Hospitals may face closure under licensing reforms

Public and private hospitals could face closure if they continue to have doctors without specialist training working in consultant positions, the Minister for Health has indicated.

Simon Harris said under new legislation all hospitals will be obliged to have licenses in order to operate. Consequently, he envisaged them having to comply with requirements for consultants to be on the Medical Council's specialist register.

In line with the proposed legislation, which Mr Harris said would not come into effect before 2022, it will be an offence for public or private hospitals to operate without a licence.

A Sunday newspaper reported that 650 active medical consultants were not on the register, which shows they have completed specialist training in their particular discipline. Mr Harris said of this number about 120 were employed in the public system with the remainder in the private sector.

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He said of those working in public hospitals, about 50 per cent had been appointed prior to March 2008 when specialist registration was not mandatory for employment as a consultant.

The Minister said the number of consultants not on the register working in public hospitals is falling and that the Health Service Executive is carrying out work in this regard. He suggested that a proportion of publicly-employed consultants may have completed their training but had not placed themselves on the register. He said in such cases the doctors concerned needed to register quickly and this was part of the work the HSE would be carrying out.

Patient care

Mr Harris was speaking at the publication of a new plan to determine the number and type of nurses needed in each hospital ward across the State. He said the framework set out, for the first time, “the staffing requirements and skill mix needed in our hospital wards to achieve the best outcomes for patients”.

“There has also been a sustained decrease, up to 95 per cent, in the use of agency staff. I’m pleased to say that a promising trend in relation to reduced mortality rates has also begun to emerge,” he said.

Dr Siobhán O'Halloran, chief nursing officer at the Department of Health, said historically the number of nurses on wards was allocated for a host of reasons. But in recent years there has been a growing body of evidence internationally that there was a science behind how a ward should be staffed.

“We recommend that the number of nurses should be determined based principally on the acuity and dependency of patients,” she said. “By measuring the acuity and dependency, we can arrive at the figure that says this is the appropriate, safe number of nurses and healthcare assistants.”