Medical Manpower crisis
It is now well accepted that Ireland is facing a medical manpower crisis with more and more younger doctors choosing to work abroad on qualification and some more established clinicians also opting to leave our shores due to in part, to the ongoing crisis in the health service.
However a study released this week revealed that the vast majority or 88 per cent of Irish medical students are also thinking of leaving Ireland when they qualify. What is particularly concerning about this study is that 83 per cent cited working conditions in Ireland as one of the main reasons for leaving.
Led by NUI Galway, this is the largest study of its kind in Ireland, and was published in the journal Human Resources for Health. The study included over 2,000 medical students in Ireland, of whom 1,519 were Irish, studying across six medical schools. The main reasons cited for possible migration included perceptions regarding career opportunities (85%), working conditions in Ireland (83%) and lifestyle (80%).
Mr Pishoy Gouda, a final year medical student at NUI Galway, who lead the study said, “We have known for some time, from previous research, that a significant percentage of qualified doctors are leaving the country. This research confirms this, with 34% definitely planning to migrate, but also shows a widespread culture of ‘intention to emigrate’ with a further 53% contemplating it. These migration intentions are a major concern to the sustainability the Irish healthcare workforce.”
“This outflow of qualified personnel may represent a financial loss to the Irish healthcare system, when one considers the costs involved in training medical students, the cost of recruiting replacements and the service delivery constraints if replacements cannot be found.”
The Department of Health issued a response to the study almost immediately stating that a range of actions are already underway to recruit and retain doctors at all levels of Ireland.
Healthcare IT
This week saw some welcome news on the advancement of healthcare IT in Ireland with the implementation of the “e-Health” Strategy and long awaited news on the introduction of “Individual Health Identifiers” (IHI).
An individual health identifier or IHI is a number that uniquely identifies each person that has uses a health or social care service in Ireland. It is basically your ID card or passport to the health service. It is not the same as an electronic health record, which is an electronic version of a patient’s medical chart.
The idea is that everyone in the country will eventually get their own IHI which will record the patient’s names, date of birth, sex, address and nationality. According to the HSE “There are many benefits for service users to having an IHI. Being able to uniquely identify each user will improve patient safety by reducing the number of adverse events that may happen, such as giving the patient incorrect medication or vaccinations or admitting the wrong person for surgery.
The advent of an identifier will also increase the efficiency of the healthcare delivery services of Ireland, reducing repeated requests for information and tests in every care episode. Furthermore, allocating an IHI to new born babies helps link their healthcare records for life at the beginning of the healthcare journey. When in place, the IHIs can be used in both the public and private sector.”
Mr Richard Corbridge, Chief Information Officer of the HSE explalined “while principally a patient identifier, the key advantages of the IHI are patient safety and ensuring that the right information is associated with the right individual at the point of care. The IHI will also help in managing our health services more efficiently and ensure that health information can be shared safely, seamlessly across different healthcare organisations associated with patient care”.
The identifiers will be used across the health service for both public and private patients. The first IHIs will be available this summer, there will then be a three year programme to make the IHI available throughout the HSE.
Alcohol and minimum unit pricing
Finally alcohol was in the news this week with the Oireachtas Health and Children Committee hearing statements in relation to the Public Health (Alcohol) Bill 2015.
Addressing the Committee on Tuesday, the President of the RCPI and liver specialist Professor Frank Murray said an estimated 1,500 hospital beds are occupied every night in Ireland’s acute hospitals as a direct result of the health harms caused by alcohol use – costing the health service approximately €1.2 billion a year.
“Given the current crisis, with hundreds of patients on trolleys in accident and emergency departments, this is a national shame. As liver specialists we are saddened and shocked by the increased number of deaths due to cirrhosis of the liver, which has doubled in the last 20 years. This reflects the doubling in alcohol consumption in Ireland in the last 50 years,” Prof Murray stated. The RCPI President said that the Ireland’s relationship with alcohol is “at crisis point.”
“Research shows that about 80% of Irish adults consume alcohol and more than half of those are classified as harmful drinkers. Almost 10 per cent of those who consume alcohol are dependent – and this rises to 15 per cent among 18-24 year olds. This means that we live in a country where virtually every family is affected by alcohol,” he said.
According to Prof Murray Minimum Unit Pricing (MUP) is the single most important aspect of the Public Health (Alcohol) Bill 2015.
“It will reduce the flood of harmful cheap alcohol that tends to be predominantly consumed by underage and young drinkers who binge drink as well as hazardous drinkers. Evidence from Canada shows that it will immediately mean that lives are saved and that fewer people are harmed as a result of their use of alcohol.”
The RCPI supports setting the MUP at least at €1 which would set the price of a bottle of wine (containing 8 to 10 units) at between €8 and €10. Although it did disappointingly fall short of banning alcohol sponsorship of sporting events, this new legislation is to be welcomed. It really is time that, as a nation, we start to take this problem seriously. Or as Prof Murray said “Let’s grasp the opportunity to turn off the tap of cheap harmful alcohol and set a constructive path for drinking alcohol in Ireland.”