Professor Robert Landers:

I am grateful for the opportunity to join in today's discussion. As members are aware, the IHCA represents more than 3,200 hospital consultants, around 95% of the total number in the country. First, I will address the current staffing situation, including the level of absenteeism. There is a severe shortage of hospital consultants in our public health service. We have the lowest number of medical specialists on a population basis in the EU. We are 41% below the EU average. We have a serious recruitment and retention crisis, with more than 700 permanent hospital consultant posts vacant or not filled as needed. This in large part has been caused by a flawed Government decision in 2012 to cut the pay of newly appointed consultants. Our younger consultants, who are being discriminated against, have been front and centre in providing care in the ongoing Covid crisis. They have carried an extremely heavy burden of work during this period and will continue to do so.

The leaders of all the parties have agreed that ending the discrimination against consultants appointed since 2012 is essential to attract and retain the number of consultants we need. The Government's failure to address the recruitment crisis and restore pay parity is bordering on negligence and only serves to exacerbate the extremely challenging task in dealing post Covid with the massive backlogs and waiting lists that are accumulating across all specialties.

In a survey of members last week, more than half said there are moderate or high staff absentee levels that are having an adverse impact on service delivery. Of the medical and dental staff, we had an absence rate of just 2.3%, around a quarter of the rate of other staff categories. However, more than half of the absences were due to Covid, which is the largest proportion for any staff category. The closure of schools is impacting on the availability for work of healthcare workers and it is increasing workloads and stress levels for those at work.

I will move on quickly to Covid transmission within hospitals. In the survey, around half of all respondents confirmed that improvements are needed to increase the number of single-occupancy rooms and beds in dedicated isolation wards. Our members also expressed concerns about the lack of regular testing and screening of staff. In the nine weeks to the end of January, more than 12,000 healthcare workers had been infected with the virus, including more than 560 doctors.

A total of over 1,400 confirmed cases were linked with hospital outbreaks in the same period. Four in ten of those infected in the hospital outbreaks were healthcare workers. Of the 1,400 cases linked with the hospitals, 30 were admitted to the intensive care unit, ICU, and, sadly, 124 died. When community transmission rates are at such high levels, it is almost inevitable that there will be outbreaks in hospitals. However, more must be done to prevent Covid infections being acquired in hospital settings. It is clear for infection control purposes that our pre-Covid bed occupancy rate of around 95% needs to be reduced to between 80% and 85%. To put that in perspective, this requires approximately 2,000 additional hospital beds to maintain current service levels.

In terms of long Covid, the Irish Hospital Consultants Association is concerned about the effects of long Covid and believes a HSE policy on long Covid is required for healthcare workers. Regarding the availability of protective equipment, IHCA members in our survey reported high levels of availability of personal protective equipment, PPE, of an appropriate grade, albeit there are some small glitches at individual sites. As regards the mental well-being of staff arising from the Covid crisis, a large majority of consultants in our survey said that Covid-19 has had a moderate or severe impact on their workload, general well-being and mental health. More than one-fifth of respondents are experiencing symptoms of burnout and work-related stress. Two in five doctors in Ireland now say their mental well-being is worse compared with what it was at the start of the pandemic. Worryingly, there is a high risk that when the pandemic eases there will be increased mental health issues impacting on our health staff. Returning to the stressful overstretched business-as-usual model is not an option if we are to avoid an even worse workforce crisis than was the case before Covid-19.

Regarding additional staffing requirements to deal with the non-Covid backlog, over 70% of our respondents confirmed that low numbers of consultants available to deliver care will have a moderate or severe adverse impact on the capacity to deal with the backlog in non-Covid care. More than 840,000 people are on some form of hospital waiting list. With over 700 permanent consultant posts vacant, our acute hospitals are very poorly positioned to provide timely care to patients. While the Government has committed record funding levels for health in 2021, until this money is channelled effectively and speedily to where it will make the most difference for patients, through the recruitment of additional consultants with supporting teams and infrastructure, public hospitals will continue to have record waiting lists and struggle to address the backlog of treatment due to Covid-19.

The Government can no longer ignore the fundamental requirement that essential treatment is delivered by consultants and that no amount of investment in hospital services will reduce waiting lists unless we recruit and retain the necessary number of hospital consultants to deliver timely care.