January
The ninth edition of the Medical Council’s ethical guide comes into effect. As reported in the Medical Independent (MI), around 300 doctors sign a letter to the Council expressing
their alarm about changes to the sections on ‘end-of-life care’ and ‘conscientious objection’.
The changes include the deletion of the line “you must not take part in the deliberate killing of a patient” from the end-of-life care section. The Council states that the guide provides “general principles” and specific guidance on areas of practice. The guide says doctors must comply with, and operate within, the law.
HSE CEO Mr Bernard Gloster announces the appointment of six regional executive officers to lead the health regions following a Public Appointments Service-led process. The regions will come into effect from 1 March.
During the month of January, there were only “three instances” where less than 500 people waited on trolleys, chairs or other inappropriate bed spaces following presentation to emergency departments, according to the Irish Nurses and Midwives Organisation (INMO).
“We need more beds and we need more patient-facing staff,” says INMO General Secretary Ms Phil Ní Sheaghdha.
February
The Department of Health releases the NCHD taskforce’s final report, which contains 44 recommendations. These include targets for less-than full-time working/training and establishing a stakeholder group to define benchmarks for safe medical staffing levels. The report cites “a significant shortage” in the domestic training pipeline to deliver consultant workforce targets set out in the taskforce’s interim report (ie, 6,000 consultants/a ratio of 110 consultants per 100,000 population by 2030).
Minister for Health Stephen Donnelly says it is “critical” the recommendations are progressed as an “urgent priority”.
Dr Lorcan Martin, President of the College of Psychiatrists of Ireland (CPsychI), says State underfunding of psychiatry training is having a “detrimental” impact on patients. Speaking ahead of the CPsychI NCHD Conference in Dublin, Dr Martin says the current funding of €1.3 million is at least €600,000 short of what is needed. He says the number of trainees completing training each year and the training posts currently allocated, fall far short of the HSE agreed target of 835 consultant psychiatrists required by 2028.
March
The new National Physical Activity and Sedentary Behaviour Guidelines for Ireland are launched. For the first time they include guidance applicable to very young children.
By the end of 2023, almost 8,900 children were classified as overdue for an assessment of need under the Disability Act, according to figures newly released by the HSE. Nearly 7,000 children had been waiting for more than three months.
The joint Oireachtas committee on assisted dying recommends introducing a legal right to an assisted death in limited circumstances, ie, where an individual has an incurable condition expected to cause death within six months or within 12 months for a neurodegenerative condition; and where the condition is causing suffering that cannot be relieved in a manner they find tolerable.
The committee also recommends legal protection of healthcare professionals’ right to conscientious objection, but with a legal obligation to refer.
April
At the IMO AGM, members voice concerns about the physician associate (PA) role. New IMO President Dr Denis McCauley says the union is concerned that PAs may be recruited to “mask the shortage” of doctors. “The role of the PA can only be to support doctors… not to replace them,” he remarks. Six motions are passed relating to role clarity, governance, impact on doctor training and employment, and choice of regulator (which should not be the Medical Council, according to the IMO). The meeting in Killarney also agrees a series of motions relating to the harms of social media overuse.
Renowned US immunologist Dr Anthony Fauci addresses RCPI doctors in Dublin. Dr Fauci receives the RCPI’s prestigious Stearne Medal for his contribution to public health. His lecture is part of a series of events marking 400 years since the birth of the RCPI’s founding president, Dr John Stearne.
In comments to MI, Dr Fauci says doctors in Ireland should not hesitate to openly communicate the benefits of vaccination on the basis of “facts, data, and evidence”.
May
The Cabinet approves legislation that will increase the age of sale of tobacco to 21.
MI reports on a HSE review describing a “severe staffing crisis” in laboratory medicine in the face of increasing demand.
June
The RCSI announces the election of Prof Deborah McNamara as President. Prof McNamara is a Consultant General and Colorectal Surgeon at Beaumont Hospital in Dublin. One of her focus areas will be supporting “the younger generation of surgeons who are dealing with considerable challenges”.
MI reports that the National Cancer Control Programme is continuing to liaise with the HSE to determine if funding for cancer strategy-related initiatives will be made available this year.
Ms Bríd O’Flaherty BL is announced as the independent Chairperson of a non-statutory inquiry into the historical licensing and use of sodium valproate in women of child-bearing potential. At a press conference, Minister Donnelly promises families the inquiry will establish a timeline showing what State agencies knew about the medication’s teratogenic risks, when they knew, and what action they took. He confirms the inquiry could lead to a redress scheme if systemic failures are identified.
