Substantially more college places in medicine and other health-related courses will be offered this autumn, as efforts to address the staffing crisis in the Health Service Executive are stepped up.
For the first time, students from the Republic will be able to apply to medical schools in Northern Ireland through the CAO system and be eligible for intern positions in HSE hospitals upon graduation.
An additional 120 places in medicine for Irish/EU students should be created this autumn, according to Minister for Health Stephen Donnelly in a letter to Minister for Higher Education Simon Harris last month.
Mr Donnelly also sought increases in training provision for nursing, pharmacy, dentistry and other health professions, according to the letter, obtained under Freedom of Information legislation.
Sixty extra places in medicine were provided last autumn and a further 60 are due next September. The extent to which even more places will be provided will depend on the outcome of consultations between the Higher Education Authority and higher education institutions next month.
“This coming September will see at least a further additional 60 medicine places again and quite possibly more,” a spokeswoman for Mr Harris told The Irish Times. “In addition, medical education will be provided on an all-island basis and Minister Harris hopes to be able to announce the details very shortly.”
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In his letter, Mr Donnelly called for a “paradigm shift” to increase the supply of medical and nursing graduates, and address the significant challenges posed by a shortage of healthcare workers.
While there are moves to increase the number of college places in health-related courses from 2024 or 2025, Mr Donnelly urged Mr Harris to “act sooner” and “explore all options” to identify solutions.
Last July, the two Ministers announced an additional 200 training places a year would be created for EU students over a five-year period, starting with 60 last September.
However, this was only half the 120 additional places sought by Mr Donnelly.
In an earlier letter to Mr Harris, in April of last year, Mr Donnelly said the proposal for a phased increase in places by the Department of Higher Education was “much slower” than was needed and “falls short” of what is required to deliver universal healthcare.
“Providing an additional 120 places in 2022 is critical to ensuring a timely and appropriate pipeline of suitably qualified medical professionals,” he wrote.
An additional 2,575 more hospital doctors are needed by 2035, according to projections. Hospitals will also need at least 5,726 more nurses and a minimum of 33 per cent more dieticians, 54 per cent more occupational therapists, 40 per cent more physiotherapists, 43 per cent speech and language therapists, and 35 per cent more social workers.
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Staffing problems are compounded by the higher percentage of health staff close to retirement – 22 per cent of doctors are over 55, along with 27 per cent of dentists and 23 per cent of pharmacists.
The HSE has plugged staffing gaps by recruiting from abroad – almost 43 per cent of nurses and 41 per cent of doctors were educated abroad – but Mr Donnelly says this is “not a sustainable model” for the future.
The Higher Education Authority is currently seeking expressions of interest from higher education institutions in providing extra places in dentistry, pharmacy, medicine, nursing and veterinary. Mr Donnelly wants the extra places from this initiative to start coming on stream from this year.
“Ensuring enough training places in Irish colleges is crucial,” Mr Harris’s spokeswoman said. “Alongside that though, the health service needs to ensure enough clinical placements in Irish hospitals and retention of graduates in Ireland.”
Ireland produces more medical graduates than any other OECD country, but almost half are non-European Economic Area students who pay on average €56,000 in fees to medical schools. However, most leave for home after graduating, while the Irish health system remains chronically short of staff.
A 2006 report recommended increasing the intake of Irish/EU students and making 25 per cent of places available to non-EU students. Even with the planned 200 additional medical school places, this target will not be reached by 2027.