Plans to expand routine hospital care at weekends could worsen waiting lists unless additional staff, beds and diagnostic services are provided, the organisation representing hospital consultants has warned.
The Irish Hospital Consultants Association (IHCA) said moving consultants from weekday duties to weekend rosters would achieve little if radiology, laboratory and community services were unavailable to support them.
About 70 per cent of consultants have signed the Public-Only Consultant Contract, which provides for Saturday working.
The association said consultants were willing to work at weekends but argued that simply redistributing the existing workforce would reduce hospital capacity on weekdays, rather than create a functioning seven-day service.
“You cannot roster your way out of a capacity deficit,” IHCA president Professor Gabrielle Colleran said in response to recent comments by Minister for Health Jennifer Carroll MacNeill about consultants’ working patterns.
“A consultant working on a Saturday without an operational radiology team, full laboratory support, or available step-down beds cannot discharge patients or run complex clinics,” she said.
“It simply shifts senior decision-makers into an empty room while stripping essential cover from Mondays, when the full hospital machine is actually built to run.”
The dispute highlights the difference between extending consultants’ contractual availability and expanding the capacity of hospitals as a whole.
Scheduled weekend care requires nurses, pharmacists, radiographers, phlebotomists, administrative employees and other healthcare professionals, as well as access to diagnostics and beds.
In a recent survey of its members, the IHCA found that 78 per cent of respondents “never” or “rarely” had access outside normal working hours to the same level of supporting staff available during the week.
The association said placing consultants on Saturday rosters without increasing the overall workforce would leave fewer available on Mondays, when demand is traditionally high and the full range of hospital services is operating.
Prof Colleran, a consultant paediatric radiologist, pointed to ultrasound services as an example.
Working alone on a Saturday, she said she could scan a maximum of 16 children.
On a Monday, three sonographers supported by a multidisciplinary team could each scan 16 children, bringing total capacity to approximately 50 patients.
The association described the proposed extension of routine weekend care without matching investment as a “politically driven illusion of progress”.
It argued that the more serious constraint facing the health service was the shortage of hospital consultants, diagnostic services and beds.
According to the IHCA, Ireland’s number of specialist doctors remains about one-third below the European Union average, despite increases in consultant recruitment.
The association also challenged the value of audits examining whether consultants were fulfilling their contracted hours.
It said 86 per cent of consultants surveyed reported working beyond those hours, while 41 per cent said they provided at least seven hours of unpaid discretionary work each week.
These findings are based on an IHCA membership survey rather than independently verified working-time data.
The organisation claimed existing hospital IT systems were not equipped to accurately record complex rotas extending across several weeks, potentially limiting the reliability of contract compliance audits.
Relations between the IHCA and the Department of Health appear increasingly strained.
The association accused the Minister of concentrating on the attendance of individual doctors while failing to address the wider staffing and infrastructure required to provide care outside conventional hours.
It also claimed the Minister had not formally engaged with the representative body since March 2025.
Prof Colleran said consultants could support a six or seven-day health service, but only if the necessary infrastructure was available alongside them.
“If the Minister wants a functional six- or seven-day health service, she must first provide the beds, the diagnostics and the support staff required to run it,” she said.
“Forcing frontline clinicians into unworkable weekend schedules is a political distraction that treats patient safety as an afterthought.”