Ms Karen Keely, Chairperson of Organisation for Anticonvulsant Syndromes (OACS) Ireland, praises those who have campaigned for an inquiry alongside OACS, in particular Epilepsy Ireland. She tells reporters: “It is the beginning of another challenge.” She says she hopes the inquiry will take no longer than 18 months. In attendance are Ms Keely’s three adult sons – Harry, Lee, and Lorcan – who are affected by foetal valproate spectrum disorder.
July
The 2023 annual report of the Practitioner Health Matters Programme outlines an increase in senior doctors presenting with burnout, stress, and anxiety.
MI reports that three hospitals have been selected as pilot sites for reforms recommended in the Model 3 Hospitals Report, published by National Doctors Training and Planning in late 2023. The sites are Midland Regional Hospital, Mullingar; Letterkenny University Hospital; and Tipperary University Hospital, Clonmel.
Consultant Paediatric Radiologist, Prof Gabrielle Colleran, is appointed as President of the IHCA. Her key aims include advocating for a “serious reduction” in waiting times and measures to reduce the carbon footprint in healthcare.
Medical workforce shortages in Ireland highlight the need for greater supports to ensure we retain doctors and incentivise them to practise medicine in Ireland
August
The report of the expert taskforce on expanding the role of pharmacy is published. The taskforce recommends that pharmacists should be able to prescribe for a range of common conditions. It further recommends development of “more widespread models” of pharmacist prescribing in the coming years.
The Medical Council Workforce Intelligence Report 2023 shows over a quarter (26.6 per cent) of clinically active doctors in Ireland self-reported working more than 48 hours a week on average. Most doctors in non-training NCHD posts obtained their basic medical qualification in Pakistan (26.7 per cent), Ireland (22.1 per cent), and Sudan (18.5 per cent). Medical Council President Dr Suzanne Crowe comments: “As the national taskforce on the NCHD workforce has stated previously, quality training and proper induction for international medical graduates is essential for both patient care and for doctor wellbeing. Medical workforce shortages in Ireland highlight the need for greater supports to ensure we retain doctors and incentivise them to practise medicine in Ireland.”
HIQA publishes the terms of reference for an independent statutory review into urgent and emergency care in the mid-west. It is due for completion in summer 2025.
An analysis by the Irish College of GPs shows that GP numbers are not keeping pace with the rapidly growing population. The deficits are particularly evident in counties Meath, Monaghan, Kilkenny, Laois, Kildare, Clare, and Leitrim.
College Chair Dr Deirdre Collins says it has warned of GP shortages for some time. The College has worked with health management to expand GP training places with an historically high number in training (1,191). The international medical graduate rural programme has enabled a further 100 doctors to work in general practice, adds Dr Collins.
The Irish Association of Social Workers welcomes the appointment of Ms Amanda Casey as the HSE’s first Chief Social Worker.
September
The new respiratory syncytial virus immunisation programme for newborn babies is commenced.
A model of care for the delivery of paediatric general surgery is published by the National Clinical Programme in Surgery and the National Clinical Programme for Paediatrics and Neonatology. The model aims to address growing challenges faced by the paediatric surgical community, including the increasing specialisation of surgical practices and the recruitment of general surgeons who can deliver paediatric care. Without intervention, these challenges could impact access to local or regional general paediatric surgical care for children in the future.
The RCPI marks 100 years since the admission of its first female Fellow, Dr Mary Hearn, a gynaecologist who worked at the Victoria Hospital for Women and Children in Cork. The RCPI now has over 600 female Fellows.
The Department of Health releases waiting list data for August. The number of patients on waiting lists “increased marginally” which it says reflects “the increasing demand for care”.
The number of people “taken off” waiting lists, and the number of new additions, are broadly equivalent (approximately 168,000 vs 169,000). At the end of August, there were 712,821 people on the total acute hospital waiting list, which represented an increase of <1 per cent in the last year.
“The figures also show, however, significant reductions in the number of patients waiting longest,” states the Department. “There has been approximately an 18 per cent reduction in the total number of patients waiting over 12 months since this time last year and a corresponding reduction of approximately 28 per cent in the number waiting over 18 months.”
The Irish College of GPs celebrates its 40th anniversary with a series of events.
The Government approves the drafting of the Public Health (Nicotine Inhaling Products) Bill. It will regulate packaging, flavours, and retail display of vaping products, as well as ban single-use or disposable vapes.
