Need for ‘clarity’ on future specialist posts

There is a need for “clarity” on long-term funding for consultant posts to support trainee retention, the Medical Director of HSE National Doctors Training and Planning (NDTP) has told the Medical Independent (MI).

Prof Anthony O’Regan, Consultant in Respiratory and Internal Medicine, University Hospital Galway, was speaking to MI at NDTP’s workforce planning conference in Dublin last month.

While noting the rising number of consultants appointed in recent years, speakers at the conference raised concerns over the lack of a long-term funding commitment for consultant and specialist
training positions.

Mr Ken Mealy, Joint Clinical Lead of the National Clinical Programme in Surgery, told MI he regarded long-term financial backing as the biggest challenge to the implementation of NDTP’s new surgical workforce plan. 

The plan calls for an increase in consultant surgeons from the approximately 673 currently working across the public and private sectors to 1,108 by 2038. 

It also recommends the “annual setting and monitoring” of workforce recruitment targets. 

If workforce planning recommendations are implemented, the ratio of consultant surgeons per 100,000 of the population will increase from approximately 13.2 in 2023 to 16 by 2030 and 19.5 by 2038.

Mr Mealy said that the “year-by-year basis” of investment through the HSE’s service plans presented a difficulty for long-term planning.

It was important to have “some certainty from the health service” regarding the expansion of consultant numbers over the coming years.

“I think that would allow…the training bodies to plan. And we do need to plan because it is a 12-to-14-year [training] lead-in time for a surgeon,” stated Mr Mealy.

Last month, NDTP also published Emergency Medicine Workforce in Ireland 2024-2038. It projected the need for an increase in the number of emergency medicine (EM) consultants from approximately 182 to 335
by 2038.

This report recommended increasing the EM core trainee intake from the current 30 per annum to 40 per annum by 2028 and expanding the advanced trainee intake from the current 16 per annum to 30 per annum by 2034. “The primary recommendation of this report is the expansion of all levels of the training programme for EM,” states the report. “The consultant workforce in EM is required to almost double in size over the next 15 years. This will only be achieved with significantly increased output from the training
programme in Ireland. Even with increased training output, it will be necessary to hire consultants from outside of the domestic training programmes to meet immediate unmet demand and service expansion targets while the training programme expands in capacity.”