Status critical: what Ireland’s health service thinks of itself

The following are highlights from the HSE’s estimate of service requirements for unmet critical need:

Benign gynaecology: There is " a critical service deficit around the country", the HSE has said. "Long waiting lists, and poor access to treatment have left thousands of women with a poor quality of life."

Anaesthetics risks: "Serious clinical risk exists because general hospitals, with emergency departments and maternity units, have only one line of anaesthetic call. It is a critical safety requirement to introduce a second."

Critical care beds: The HSE said there was a national shortage of critical care beds impacting on access to scheduled and unscheduled care services. It proposed opening new critical care facilities as well as high dependency and intensive beds in Cork and the main Dublin hospitals. This would involve recruiting over 150 staff with a total cost of €4.5 million.

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Opthalmology: The HSE said ophthalmology theatre closures and waiting lists were affecting preventable deterioration in vision and potential blindness.

Endoscopy: The HSE warned if priority investment in endoscopy services in a number of hospitals around the country was not funded – at an estimated cost of €2.7 million in 2018 – "overall endoscopy waiting lists will continue to risk significantly and urgent colonoscopy targets will be further breached on a more regular basis".

GP shortage: The HSE has proposed appointing 15 GPs on a salaried basis to work in rural and urban disadvantaged areas over a three-year period. At present GPs operating the medical card scheme are not HSE employees but rather contractors.

Cancer care: The HSE said additional staff in surgical, medical, radiation oncology as well as haematology, child and adolescent, palliative care, geriatric oncology were needed to address current and growing demands. "Additional staffing will be required just to get to acceptable international standards based on size of population and prevalence of disease. There is a staffing deficit of all clinical staffing numbers in line with international standards and best practice . . ."

Paramedics: The HSE said additional frontline paramedics were required to meet capacity shortfall, improve response times and meet planned development requirements.

Our Lady of Lourdes hospital: The HSE said over 80 beds were needed as well as five theatres at Our Lady of Lourdes hospital in Drogheda; a new dialysis unit in Galway and a new modular build emergency department unit at Mayo General hospital. It said this would cost nearly €12 million in 2018.

Policy: The HSE said there was no defined policy, framework, structure or strategy for the coordination of business continuity across its infrastructure in the aftermath of events such as power failures within hospitals, ICT crises such as the recent Ransomware virus, or flooding such as experienced at Letterkenny General Hospital.