The HSE publishes the report of former Chief Justice Mr Frank Clarke into the death of Ms Aoife Johnston (16) at University Hospital Limerick (UHL) on 19 December 2022. The anonymised report is published after Ms Johnston’s family had called for its full release.
Ms Johnston died of sepsis after waiting on a chair for 12 hours in the UHL emergency department. She had been referred by a GP for suspected sepsis.
Mr Clarke concluded that Ms Johnston’s death was almost certainly avoidable. Hospital communication breakdowns, ED crowding, and under-staffing, were contributory factors.
The HSE CEO says six people are facing a disciplinary process in relation to the death of Ms Johnston. Mr Gloster apologises again to Ms Johnston’s family for the failings in her care.
October
The Government announces “a record €25.8 billion budget” for the delivery of health services in 2025.
Minister Donnelly states the National Children’s Hospital contractor is “committed” to the June 2025 completion date. His comments follow a meeting with BAM Ireland’s parent company. The hospital is expected to cost more than €2.2 billion.
The IHCA’s Annual Conference hears that 56 per cent of consultants say their working environment does not reflect a culture of mutual support, cohesion,
or trust.
“Healthcare can often feel consumed by contention and confrontation. Healthy debate has its place, but it should not define us,” says IHCA President Prof Gabrielle Colleran. “The path forward requires a new mindset – a shift towards collaborative and compassionate leadership. We all must play our part.”
The Beaumont RCSI Irish Cancer Society Lung Outreach Programme is launched. The €4.9 million research programme, funded by the Irish Cancer Society, is the largest single investment in lung cancer in Irish history.
Prof Anne Scott, Professor Emerita, University of Galway, is appointed to chair the ‘evaluation’ of the State’s response to the Covid-19 pandemic.
The path forward requires a new mindset – a shift towards collaborative and compassionate leadership
November
The Medical Council launches “CAREhub”. It is an external mental health support service for doctors, medical students, and members of the public who are engaged with the Council’s regulatory functions.
Minister Donnelly commits to implementing recommendations from a national oversight group to support expansion of clinical trials. The Minister says he wants to double the number of trials and bring Ireland in line with top European performers, such as Denmark.
The HSE publishes the Cervical Cancer Elimination Action Plan 2025-2030. The plan aims to ensure Ireland achieves ‘elimination’ by the target date of 2040. Dr Colm Henry, HSE Chief Clinical Officer, announces that Ireland’s rate of cervical cancer is continuing to decline. “According to our most recent data, for the year 2022, we are at 10.1 cases per 100,000; a drop from 15.8 in 2008,” he outlines.
GP Dr Angela Skuce, member of Irish Healthcare Workers for Palestine, tells MI the group wants the Government, professional bodies, and medical colleagues to support human rights and medical staff in Gaza. The group is also advocating for a boycott, divestment, and sanctions against Israel.
INMO members vote in favour of industrial action over unsafe staffing.
The Irish Wheelchair Association calls on the Government to deliver on its commitment to resolve the pay issues affecting section 39 organisations.
December
Minister Donnelly is the biggest political casualty of the General Election early on 2 December, when he loses his Wicklow seat on the final count. Minister of State for Disabilities, Anne Rabbitte, has also lost her seat.
MI reports that over 60 per cent of consultants in the public health service now hold the public-only consultant contract.
The Medical Council publishes a position statement relating to scope of practice and regulation of PAs in the Irish healthcare sector.
“As the independent statutory body which regulates doctors in Ireland, the Medical Council is of the opinion that it is not the appropriate regulatory body for PAs.”
The position statement also references “the potential for emerging patient safety risks arising from confusion for patients, as observed recently because of regulation of PAs by the GMC [General Medical Council] in the UK”. It says it is “essential” that PA roles in Irish healthcare are defined in respect of scope of practice.
The RCSI – which runs the only PA postgraduate programme in the Republic of Ireland – “welcomes” the Council’s statement.
According to the College, it had long advocated for a PA regulatory body. It says PAs are “not replacements for doctors” but increase the productivity of medical and surgical teams.
“Without significant change in our health service, the future demand for healthcare is unsustainable and we will face a public healthcare crisis that will see many more of us unable to access the care we need.”
The RCSI maintains there is “broad agreement” worldwide that the most promising model for a sustainable system is one that extends the scope of practice of existing healthcare professionals and creates new professional groups. It says this is line with calls from the World Health Organisation “to innovate medical workforces”.
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