Dr Peadar Gilligan IMO President Consultant in Emergency Medicine Getting Healthcare Dr Peadar Gilligan IMO President Consultant in Emergency Medicine

Understanding healthcare in Ireland Accessing healthcare in Ireland

Challenging environment “Emergency departments have an extremely important function and compromising the ability of the staff and units to perform it by allowing them to be dangerously overcrowded is potentially life threatening and absolutely unacceptable.” Dr Peadar Gilligan, Consultant in Emergency Medicine, Beaumont Hospital, Letters to the Editor, Irish Times, 26 February 2007 Health Service Executive Acute Hospital Bed Capacity Review: A Preferred Health System in Ireland to 2020 Detailed Report PA Consulting published 2007

Based on this calculation, Ireland requires 12,778 public patient beds to meet existing demand. This is in comparison with an actual figure of 11,660. This is a short-fall of 1,118 beds. Health Service Executive Acute Hospital Bed Capacity Review: A Preferred Health System in Ireland to 2020 Detailed Report PA Consulting published 2007

What actually happened? Acute Hospital beds decreased by 13% from 12,110 in 2006 to 10,473 in 2015

Black hole

Angola

The Facts Life Expectancy in years at birth: Males 79.9 Females 83.6 % population 65 and over 2017: 13.6% No. of people with a medical card end October 2017: 1,626,702 No. of people with a GP Visit Card end October 2017: 484,674 Total public health expenditure 2016: EUR14.7 billion Number of births registered: 2016: 63,897 No. acute hospital discharges: 2016: 1.69 million % as daycase 2016: 62% WTEs employed in the health service end October 2017: 109,933

Euro Health Consumer Index ranks Irish health system 21st overall in 2016 Ireland worst of 36 countries for ease of access to healthcare

Persons reporting unmet healthcare needs

It’s alright when you are in

to increase the number of consultants to 3,100 by 2009 and to 3,600 by 2013. Current data suggests 3153 Consultants in post 133 of these are not on the specialist register

The current system appears to be operating at or above capacity – acute bed occupancy, trolley waits and waiting lists point to an acute service under extreme pressure, while ED attendances, delays in hospital discharges, and growing waiting lists for HC indicate that both primary care services and community-based homecare services for older people are also under pressure.

The demand for healthcare is expected to grow significantly across the primary, acute and social care settings in the next 15 years as a result of demographic and non-demographic change.

CSO – “Population and Labour Force Projections, 2016- 2046”

If in patient bed occupancy is reduced to 85% when calculating capacity, then it is estimated that there would be the immediate need for an additional 1,260 beds, approximately, in the system to meet current demand.

Patient and Carer forum “Supporting doctors and health professionals in their roles is a patient safety issue.”

“ Clarity is needed about what is reasonable to expect from the health service, what funding is to be allocated to meet those expectations, and what decisions need to be made to benefit the greatest number of people in a fair and transparent way. Central to this debate will be the issue of what society is prepared to invest in its health service.”

2012 30% pay cut for all newly appointed Consultants 2008 Contract not honoured Reversal of FEMPI cuts (GPs excluded to date) Public Health Specialists not treated as Consultants NCHDs poorly treated by employing hospitals Potential further reduction in access to supplementary income and the impact this will have on recruitment