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Seven-day rosters in hospitals is 'robbing Peter to pay Paul', say consultants

Consultants warned that weekend rostering cannot come at the expense of weekday treatment.

CONSULTANTS HAVE EQUATED the health minister’s decision to spread outpatient services across seven days with “robbing Peter to pay Paul”.

Minister Jennifer Carroll MacNeill today announced that thousands of healthcare staff – including senior consultants, social workers, administrative employees and therapists – will have to work weekends in an effort to curb overcrowding and reduce waiting times.

The Irish Medical Organisation’s (IMO) Consultant’s Committee says, despite the minister’s plans, no new rostering arrangements outside of existing contracts can be invoked.

“There has been no change to the contractual provisions already in place; consultants on the new public-only contract may be rostered over six days from Monday to Saturday.

“Meanwhile, those on older contracts may be rostered in line with their contractual provisions.”

Professor Matthew Sadlier said they recognise the need to extend services to the weekend, but the presence of staff on these days will not be enough to alleviate the long delays for patients.

“We desperately need to see wholescale recruitment of staff and the elimination of the effective recruitment freeze,” he said.

“We also need greater capacity in acute beds so that all patients, once deemed ill enough to be admitted, can be moved to an appropriate bed and treated in the right setting.”

Professor Sadlier warned that weekend rostering cannot come at the expense of weekday treatment.

“The IMO is not ideologically opposed to extended services, but their introduction cannot be based on robbing Peter to pay Paul where there may be a reduction in services on other days.

“If the HSE and government want extended services, they must invest in workforce and capacity and ensure that all services are safe for those working in them and using them.”

Sinn Féin’s health spokesperson David Cullinane said weekend rostering is a step in the right direction, but existing staff shouldn’t be burdened by an increased workload.

“This change by itself will see more staff working at weekends, but without additional staff it will mean less staff working during the week,” said Cullinane.

“The HSE must ensure that there is the same level of productivity and quality of care delivered whether it is during the week or at the weekend. More staff working ordinary contracted hours at the weekend and during the evenings is the best way to achieve this.

“Tinkering around the edges will only give the appearance of change, but it will not solve the waiting list crisis.”

The health minister said the new arrangements will create a “more spread out and stable hospital system”.

Carroll MacNeill told RTÉ’s News at One that those visiting hospitals this week will notice a “huge difference” in the contrast of activity between weekdays and weekends.

“I’ve heard this argument from consultants: If you come in on Saturday, we won’t be available another day. I already know that.”

She said it’s about having the same standard of care available every day of the week.

The plan means more appointments for scans and other diagnostic activities will take place in the evenings and on weekends, with the hope of eventually having theatres operating on weekends too.

MacNeill says she will now engage with hospital managers and clinical leadership about how the expanded roster can be implemented.

She is to hold a conference in the Department of Health in September to hear how hospitals are finding the changes.

The Irish Hospital Consultants Association (IHCA) says they “have no issues” working weekends and “have done so for decades”, but they welcome the provision of additional support staffing at weekends to help deliver care.

“However, it must be acknowledged that there is a finite number of consultants in the system. Simply rearranging rosters does not address the underlying and chronic issues facing our health service,” a spokesperson said.

“The core problem remains a capacity crisis — a shortage of beds, staff, and facilities — and any initiative that suggests otherwise risks creating a misleading sense of reassurance.”

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