About 500 additional hospital beds need to be provided each year – the equivalent of a new hospital annually – to keep up with Ireland’s projected population growth, former taoiseach Leo Varadkar has said.
Delivering the Irish Medical Organisation’s annual Doolin lecture in Dublin on Saturday, the former Fine Gael leader and minister for health said he feared the pipeline of new hospital development projects was not sufficiently strong.
He suggested a new €1 billion hospital was needed in Galway, where the existing facility is “just not what it should be”, and that significant investment was also required in Limerick and elsewhere.
Mr Varadkar said he hoped the next programme for government would include a commitment to open about 5,000 additional hospital beds. He forecast that the Irish population would reach six million by about 2040.
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“When I was minister for health we had three hospital projects on the go – the national children’s hospital, the national forensic mental health hospital in Portrane and the National Rehabilitation Hospital in Dún Laoghaire. Two of these are open and the other will probably be commissioned next year or in 2026,” he said.
However, Mr Varadkar said he was worried about the pipeline of capital development projects coming after that. He said the planned national maternity hospital project – to replace the existing facility at Holles Street – was “crawling along” and had not yet gone to tender or for construction.
He said the “type of projects that we need – some of the big extensions” are not coming “which kind of worries me”.
During his address to an audience at the Royal College of Surgeons in Ireland, Mr Varadkar said a shortage of hospital beds was at the heart of a lot of the problems in the Irish health system.
“We have done a terrible thing in policy terms – a lot done with advice from medics and specialists – by reducing hospital beds by far too much and making the emergency department the only way through which most patients can get into the hospital,” he said. “That is a fundamental thing that has not been resolved yet.”
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Mr Varadkar said in his defence as a former minister for health that he stopped the closure of hospital beds. He said over recent years governments had been increasing the bed stock “but not anywhere near what is required”.
He forecast that health spending and health staffing would increase further in the years ahead but not at the rate experienced in recent times. He said the health service and the public should be “prepared for that”. He suggested health spending could rise by 3 or 4 per cent, about an additional €1 billion year, but not by €2 billion annually.
“When I was minister for health, 2014-2016, at that time there were about 9,000 whole-time-equivalent doctors and dentists employed by the HSE,” he said. “It is now at 14,000 – there has been a 50 per cent increase in number of doctors and dentists. A further 50 per cent increase would not be sustainable and not affordable.”
Mr Varadkar also said Ireland was “an outlier” in terms of the number of staff in the health service who were trained overseas. He said 51 per cent of nurses and midwives in Ireland were foreign trained as well as more than a third of doctors.
“[There is] no other country in the western world where the numbers are that high. Norway and the UK are not that far off, but we are a definite outlier in that regard,” he said. “Of course there is nothing wrong with being a foreign-trained doctor. My dad is one and was a very popular GP in west Dublin.
“There is something not right when more than half of nurses are foreign trained and one third of doctors are.”
“Something that has to be looked at in the years ahead both in terms of the number of people being training and what more we can do to ensure that more people who go abroad come back.”
He said that more healthcare professionals who went abroad stayed there for good compared with those working in other sectors.
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