JUST AROUND 10% of hospital consultants were working on the most recent bank holiday weekend at the start of February, according to Health Minister Jennifer Carroll MacNeill.

Over the St. Brigid’s Day bank holiday weekend, the number of people on trolleys in hospitals across Ireland rose from 253 on the Saturday morning to 617 on the Tuesday morning.

Carroll MacNeill remarked that the “very high level of hospital congestion” on Tuesday, 4 February “has not been seen since January 2023”.

She said this spike in trolley numbers highlights a need to “ensure such weekend spikes do not occur in the future”.

As a result of this spike in trolley numbers, Carroll MacNeill requested detailed information on the number of admissions and discharges per hospital “to identify where the issues may be particularly pronounced”.

This data revealed that 1,000 more patients were admitted than discharged.

She said this is “in large part connected to the presence of senior decision makers on site” and Carroll MacNeill requested an analysis of the consultants rostered over the St. Brigid’s Day bank holiday weekend.

She said the initial data, from around a third of hospitals, show that just 10% of consultants were rostered, either on-call or on-site.

“This is not enough,” said Carroll MacNeill.

“Of course, other senior decision makers to support consultants are needed but clearly consultants are the clinical lead and indeed the cultural lead of every hospital.”

Speaking to RTÉ’s Morning Ireland, Carroll MacNeill said similar trolley number spikes have been observed over the last three weekends, with trolleys numbers of around 200 on a Saturday morning but increasing to around 400 by Monday morning.

“We have an issue at the weekends, which is that when there are fewer consultant and senior decision makers, junior doctors are more likely to admit patients, being conservative about it, and there are fewer discharges,” said Carroll MacNeill.

The Health Minister said around 60% of hospital consultants have signed up to the public-only consultant contract, wherein consultants can be asked to work 8am-10pm Monday to Friday and 8am-6pm Saturday as part of their core 37-hour, six-day week.

“Normal patient flow and outpatient clinics on Saturdays should be occurring,” said Carroll MacNeill.

“This data that I obtained in response to very significant spike over the bank holiday weekend has given me cause for concern.”

The Health Minister has asked the CEO of the HSE, Bernard Gloster, “to do a much deeper dive on what is happening with the rotation of consultants and maximising the public consultant contract that we have”.

She said Gloster will report back in around two weeks and will provide a “full analysis of how consultants are being used and deployed and supported in our hospitals”.

Carroll MacNeill remarked that some hospitals, such as Waterford and Mullingar, don’t have a “trolley problem” but remarked that there’s “far too much inconsistency among the other hospitals”.

She further remarked that there are “really good outcomes where consultants and managers are working together”.

When asked what can be done based off the initial figures she has received, Carroll MacNeill said she needed “much better data”.

“I will continue to bring this to cabinet once I get that data, and then I will bring the plan that there is for the bank holiday weekend – St Patrick’s Day, over Easter, May and June – because it’s about making sure that we’re using the tools that we have.”

Meanwhile, it was put to Carroll MacNeill by RTE that some consultants may simply not want to work on a Saturday.

Carroll MacNeill said she hopes that this is not the case, and she has to “get the data to show what is happening”.

“I was struck to observe, on the data that I did have, that there wasn’t much of a difference between Saturday, Sunday and Monday,” said Carroll MacNeill.

She added: “I would have expected a full complement of consultants working on Saturday, and then obviously, for it to fall off on Sunday and Bank Holiday Monday, and that wasn’t apparent to me.

“So, it does raise a very significant question that I have to shine a light on, that I have to bring to cabinet, and that I have to get better data on to be able to show what is happening hospital by hospital.”