this new initiative is successful, the Government must work with hospital management and consultant representative bodies.  

“It is critical that we get this plan in place now, in order to attract and retain the Consultants and healthcare professionals required to staff these beds so we are not left in a scenario, as seen in the past, where hospital beds lie vacant due to staffing shortages,” he added. 

The IHCA also stressed the need for more acute hospital beds in Ireland. 

“As it stands, Ireland has one of the lowest numbers of acute hospital beds in the EU, 40% below the EU27 average of 4.83 per 1,000 population and one third the number in some European countries,” a spokesperson said, referencing Eurostat statistics. 

Bed capacity has in fact decreased on a population basis from 3.03 beds in 2008 to just 2.68 beds in 2022. Ireland also has one of the highest hospital bed occupancy rates in the developed world.

Row over consultant contracts

The Government was at loggerheads with various consultant organisations for 18 months from January 2020 as talks dragged on over the new contracts for hospital consultants. 

Despite the talks ending without an agreement being reached, the new contract went live last month and it will now be the only one offered to consultants by the HSE. 

Under the new contract consultants are rostered on weekends for the first time, with the aim of making them more available for patients, and for doctors seeking advice from top specialists. 

The salary for consultants under this new contract ranges from €214,113 to €257,193, but consultants will also receive other substantial payments for being on call and working overtime. 

Consultants who sign up for the contract will be working in the public system full time, and will be unable to do private work within that system, but they can do private work outside of the HSE in their own time. 

The Irish Medical Organisation has stated that there are issues with the new contract that will deter consultants from signing up, such as there being no limit on the number of evenings and Saturdays they will be required to work, on top of existing on call commitments. 

It has also stated that there is real concern about the ability of the HSE to change the work location of consultants without reaching an agreement with them prior.