Ireland will need more than 9,000 additional hospital doctors within 20 years to meet the demands of a growing and ageing population, a new report has found.
Having this number of extra staff in place by 2042 would cost the Exchequer some €2.2 billion more a year, according to a Parliamentary Budget Office (PBO) report on the cost of non-consultant hospital doctors (NCHDs) and consultants in a “consultant-delivered health service”.
The Government has consistently said it wants to move to this kind of health service operation as senior on-site decision-making results in reduced emergency admissions, shorter lengths of stay and more complete care plans for discharge.
The report found Ireland is an outlier among its OECD peers in terms of its excessive reliance on non-training NCHDs in the public health system.
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Furthermore, Ireland has the lowest number of consultants per 1,000 population in Europe, according to the most recent figures, from 2021.
The PBO report, which looked at increasing population, as well as forecasted growth in chronic disease prevalence, found there would be a demand in 2042 for an extra 3,750 NCHDs. This would result from an increase of 4,650 of those in training and a decrease of 900 non-training.
A further 5,285 consultants will also be required by 2042, resulting in a total increase in cost between now and then of approximately €2,278.2 million.
The analysis in the paper also indicated an “overall likelihood that supply via the Irish training system will be outstripped by likely demand”.
“This accounts for matters such as the likely trajectory of chronic disease prevalence, historical progress of medical students to specialty and other matters,” it added.
The report also examined current workforce levels. The PBO said that in terms of purchasing power, consultants working in Ireland earn more than most of their OECD counterparts.
In terms of gender, the report said that in recent times, the majority of consultants have tended to be male doctors, while there is a “significant” female majority at the earlier stages of postgraduate medical training.
“It is apparent that a disparity remains between the proportions of female doctors on consultancy training paths and those actually working as consultants,” the report said.
“An IMO [Irish Medical Organisation] survey indicated dissatisfaction with matters such as the range of family-friendly work options, and differences in childcare responsibilities between male and female doctors.”
It said the recruitment of doctors from outside of Ireland is “significant by international standards and may be in breach of the country’s World Health Organisation (WHO) obligations”.
According to the report, Irish doctors comprised only 23 per cent of non-training NCHDs in the Irish public health system in 2022, while 26 per cent were educated in Pakistan and 18 per cent in Sudan.
“Given there were 3,281 non-training NCHDs recorded as working in Ireland in 2022, this indicates a significant level of recruitment from overseas, particularly from countries that may suffer from excess migration of qualified doctors,” the report said.
“Such a level of recruitment may be at odds with Ireland’s obligations under the WHO Global Code of Practice on the International Recruitment of Health Personnel. The supply deficits in training NCHDs may also require further recruitment from outside of the country, putting Ireland further in breach of its WHO obligations.”
Earlier this year, the Department of Health published the final report of the NCHD taskforce, which sought to achieve a better work/life balance and improved work conditions.
Among the recommendations, was that the junior doctors should no longer have to move regularly between hospitals in different locations during their training, as well as greater flexibility in working and training options.
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