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The Journal
4 days ago
- Health
- The Journal
Seven-day roster is 'robbing Peter to pay Paul', say consultants, as staffing still a pain point
CONSULTANTS HAVE EQUATED the health minister's decision to spread outpatient services across seven days with 'robbing Peter to pay Paul'. Minister Jennfier Carroll MacNeill today announced that thousands of healthcare staff – including senior consultants, social workers, administrative employees and therapists – will have to work weekends in an effort to curb overcrowding and reduce waiting times. The Irish Medical Organisation's (IMO) Consultant's Committee says, despite the minister's plans, no new rostering arrangements outside of existing contracts can be invoked. 'There has been no change to the contractual provisions already in place; consultants on the new public-only contract may be rostered over six days from Monday to Saturday. 'Meanwhile, those on older contracts may be rostered in line with their contractual provisions.' Professor Matthew Sadlier said they recognise the need to extend services to the weekend, but the presence of staff on these days will not be enough to alleviate the long delays for patients. 'We desperately need to see wholescale recruitment of staff and the elimination of the effective recruitment freeze,' he said. 'We also need greater capacity in acute beds so that all patients, once deemed ill enough to be admitted, can be moved to an appropriate bed and treated in the right setting.' Professor Sadlier warned that weekend rostering cannot come at the expense of weekday treatment. 'The IMO is not ideologically opposed to extended services, but their introduction cannot be based on robbing Peter to pay Paul where there may be a reduction in services on other days. 'If the HSE and government want extended services, they must invest in workforce and capacity and ensure that all services are safe for those working in them and using them.' Sinn Féin's health spokesperson David Cullinane said weekend rostering is a step in the right direction, but existing staff shouldn't be burdened by an increased workload. Advertisement 'This change by itself will see more staff working at weekends, but without additional staff it will mean less staff working during the week,' said Cullinane. 'The HSE must ensure that there is the same level of productivity and quality of care delivered whether it is during the week or at the weekend. More staff working ordinary contracted hours at the weekend and during the evenings is the best way to achieve this. 'Tinkering around the edges will only give the appearance of change, but it will not solve the waiting list crisis.' The health minister said the new arrangements will create a 'more spread out and stable hospital system'. Carroll MacNeill told RTÉ's News at One that those visiting hospitals this week will notice a 'huge difference' in the contrast of activity between weekdays and weekends. 'I've heard this argument from consultants: If you come in on Saturday, we won't be available another day. I already know that.' She said it's about having the same standard of care available every day of the week. The plan means more appointments for scans and other diagnostic activities will take place in the evenings and on weekends, with the hope of eventually having theatres operating on weekends too. MacNeill says she will now engage with hospital managers and clinical leadership about how the expanded roster can be implemented. She is to hold a conference in the Department of Health in September to hear how hospitals are finding the changes. The Irish Hospital Consultants Association (IHCA) says they 'have no issues' working weekends and 'have done so for decades', but they welcome the provision of additional support staffing at weekends to help deliver care. 'However, it must be acknowledged that there is a finite number of consultants in the system. Simply rearranging rosters does not address the underlying and chronic issues facing our health service,' a spokesperson said. 'The core problem remains a capacity crisis — a shortage of beds, staff, and facilities — and any initiative that suggests otherwise risks creating a misleading sense of reassurance.' Readers like you are keeping these stories free for everyone... A mix of advertising and supporting contributions helps keep paywalls away from valuable information like this article. Over 5,000 readers like you have already stepped up and support us with a monthly payment or a once-off donation. Learn More Support The Journal
RTÉ News
18-06-2025
- Health
- RTÉ News
Almost 1,000 extra GP's required to meet demand over next 15 years
Clip • 6 Mins • 18 JUN • Morning Ireland Tadhg Crowley, GP Chair of the Irish Medical Organisation, on new research outlining the projected demand for GP services over the next 15 years.
