Ms Susan Clyne:

Good afternoon. I thank the committee for the opportunity to address it.

The IMO is the trade union and representative body for all doctors in Ireland who are delivering care to patients across the health services. This includes consultants, public health doctors, community health doctors, GPs and non-consultant hospital doctors, NCHDs. The fundamental problem within our health services is one of capacity and this predates Covid. As a country, we have restricted patient care to match the deficits of our services rather than investing in those services to meet patient need. The Health Service Capacity Report was published in 2018 but little or no progress has been made since. Covid has resulted in extreme pressures on our health services. Our response should not be to limit all other care, but to proactively increase capacity to allow for non-Covid care pathways and create capacity for any Covid surge. To do otherwise will only compound the problem. It is inevitable that patients whose care has been delayed will present with more complex needs as they deteriorate and they will suffer negative health outcomes. Mortality rates will increase. We now have a situation where capacity will be reduced by up to 50% while at the same time there are more than 800,000 people waiting for an outpatient appointment or inpatient care.

We have mounting pressures on our emergency departments throughout the country. Extremely limited referral pathways are available to GPs and there are increased pressures on GP services in situations when patients cannot access secondary care, diagnostics mental health services and other community supports.

There is severe overcrowding in our emergency departments with patients languishing on trolleys, elective procedures are routinely cancelled, there are lengthening waiting lists and hospitals are operating at dangerous levels of occupancy. Unfortunately, this year will be worse with the additional impact of Covid-19.

In summary, we have too few beds and we need to plan for an additional 5,000 public acute beds and 300 additional ICU beds. In this context, we must immediately embark on a temporary build programme in tandem with longer-term builds. We have more than 500 vacant consultant posts, and for many years the system has not been capable of attracting sufficient numbers of consultants due to inequitable pay policies. General practice and the much needed shift of care to the community must be planned and resourced. There is little additional capacity in general practice at the moment. We must strengthen our public health capacity. We have relied on public health throughout this crisis, but public health is understaffed and undervalued within our system. Care of the vulnerable and elderly in our society requires urgent attention with significantly more resources deployed to allow people to remain at home. We need to continue to invest in prevention with appropriate resourcing of our vaccination programmes and significant investment in diagnostics and treatment pathways to support our screening programmes, and those screening programmes should open as soon as practicably possible. We also need to invest in e-health across all hospitals and community healthcare settings.

Since the commencement of the pandemic, doctors and all other healthcare workers have shown dedication to patients, professionalism and agility in adopting new ways of working. We now appeal to the members of the committee and the new Government to respond in kind to support us and our patients by investing immediately. This is a health crisis and we must respond accordingly and prioritise investment in our health services.