Dr. Peadar Gilligan:

It is fair to say that the acquisition of the private hospitals for a period by the State was absolute recognition of the challenges we have had in capacity. What we in the IMO would like to see, and what every doctor in the country would like to see, is an actual plan to invest in the capacity requirements of the system. Essentially, 5,000 beds would look like a 500-bed hospital. My concern is that, to my knowledge, no plan as yet has been put in place with regard to capital expenditure, despite a 2018 document advising us that significant investment needed to take place. We need the planners, the engineers and the architects of the country to address the requirements to provide that capacity, but we need 5,000 beds. With those beds we also need specialists in the acute hospital system. We need approximately 1,600 more specialists in the system just to bring us close to the OECD specialistper capitaaverage. Without those, we cannot provide the timely care that our patients need in a safe way.

Modular builds now are significantly better than they were when I was in school where one could put one's pencil through the walls of the prefabs. They are significantly better now and many countries have invested in those as a temporising measure while putting more significant structures in place. There are tents on nearly every hospital campus in the country. Available capacity within acute hospitals has been looked at whereby areas that historically were not clinical areas have become clinical areas in those hospitals but we need to see that commitment.

Part of the challenge we face is that we want to attract specialists back to Ireland but since October 2012, we have treated them poorly. We have paid them 30% less than existing colleagues. A colleague who took up his appointment after 2012 told me recently that the applause and the thanks were very nice but the reality is that he goes to work and he gets paid 30% less for doing the same job as me. He asked if that was acceptable. I know it is not acceptable. I know that this committee knows it is not acceptable but we need to address that to allow us recruit the specialists we need in our acute hospital system.