Irish Examiner
10-06-2025
- Health
- Irish Examiner
Irish Medical Organisation joins calls for Government to help get aid to people in Gaza
The Irish Medical Organisation has joined the chorus of calls on the Irish Government to do all it can to help get aid to people in Gaza. Dr Anne Dee, president of the IMO, has written to Taoiseach Michéal Martin to express 'grave concern and fear' on behalf of her organisation at what is happening in Gaza. The IMO represents 5,000 doctors in Ireland. Dr Dee strongly criticised the actions of Israeli authorities: "We are seeing blatant contraventions of international humanitarian law by the state of Israel, and I urge the Irish government to do all in its power, nationally and through international organisations to end this horror and to ensure that Israel honours its obligations under international law.' She added: "We abhor the actions of Hamas and we call for the return of hostages and an immediate ceasefire. But what we are witnessing in Gaza at the moment is mass starvation arising from a deliberate blockade of aid through well-established partnerships, by the state of Israel." She criticised the introduction of Israeli-backed aid agencies 'where the most vulnerable, who are seeking assistance, either have been killed or are putting themselves at risk of being killed or injured as they try to feed themselves and their families". 'There is no functioning healthcare system in Gaza and many of our healthcare colleagues have died, along with their patients, as healthcare facilities have come under military attack," she said. This comes as a group of 50 Irish activists are about to join a global march to Rafah in support of the people of Palestine. From June 12 to 20 they will be at the Rafah border among thousands of people to demand an end to the genocide. Cork podcast producer, Bairbre Flood, will be part of the group heading to the Rafah border. "The governments of the world aren't doing anything and the Irish government isn't doing anything. I feel like, as citizens, we have to really step up now and do something to stop this genocide," she told the Irish Examiner. Ms Flood said there are concrete steps Ireland could take. "Why hasn't the Occupied Territories Bill been passed yet? The Central Bank still allowing the sale of Israeli bonds in Ireland, the issue of war planes stopping in Shannon. These are really concrete steps that Ireland could take. I know we have a brilliant reputation and the people are really pro-Palestine, but I just don't feel like it's being reflected in the government policy. "I feel like we should be putting more pressure on America," she said. On June 12, she will be travelling to Cairo before getting onto a bus to Al-Arish. She will then march to the Rafah border. "We have about two nights camping in the desert, and then we should get to Rafah," she explained. She said one of the most important actions would be for "America to stop supplying the weapons" to the Israeli army. "The second most important thing that they need to do is open the border for all the humanitarian aid. There are thousands of trucks sitting with medicines and food and supplies for Palestinian people, and the Americans and the Israelis are blocking it from coming in. "Doctors and medics who've gone over there are coming back and telling us they're seeing children with gunshot wounds to the head, deliberately targeted by the Israeli and shot in the head. We're getting such a mountain of evidence, "I really feel like most people want this to stop. They want Palestine to be free and for the Israelis to leave Gaza," she said. Read More Deadly shooting by Israeli forces near Palestinian aid site in Gaza
Irish Independent
12-05-2025
- Health
- Irish Independent
The Irish Independent's View: A&E waiting times must be driver for badly needed hospital reforms
From this summer, health service chiefs are promising that staff across the entire health service will be rostered to work outside normal office hours. HSE chief executive Bernard Gloster has set a deadline of next month for the introduction of weekend working. The HSE is currently in crucial discussions with unions on the changes. The move to a seven-day-a-week roster comes after Health Minister Jennifer Carroll MacNeill raised concerns earlier this year about a lack of consultants being on duty ahead of a bank holiday weekend. A comprehensive study of hospital consultants has shown that just one in 10 were working on Saturdays, despite their contracts providing for weekend work. A consequent increase in the number of consultants working over the St Patrick's Day bank holiday dramatically reduced the number of patients on trolleys in emergency departments. Addressing the Irish Medical Organisation conference last month, Mr Gloster highlighted the resulting improvement between the holiday weekends. The experiment worked and is now becoming permanent. The contract negotiations of recent years weren't supposed to be just about money, but also about introducing greater flexibility into the health service. Mr Gloster says improvements in the process inside and outside hospitals and how the workforce is deployed are key to better results. He says multi-annual funding can be a game-changer, but can only be achieved if the health service shows evidence of how it uses the resources better. A budget of €25bn and a 25pc growth in the workforce in five years, along with additional infrastructure investment, means the taxpayer is making a significant commitment to the health service. It is only right that the public expect a return for this spending. Aontú leader Peadar Tóibín has obtained figures which call into question whether the health service is running to a standstill – or indeed going backwards. Over the course of a decade, the average time spent in an emergency department – from the time the patient is registered to when they are discharged or admitted to a bed – has risen from six hours to over seven hours. Alongside the additional spend on staff and resources, attendances at hospitals have increased and the population has risen substantially. An ageing population, more complex demands and a bottleneck of treatment built up during the Covid-19 pandemic have also added to the pressures. But the figures also suggest the extra investment was actually required just to keep pace with demographic changes in the country. It also shows the need for the health service to continue to reform, to focus on primary care and outpatient appointments, to take patients away from what should be the last resort of the emergency department.
