Consultants seek clarification on Government’s proposed €1 billion ‘accelerated hospital bed-building plan’

The Irish Hospital Consultants Association (IHCA) says it has called on the Minister for Health Stephen Donnelly to clarify plans announced this week, which are aimed at rapidly delivering up to 1,500 new hospital beds across the country in 2023 and 2024.

The IHCA acknowledged the Minister’s efforts to expediate the delivery of much needed extra capacity across our health service, at a time when almost 900,000 people are on some form of waiting list and the number of patients on trolleys has reached record levels.

However, the Association says it is imperative that there is a whole-of-service approach to alleviating these long-running, severe deficits.

The Consultants have called on the Minister to work with health service management and consultant representative bodies to put in place a clear staffing plan in parallel to the proposed bed-build programme, which could potentially see blocks of 50 to 150 beds constructed at up to 15 hospital sites.

Capacity shortages

As it stands, Ireland has one of the lowest numbers of acute hospital beds in the EU, 40% below the EU27 average of 4.83 per 1,000 population and one third the number in some European countries.¹ Bed capacity has in fact decreased on a population basis from 3.03 beds in 2008 to just 2.68 beds in 2022. Ireland also has one of the highest hospital bed occupancy rates in the developed world.

The IHCA has previously warned that some 5,000 hospital beds are needed by 2030 alongside a total of at least an additional 2,000 permanent Consultants to treat patients in a timely manner, bring down unacceptable waiting lists and address population/demand changes. To meet this target would require opening more than 700 beds per year over the next 7 years and appointing around an additional 300 permanent Consultants on an annual basis. Just 196 additional approved permanent Consultant posts were filled last year, despite there being around 900 approved permanent post that are not filled as needed.²

Furthermore, the Government only plans to deliver 209 additional inpatient beds in 2023 and has already missed its target for the end of 2022 by around 260 beds that are yet to open.³ Just 157 additional public hospital beds were opened last year.⁴

The IHCA says it is concerned that the HSE Capital Plan for 2023 also released this week does not make provisions to reflect the ambitious €1 billion rapid build capacity plan, nor has it allocated any specific funding for the proposed three new elective hospitals in Cork, Dublin and Galway or for the five suggested surgical hubs nationally.⁵

Staffing plans

While Government has made some plans to increase capacity in the immediate term, Consultants say the Minister must in parallel prioritise a plan to fully resource and staff new beds, noting that the delivery of basic infrastructure alone is not enough to achieve the change required to provide timely care to patients.

Without a whole-of-service plan to build and adequately staff extra hospital beds, which would include filling the 900 permanent Consultant posts currently not filled as needed, any plans and efforts to cut waiting lists and tackle the rising numbers of people on trolleys may fall at the first hurdle.

IHCA President Prof Robert Landers said: “We welcome the Minister for Health’s initiative which attempts to start addressing the serious bed and consultant shortages in our public hospitals. But Government must take a whole-of-service approach combined with credible time-bound approaches if it is serious in its efforts to expedite the delivery of extra hospital capacity.

“These beds are long overdue and stem from the 2018 Capacity Review and two subsequent National Development Plans for 2018-2027 and 2021-2023. However, we know these plans are outdated and bed projection figures are underestimated. While the 1,500 rapid build beds are badly needed, we also believe the Minister for Health must plan now to deliver 5,000 beds by 2030.

“This additional capacity is urgently and desperately required across our public hospital system, but the opening of a fully functioning hospital bed requires more than just bricks and mortar.

“To ensure this new initiative is successful, Government must work in parallel with hospital management and consultant representative bodies to ensure that a clear, time-bound and fully funded staffing plan is put in place, so that if and when these new rapid build beds come on stream, there are the Consultants, doctors, nurses, porters and others needed to ensure we are providing care to patients in those beds from day one.

“It is critical that we get this plan in place now, in order to attract and retain the Consultants and healthcare professionals required to staff these beds so we are not left in a scenario, as seen in the past, where hospital beds lie vacant due to staffing shortages.”