Irish Medical Council highlights concerns in new Intelligence Report

Further concerns highlighted in Medical Council’s Workforce Intelligence Report

Millions at Risk as HIV Progress Falters

The Medical Council has launched the Medical Workforce Intelligence Report for 2021. The report provides a detailed analysis of the Medical Council’s registration data, focusing on demographics of those retaining and withdrawing from the medical register in Ireland. Much of the report highlights deficits in the system and the resulting risks attached to patient safety and care. The Medical Workforce Intelligence Report is a central document in informing workforce planning and improved patient safety in Ireland. The report contains significant findings, which need to be addressed collaboratively amongst policymakers, educators, planners and employers. Key Highlights: • Overall, 21,680 doctors retained their place on the Medical

Council’s register in 2021, with 18,424 or 85% of those being clinically active. • Of the active registered doctors in Ireland, 53% were male and 47% female.

• Over one-third of all clinically active doctors in Ireland are on the General Division of the Register • The number of new doctors who registered in 2021 was 2,605, which represented a 14% increase on the previous year. • Of those, 1,717 were international graduates and 888 were Irish graduates. • 49.8% of NCHDs occupied non-training posts • 62% of doctors self-reported working more than 40 hours a week, • Dublin has the largest number of working doctors with 7,426, which equates to 35% of the total. Medical Council CEO, Leo Kearns and Dr Suzanne Crowe, Medical Council President

For the first time in its Workforce Intelligence Report, the Medical Council is providing a summary of the key risks it has identified as part of the research project. Concern for patient safety is at the core of the five specific risks identified: • General Division – 34.9% of clinically active doctors in Ireland are on the General Division. This represents a key risk to patient safety, as while there is an increase in the General Division, consultant and specialist posts are not being filled. • Non-Consultant Hospital Doctors (NCHDs) – patient safety is further highlighted as there is a considerable proportion of

NCHDs required to perform the duties of hospital consultants • Reliance on International

Medical Graduates (IMGs) – the majority of NCHDs are trained overseas and do not have access to specialist training in

Ireland. The health service is over-reliant on IMGs who report being overworked, undervalued, experiencing discrimination and unable to access specialist training. Aside from the individual impact on the doctors, the treatment of IMGs has serious implications for patient safety. • Non-compliance with European

Working Time Directive – in 2021, over one quarter of doctors reported working more than 48 hours a week, in contravention of the EWTD. This has further serious implications for patient safety. • Attrition – Acute doctor shortages within the Irish health system, especially at skilled and experienced consultant level, affect quality of care and can undermine patient safety. In 2021, doctors cited family and personal issues, lack of training opportunities, inadequate resourcing and work conditions as reasons for withdrawing.

The Medical Council highlights five recommendations for action:

• Commencing coordination and collaboration across all key stakeholders by setting up a

Planning and Advisory

Group to explore and plan workforce strategy

• Undertake a national consultation with individuals, patient groups and medical stakeholders to identify key priorities, issues, and challenges

• Identify priority workforce issues and contributing factors, determined by research and consultation

• Exploring the impact and feasibility or proposed approaches to ensure a fit-forpurpose approach

• The proposed strategy should not be developed in isolation, and health reforms and policies that are underway, including Sláintecare, Regional

Health Areas, Healthy Ireland programmes and initiatives, national clinical programmes, and other developments should be considered.

New data from UNAIDS on the global HIV response reveals that during the last two years of COVID-19 and other global crises, progress against the HIV pandemic has faltered, resources have shrunk, and millions of lives are at risk as a result. The new report, In Danger, is being launched ahead of the International AIDS Conference in Montreal, Canada. Globally the number of new infections dropped only 3.6% between 2020 and 2021, the smallest annual decline in new HIV infections since 2016. Eastern Europe and central Asia, Middle East and North Africa, and Latin America have all seen increases in annual HIV infections over several years. In Asia and the Pacific – the world’s most populous region – UNAIDS data now shows new HIV infections are rising where they had been falling. Climbing infections in these regions are alarming. In eastern and southern Africa rapid progress from previous years significantly slowed in 2021. There is some positive news, with notable declines in new HIV infections in western and central Africa and in the Caribbean, but even in these regions, the HIV response is threatened by a tightening resource crunch.

New infections occurred disproportionately among young women and adolescent girls, with a new infection every two minutes in this population in 2021. The gendered HIV impact, particularly for young African women and girls, occurred amidst disruption of key HIV treatment and prevention services, millions of girls out of school due to pandemics, and spikes in teenage pregnancies and gender-based violence. In sub-Saharan Africa, adolescent girls and young women are three times as likely to acquire HIV as adolescent boys and young men. The report also shows that efforts to ensure that all people living with HIV are accessing life-saving antiretroviral treatment are faltering.