THE number of hospital consultants in the State should be increased by more than 50 per cent over the next eight years, according to the consultants' organisation.
The Irish Hospital Consultants' Association adopted this proposal at an emergency general meeting in Dublin yesterday. It rejected a suggestion, in the Health Funding Report of 1989, that a new subconsultant grade should be introduced to deal with the demands for specialist medical services, at least until its demands for more consultants were met.
The number of consultants should be increased from the present 1,388 to 2,163 by 2007, according to a briefing document accepted by the e.g.m. For example, this would include an increase in the number of orthopaedic surgeons from 61 to 96, four more cardiac surgeons, bringing the total to 14, and an increase in the number of psychiatrists from 173 to 244.
The IHCA president, Dr David Lillis, said the demand for specialist services had increased and was set to increase further due to demographic changes. The reduction of the working week for junior hospital doctors from 65 to 48 hours would also increase the demands on consultants.
"The number of hospital consultants in the various medical specialities, such as anaesthesia for example, needs to be doubled from the current total of 248 to at least 491 by the year 2007 if our hospital services are to have any hope of coping with the projected increase in demand."
Dr Lillis advanced three reasons for the IHCA opposition to the creation of a non-consultant specialist grade. He said the public was demanding more consultants, not sub-consultants; there was no evidence they would bring any real savings; and the UK experience was not very satisfactory.
"It leads to problems, to people being in a career structure which is dissatisfying. In the UK they are neither fish nor fowl. The consultant has to be the head of a department. The buck stops with him. He makes the decision on admitting and discharging the patient. It will lead to more medico-legal problems."
He stressed that the question of dealing with waiting lists was not simply one of appointing more consultants. "We have to look at the other resources needed, like hospital beds, theatre time, specialist nurses, etc. If orthopaedic surgeons were increased from 60 to 90 you have more out-patient clinics but there is a need also for greater speed with admissions, going to theatre, etc."