The Oireachtas committee has been informed that the Health Service Executive (HSE) has included the financial implications of compensatory payments to overworked doctors in its budget. The committee, focusing on the effect of the employment hiatus on consultants and non-consultant hospital doctors (NCHDs), noted that compensatory rest payments have become a standard part of the system.
According to Susan Clyne, Head of the Irish Medical Organisation (IMO), since the implementation of a new agreement in January 2023, the HSE has disbursed over €1 million in payments for compensatory rest. Despite the new regulation requiring physicians not to work for more than ten days consecutively without a day off, it’s been found that 68 percent of NCHDs often exceed this limit, with some performing duties for more than twenty consecutive days.
Ms Clyne claimed that the HSE, instead of prioritising reasonable hours and providing systems that allow doctors to rest adequately, has considered the financial burden of supporting physicians who work without breaks in their calculations. The IMO had included penalties in the agreement, hoping that the system wouldn’t resort to paying them, but instead allowing safer working hours. Nevertheless, it seems the system has opted for paying these penalties for convenience.
The IMO conducted a study that revealed 94 percent of doctors have seen their depression, anxiety, and stress exacerbated by their work, while 80 percent are on the verge of collapse. The seven-month-long recruitment freeze imposed by HSE has led to an increase in hazardous and illegal work conditions, with 83% of NCHDs exceeding 48 work hours a week. Moreover, it is not uncommon to find doctors on duty for 72 hours or even exceeding 100 hours weekly.
On the eve of the recruitment freeze declaration in October, the HSE informed the IMO that hiring up to 800 additional NCHDs was required to assure reasonable and legal working hours.
As per the International Medical Organization (IMO), a considerable 65% of non-consultant hospital doctors (NCHDs) reported that they were unable to use their guaranteed study leave of ten days every half a year for compulsory exams due to rotation gaps. Furthermore, an alarming 77% of NCHDs claimed they had experienced pressure from their institutions to take on additional shifts, often without much warning. Ms Clyne, an IMO representative, mentioned that it’s not unusual for NCHDs to be expected not to disappoint their peers.
Independently, the IMO has found that every year, 80% of interns decide to leave Ireland after one year of service, although, around 75% eventually return. They discovered from a total of 850 interns, the committee was told, in excess of 700 emigrate annually. Ms Clyne emphasised that if these doctors decide to return, it cannot be taken for granted.
It was also noted that doctors are frequently targeted by overseas recruitment efforts in the form of numerous daily emails and advertisements situated by hospitals and bus stops, with a particular focus on enticing them to Australia. Ms Clyne suggested the main reason for their emigration being the desire for a more favourable work-life balance, rather than the financial benefits.
In the meantime, the IMO clarified that due to chronically insufficient funding, there is a requirement for an additional 5,000 hospital beds over the next five years, which translates to 1,000 per annum, according to Ms Clyne a “not overly ambitious” target. She cautioned that with the growing population, the health service needs substantial improvements just to hold to current levels.
She also highlighted that emergency departments are presented with the most evident deficiency in acute beds, indicating that patients often find themselves receiving all their treatment on a trolley right up until their discharge. This, unfortunately, is the norm at the University Hospital in Limerick, with patients often being cared for in passageways next to toilets, she revealed.