Irish Examiner
30-04-2025
- Health
- Irish Examiner
Sarah Harte: Our broken food culture is driving us towards weight loss drugs
Is the age of body positivity gone? The waif is back on the catwalk with millions embracing weight-suppressant drugs known as GLP-1 agonists. Hardly surprising that people turn to drugs to shrink themselves when weight bias is so heavily ingrained in society and being fat is so highly stigmatised. It's baked into our psyches that it's better to be thin, and when you fall short of this mark, it can be a source of intense shame. This is true for all genders, although it's particularly pernicious for females, such is our cultural bombardment from birth about the necessity of being thin. What makes people overweight or in some cases obese is complex and varied, with drivers including disordered eating, genetics, a dysregulated part of the brain priming a person to overeat, socioeconomic factors including poverty and lack of education around and access to healthy food. However, the elephant in the room is that a broken food culture has much to answer for. Societally, we have allowed transnational companies to aggressively market ultra-processed foods (UPFs), which have displaced healthy diets globally. Scientists have long warned that these foods are driving 'the pandemic of obesity and other diet-related chronic diseases, such as diabetes.' Instead of tackling the source of the problem, we are turning to biochemical engineering to solve obesity. These 'miracle' weight loss drugs mimic the action of a natural hormone, promoting the feeling of being full. No day is complete without somebody famous or otherwise posting snaps on social media of their reduced girth. Good luck to them. Yet, what is the cost of all of this, and how should the State respond? As reported in this newspaper on Friday, the Irish Medical Organisation (IMO) conference discussed last week how the Irish State's medicines bill could double if we funded weight loss drugs for all those who need or, in some cases, want them. There are over one million obese people in Ireland. Weight loss injections Wegovy (the brand name for a GLP-1-based medicine called semaglutide) and Mounjaro (the brand name for tripeptide) are currently being assessed for reimbursement under State schemes. Apparently, we have over one million obese people in Ireland who are potentially eligible for the drugs. Professor Michael Barry, clinical director of The National Centre for Pharmaoeconomics, posed a valuable public health question (somewhat ironically saying that big decisions had to be made): 'Do we fund them [the drugs] or fund them only for a subgroup of people?' Utilitarian policy decisions made by people like Professor Barry must balance the array of needs of the citizenry. Who gets what drugs, weighing the efficacy versus the financial cost to the State? Another question I have is: If we overfund these drugs, what resources might be diverted from other essential health areas? There are other considerations quite apart from cost. Two people I know are currently losing weight. One uses weight loss medications and seems very optimistic about her journey. The other is losing weight through the time-honoured method of exercise and pushing back from the table because she is dubious about the possible long-term effects of weight-loss drugs. Maybe she is right to be. Side effects As these drugs are relatively new, the potential adverse side effects in the wider population are still being studied. So far, it appears that patients ultimately have to remain permanently on medication to avoid weight regain. Lean body tissue, meaning muscle mass and bone, is also lost. Common side effects include vomiting, diarrhoea, and constipation, with some reports of hair loss. Where they are abused, more dangerous side effects occur, like inflammation of the pancreas. There are legal actions currently under way in the USA about the side effects, including gastrointestinal injuries. It will be interesting to see where liability will lie, whether it will be with the drug manufacturers, healthcare professionals who prescribe them, etc. Earlier this month, the Trump Administration announced that Medicare and Medicaid will not cover anti-obesity drugs, which the Biden Administration had planned to do. More than two-thirds of Medicare beneficiaries are classified as obese. Health Secretary Robert F Kennedy has criticised the drugs. Do we want to be on team Trump and Kennedy (a conjunction which once seemed impossible)? No, we don't. We should consider funding these drugs for a limited subgroup of obese people. The old-fashioned method often doesn't work, and we have the statistics to prove it This public health crisis is a global problem. A recently published Global Burden of Disease Collaborators on Obesity report shows that rates of overweight and obesity increased at the global and regional levels, and in all nations, between 1990 and 2021. Strikingly, in that period, the prevalence of overweight and obesity in children and adolescents doubled, with obesity alone tripling. In terms of our response, surely banning ultra-processed foods high in salt, fat and sugar or at least curtailing food companies' ability to advertise them must be part of the equation, particularly where children are concerned. Some years ago, one Southern Mexican State implemented a ban on selling fizzy drinks and sweets to children. Deeply unpopular, the ban was never enforced. Coca-Cola is the most popular soft drink in the world and, for the last twenty years, the biggest-selling brand in the Irish soft drinks market. One 12-oz can of Coke has 39 grams of sugar, which equals 10 teaspoons. I'm never madly keen on being part of the fun police. My default position tends to be 'you do you,' and whatever gets you there is your own business, provided it doesn't involve minors and doesn't hurt anyone. But this does involve minors, rapidly expanding ones with all the problems that weight gain brings. I wonder if we should consider banning soft drinks and sweets for children as a preventative measure rather than intervening later with drugs, and figuring out whether we will be able to afford weight loss drugs for the approximately one in five obese or overweight Irish children when they grow up? And where are the public education campaigns warning of the health hazards of fizzy drinks, cereals, ultra-processed foods, and fast meals, as we had with tobacco? Consider the following as an example of the profound ignorance of the current approach. In the month that the HSE's National Clinical Lead for obesity, Donal O'Shea, voiced concerns about the inclusion of ultra-processed foods in school meals for which 475,000 children are eligible, Minister for Social Protection Dara Calleary responded that products high in fat, salt, and sugar would be removed from meals. Then, in the same month, at the IMO conference, it was debated how many adults we could subsidise for weight-loss drugs. Weight loss drugs are a revolutionary development that can improve human health as part of a suite of measures. Our clear focus, though, should be on the primary prevention of excessive weight gain, which includes reining in companies that produce UPFs rather than intervention through creating a culture of drug dependency for weight loss. The question is how we intelligently prevent the onset of obesity and diet-related diseases, particularly in children. We owe it to them at least to try.
