A slowdown in the growth of consultant posts could “critically undermine” efforts to reach the target of 6,000 consultants by 2030, according to internal reports presented by the HSE Chief Clinical Officer (CCO).
Just 100 consultant posts were funded in the HSE National Service Plan 2024, stated a report by CCO Dr Colm Henry to the HSE safety and quality committee on 15 February.
“Slowing down growth in the number of new consultant posts established could critically undermine the ability of the HSE to achieve the 2030 consultant target and workforce recommendations published by the Department of Health NCHD taskforce,” outlined the partially redacted report obtained under Freedom of Information law.
The NCHD taskforce’s final report, approved by the Minister for Health and published on 7 February, recommended increasing consultant posts to 6,000 with a target ratio of 110 consultants per 100,000 population. According to the Medical Workforce Analysis Report 2023-2024, consultants per 100,000 people ranged from 76 in HSE West and Northwest to 52 in HSE Midwest.
Over 300 new consultant hires are required this year to help meet the 2030 target, according to data from HSE National Doctors Training and Planning that was included in Dr Henry’s report to the committee in April. The report highlighted that Ireland “has too few consultants by international standards”.
As of late January, there were 4,421 posts approved by the consultant applications advisory committee (CAAC). Of these, 3,538 posts were filled by permanent consultants; 441 were filled by temporary/agency/locum consultants. In recent years there had been a “significant” rate of growth in approval of posts, which averaged 7.2 per cent per annum from 2018 to 2022.
However, meeting the target would require 1,600 to 1,800 new posts over the next number of years. “This is an ambitious target which will require annual investment, but is possible given our growing success in consultant recruitment increasing from a net growth of +4.3 per cent in 2021 to +9.7 per cent in 2023,” stated Dr Henry’s report in February.
Under current projections, total new hires would need to rise incrementally from 316 this year to 424 in 2030. International recruitment and further expansion of domestic training programmes were required.
A substantial proportion of the required training posts could be created through conversion of non-training posts, which numbered 3,885 (2,275 registrar posts and 1,610 SHO posts).
There were several “risks and dependencies” to meeting medical workforce targets. These included introducing “attraction and retention policies” in model 3 hospitals, funding for the postgraduate training bodies to expand programmes, a sufficient number of trainers with protected training time, and policies to improve the working conditions and work/life balance of the medical workforce.
“Retention and attraction of medical staff will require sustainable workforce planning strategies and policies to address and improve experience of the medical workforce – the recently published Department of Health NCHD taskforce report outlines a number of recommendations to be implemented by the HSE.”
As of mid-July, the number of new consultant posts approved by the CAAC this year is 88.
“All new posts approved by CAAC have confirmed funding,” a HSE spokesperson told the Medical Independent. “The HSE will determine with the Department of Health the target of new consultant posts for 2025 to be established as part of the upcoming annual planning process and in the context of the pay and numbers strategy.”
The spokesperson said the targeted increase in the total number of trainees enrolled in postgraduate training schemes for July 2025 is 200. This is subject to funding and the recruitment process.
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