Public hospital system ‘on fire’ over consultant shortages

Salary talks will have to include issue of private practice in public hospitals, Dáil hears

Fianna Fáil health spokesman Stephen Donnelly.Photograph: Alan Betson

Fianna Fáil health spokesman Stephen Donnelly.Photograph: Alan Betson


Pay discussions to encourage the recruitment of medical consultants will also have to consider the concept of not having private practice in public hospitals, Minister for Health Simon Harris has said.

He told Fianna Fáil health spokesman Stephen Donnelly that “addressing the concerns of consultants in the next major issue to be resolved” in the wake of agreements with GPs, still under consideration, and nurses, more than 60 per cent of whom had accepted the agreement.

“Both sides have a list of asks in terms of how we can ensure we retain consultants and pay them properly and respect them and give them good working conditions but also what the health service will look like over the course of the delivery of Sláintecare as well,” Mr Harris said.

Sláintecare is a 10-year plan for the reform of the health service to move it from a public and private care service into a universal, single-tier healthcare system where patients are treated on the basis of need rather than ability to pay.

Mr Donnelly quoted one consultant who said the “public hospital system is on fire” because of the lack of specialists.

“We have severe shortage of hospital consultants and there is a very significant discrepancy in pay between new entrants and existing consultants,” he said.

Mr Harris said the public sector pay commission acknowledged the difference in pay between new entrants and existing consultants was greater than in any other sector and they would have to establish a process to deal with this.

“I’ve had talks with Irish Hospital Consultants’ Association and the IMO (Irish Medical Organisation) and will be working with colleagues in Government on how best to design a process, one that respects the public sector pay parameters.

‘Other factors’

But he said “there are other factors we have to consider”.

They included issues “highlighted by the Sláintecare committee in relation to the de Buitléir report and the concept that we shouldn’t have private practice in public hospitals”.

During health questions in the Dáil, Mr Donnelly expressed concern at the Minister’s reference to a “process” because there was a need for speed to deal with the chronic shortage of specialists.

The Minister had said the number of consultants had increased by 4 per cent in the year to March, with 119 extra whole-time equivalent consultants and by 20 per cent over the past five years with an increase to 3,110 whole-time equivalents.

But Mr Donnelly said there were 400 unfilled position including 300 locums and 150 non-specialists in consultant roles, meaning the figure was closer to 2,000 consultants than 3,000.

“People are waiting longer in Ireland than anywhere else in Europe to get a doctor.”

The Wicklow TD said that between 21015 and 2016, there were 44 consultant psychiatric posts and a quarter did not have any applicants, while another 30 per cent only had one applicant.

Citing the situation in Kerry in histopathology, rheumatology and urology specialities, he said they were running out of consultants to provide these services.

He asked when the process would be concluded and pay disparity for consultants addressed.

Mr Harris said there was a worldwide shortage of consultants. Pay was a factor and opportunities in career development, location and training.

He said he cannot give a “ definitive timeframe,” for completion of the process.

They absolutely needed more consultants and had to deal with pay and how health services are provided. Both sides had “asks” and these would have to be considered in the context of delivering Sláintecare.