University Hospital Limerick. File Picture.

As the country deals with record numbers on trolleys, with 100 patients without a bed in University Hospital Limerick yesterday alone, there are fears the health crisis will worsen as many doctors consider leaving the country.

Dr Niamh Humphries, senior lecturer in the Royal College of Surgeons of Ireland's Graduate School of Healthcare Management, told the Oireachtas health committee that the country should be "fearful" about high levels of doctor emigration post-Covid, due to poor working conditions.

She said 391 doctors applied for Australian work permits last year, and there is no guarantee they will return.

She warned this will get worse when the pandemic ends, as Irish-trained doctors are in high demand abroad. 

Dr Humphries carried out research that found conditions actually improved temporarily when extra staff were deployed to crisis points.

One doctor's response to her survey was: "And all of a sudden we had a working healthcare system…. now that Covid is ‘over’, which it obviously most definitely isn’t, we’ve gone back to the crisis … and everyone is tired and burnt out again".

Dr Humphries told the committee the number of vacant roles is “terrifying” and said hospitals are “running on temps”.

The Irish Hospital Consultants Association said: “These doctors are not returning to Ireland, which is leaving our patients without access to the care they need.” 

The IHCA, along with the Irish Medical Organisation, are in negotiations with the Government about a new contract, but the committee heard doctors do not feel the proposed contract addresses the challenges they are facing on the frontline.

The warnings come as the Irish Nurses and Midwives Organisation has demanded direct ministerial intervention to tackle the trolley crisis.

INMO general secretary Phil Ni Sheaghdha said her union is again calling on Hiqa to urgently investigate the overcrowding issue in UHL and make recommendations.

Last night, University Hospital Limerick announced a deferral of almost all elective activity as it attempted to manage “a sustained surge in emergency presentations and a significant increase in Covid-19 activity”.

According to the HSE, there were no general beds available at the Limerick hospital, a situation replicated in 14 other hospitals yesterday.

There were two beds available in UHL’s intensive care unit where six Covid-19 patients were being treated.

A spokesman for UHL said the hospital had “moved to its highest level of escalation, meaning emergency and time-critical care for the sickest patients is being prioritised”.

Outpatient appointments, elective surgery and diagnostic investigations, have been “deferred until further notice”, and “affected patients will be contacted as soon as possible to reschedule their appointments and procedures,” he said.

A visiting ban remains in place at UHL which was treating 89 Covid-positive patients, however visits of one person per patient were being facilitated for parents visiting children; for people assisting confused patients; and for people visiting on compassionate grounds; for example, for patients who are critically unwell or at end of life.

Other hospital services in the region remained “largely unaffected” and scheduled care was operating as normal at Ennis Hospital, Nenagh Hospital, University Maternity Hospital Limerick, Croom Orthopaedic Hospital, and St John’s Hospital.

While the region’s only 24-hour emergency department, based out of UHL, remained open for emergency cases and emergency and trauma surgery, the Limerick hospital urged people “to first consider the care options that are available in their own communities, including family doctors, out-of-hours GP services, local pharmacies, and local injury clinics”.

A limited number of scheduled care appointments we’re still going ahead, including: cancer services; dialysis; breast radiology; cardiology; clinical age assessment unit; rapid access medical unit; nurse-led outpatient clinic; dermatology outpatients; bronchoscopy outpatients; OPAT (outpatient therapy); fracture clinic; paediatric outpatient clinics; endoscopy.

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