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Why medical staff shortages have been a chronic problem

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Roadmap: Róisín Shortall TD, centre, chair of the Oireachtas Committee on the Future of Healthcare with committee members at the launch of Sláintecare in 2017

Roadmap: Róisín Shortall TD, centre, chair of the Oireachtas Committee on the Future of Healthcare with committee members at the launch of Sláintecare in 2017

Roadmap: Róisín Shortall TD, centre, chair of the Oireachtas Committee on the Future of Healthcare with committee members at the launch of Sláintecare in 2017

When the Department of Health moved out of Hawkins House into its shiny new home on ­Baggot Street, did anyone bother to bring the dusty old pile of reports on medical workforce planning? The Hanly report, the MacCraith report and so on - they made for good reading, but the failure to implement their recommendations has meant that Ireland's hospitals remain ­woefully understaffed.

The Irish health service's ability to recruit and retain staff was already at crisis point before the onslaught of a global pandemic. Medical representative bodies have been decrying the shortage of staff for years, yet doctors and nurses continued to emigrate in their droves. This brain drain of Irish-trained medics and nurses, a perennial issue, intensified in the years after the 2008 recession, driven by swingeing cuts in pay and a recruitment freeze. Medical schools and nursing colleges were in effect training graduates for export. In 2016, six out of 10 newly qualified doctors indicated they planned to leave once their intern year was finished.

Consider that our number of hospital beds per 1,000 of the population is considerably below the average for the OECD group of developed countries. Our occupancy rates, at about 95pc, are among the highest in Europe. An occupancy limit of 85pc is recommended internationally to ensure patient safety and allow for surges in activity. Yet these beds are served by ever-dwindling numbers of medical staff. According to the Irish Nurses and Midwives Organisation, last year there were 1,157 fewer nurses and midwives working in the HSE than in 2007, despite increased activity in the system. Ireland also has the lowest number of consultant specialists in the EU; the European average is 2.45 per 1,000 of the population, but Ireland has just 1.44.