Medical staff shortages in Ireland’s Emergency Departments cause serious concern
A recent medical staff survey by the Irish Association for Emergency Medicine confirms ongoing shortages of medical staff in the country’s Emergency Departments (EDs). The worst shortages are at the middle grade level (senior doctors at a grade below Consultant). In addition, the experience of departments in attempting to recruit medical staff for July 2013 to January 2014 (the next contract period for NCHDs [non-consultant hospital doctors]) suggests that the problem will greatly worsen after July. There is a genuine risk that EDs will not be able to fill enough of their posts to continue to provide current levels of service. There is a real prospect therefore of certain EDs being obliged to reduce their hours of service. For many EDs there is a likelihood of fewer doctors on duty with consequent increases in waiting times and increased risk for patients. This issue is not just confined to EDs in smaller hospitals which have been vulnerable to staffing difficulties in recent years but is likely to significantly affect many larger hospitals across the country.
In addition to these difficulties with NCHD recruitment, there are significant and increasing difficulties recruiting Consultants in Emergency Medicine (EM) around the country. Recent media comment on unfilled Consultant posts in a range of medical specialties relates particularly to EM. At the same time as new entrant Consultant salaries in Ireland are cut, other countries are offering very heavily incentivised packages to attract suitably qualified Irish doctors to staff their EDs. These are countries where EM is better resourced, provided in better staffed, un-overcrowded and more fitfor-purpose environments and incentivised and remunerated in a way which attracts much greater numbers of medical graduates to the specialty. Unless the well documented problems that make a career in EM in Ireland so unattractive are finally and definitively addressed, the staffing shortage will inevitably worsen and may lead to a downward spiral whereby current Consultants in EM consider relocating to these countries.
The 1.2 million patients who attend Ireland’s EDs annually cannot afford the continuation of current policies which result in an increasingly demoralised and shrinking EM workforce struggling to provide a quality service in the increasingly hazardous environments that are Ireland’s Emergency Departments.