‘Urgent assessment of health service capacity needed’

An urgent assessment is needed of current capacity and how that capacity will be affected as we deliver care under new physical distancing arrangements and infection control guidelines, Irish Medical Organisation (IMO) representatives told members of the Oireachtas Special Committee on Covid-19 Response this morning (Tuesday June 2).

The IMO would fully support the National Public Health Emergency Team in the two metres rule in the health services.

Susan Clyne, IMO Chief Executive, warned of complacency about the outlook for further Covid-19 infections: “Until we have effective treatment options and a vaccine, we face continued uncertainty as to the impact of a second and subsequent waves particularly as respiratory illnesses begin to circulate again as early as September.”

With the ending of the Government agreement with the private hospitals, the IMO representatives told members their focus was on the urgent measures required to enable Ireland’s public health services to deliver care for both Covid-19 and non-Covid patients.

“By the time we get back to work we will be dealing with six months backlog. We cannot continue to lock public patients out of the services any longer,” said Dr Anthony O’Connor, who had been doing a lot of his elective endoscopy work in a private hospital the Health Service Executive (HSE) had partnered with.

Clyne charged that it was “untenable” to continue with historic deficits in manpower and bed capacity in the context of increasing waiting lists.

IMO Council member Prof Matt Sadlier said that while capacity could be reduced for an emergency for a couple of months, ultimately stressed the health service needed more capacity across the country.

At the forefront of this national effort to deal with the pandemic, and notwithstanding the long-standing contractual issues and inequities, the IMO reminded the Committee members that doctors across the health system had stepped up, working long hours and long weeks both in their normal work locations and being redeployed to other sites to deliver specialist care.

The rate of infection in healthcare staff was of extreme concern.

Many doctors had worked without leave since the pandemic began, they added.

They stressed the part played by non-consultant hospital doctors who had been at the front-line of care for Covid-19 patients, and public health specialists who played an invaluable role in health protection “and who should be awarded consultant status in line with the recommendation of Prof Gabriel Scally”.

The IMO representatives presented several recommendations to the Special Committee.

The imminent clinical roadmap for the reopening of services by the HSE must allow for a gradual reopening of both public and private care in tandem, prioritising patients based on clinical need.

Clyne told the Committee meeting that diagnostic, radiology and laboratory departments must be appropriately resourced to allow timely access to investigations for both hospital doctors and general practitioners in the community; clear referral pathways were needed for all patients into secondary care.

Immediate investment to recruit and retain doctors to work in the health service, including targeted measures to address the unprecedented number of hospital consultant vacancies, was needed.

Successive reports and studies had demonstrated that the two-tier consultant pay issue was a major barrier to recruitment.

valerie.ryan@imt.ie