CUH Chief Executive Warns Hospital Is 'Unsafe' for Patients Amid Over 1,000 Staff Shortfall
核心洞察
Cork University Hospital's chief executive warned the hospital is "unsafe" for patients, citing a shortfall of over 1,000 whole-time equivalent staff posts.
Of 1,053 affected posts, 348 funded vacancies remain unfilled, with 172 priority posts deemed essential to safeguard patient safety ahead of winter.
The health minister said she found no evidence of increased patient safety incidents, while acknowledging the South West region is "significantly over budget."
Cork University Hospital (CUH) chief executive Jennifer Kearney has warned that the hospital is "unsafe" for patients, attributing the situation to a shortfall of more than 1,000 whole-time equivalent (WTE) staff posts and what she described as "increasingly bureaucratic processes" and "a prolonged suppression of recruitment."
In a letter first reported on RTÉ radio, Ms Kearney wrote: "My responsibility as chief executive is not simply to comply with a process. It is to speak clearly when I believe that process is creating a foreseeable risk to patients and staff. I would rather raise that concern now, when there is still an opportunity to act, than remain silent and explain afterwards why we did not."
Scale of the Staffing Shortfall
Ms Kearney pointed to the fact that 348 WTE posts are vacant despite funding for them already being secured. Of the total 1,053 affected posts, a further 249 are approved but unfunded, 202 posts identified in National Service Plans have never been filled, 166 WTE are on maternity leave, and 88 are on long-term sickness leave.
"There is a very real danger that we become focused on whether a post has passed through the correct approval gateway, rather than asking the more fundamental question: Is the hospital adequately staffed to provide safe care to patients?" Ms Kearney wrote. She said services are already reducing capacity, cancelling patients and "relying on expensive temporary solutions."
Demands for Immediate Action
Ms Kearney has demanded immediate escalation of the CUH workforce position to the HSE (搜索) executive team, with the current list of clinically prioritised funded vacancies reviewed as a matter of urgency. She also called for a derogation from current employment restrictions for CUH, recognising the specific patient safety and winter resilience risks facing the hospital, and approval of a minimum of 172 priority posts to allow CUH to safely strengthen its workforce ahead of winter.
She said those posts should be drawn from the hospital's existing list of funded and clinically prioritised vacancies, rather than being treated as new unfunded establishment growth.
Ms Kearney revealed that, at a meeting on May 7, CUH management were "asked to significantly reduce its list of approximately 120 prioritised posts, with the rationale that the number would 'not look good nationally'." She said that on August 17, she was asked again to prioritise posts, including those already awaiting approval, with an expectation to prioritise only four or five posts.
"We should not wait for a patient safety incident to demonstrate that the current position is unsafe," she said, adding that paediatric neurology, radiology, geriatric medicine, endocrinology, and the St Finbarr's rehabilitation unit are among the areas most affected.
HSE and Union Response
A HSE (搜索) South West spokesperson said it is working to implement newly introduced employment approval processes and to progress recruitment across all sites. However, they added: "As of the end of last month, Cork University Hospital (CUH) was operating at 258.67 whole-time equivalent (WTE) staff above its approved workforce limit. CUH has continued to increase its workforce during the most recent reporting period. In contrast, other service areas have experienced workforce reductions while continuing to manage significant service pressures and associated risks."
Irish Nurses and Midwives Organisation (搜索) assistant director of industrial relations Liam Conway said Ms Kearney's letter echoed the union's concerns. "The decision making is so far away from the frontline — it's having a significant impact on patient care, and there's a real concern that services will have to be curtailed. We don't have enough staff to open the surgical hub, or to staff wards — there's so much onus on trying to reduce costs, but at what cost to patient care?"
The Irish Hospital Consultants Association (搜索) (IHCA) said 24 consultant posts in CUH are among those stalled. It said many consultants were offered and accepted the posts as far back as February, but they have not been provided with formal contracts due to an impasse at national HSE (搜索) level, though some had agreed start dates that have now passed. IHCA chief executive Jim Daly expressed concern that the reputational damage arising from this could deter healthcare staff abroad from returning to Ireland.
Sinn Féin's David Cullinane said the request to reduce the list of priority posts is "absolutely scandalous," as reducing the number of posts on a list does not reduce the number of patients who need care.
Health Minister's Response
Health Minister Jennifer Carroll MacNeill said she was not dismissing the patient safety concerns and said she is "personally notified of patient safety incidents" which come to her at "different times of the day." She said that as soon as she saw the letter come into the public domain, she checked with the National Patient Safety Office to see if there were any markers that would be visible in an unsafe environment, including unexplained falls and pressure sores.
"I am happy to reassure that we have not seen any such increase, nor have we had communication to the National Patient Safety Office or to HIQA about safety concerns," she told RTÉ's Morning Ireland.
The minister highlighted that the South West region generally has hired more people this year than any other region and is "significantly over budget." She noted that Cork has had a "very significant increase in staffing" in the last five to six years of more than 40%, alongside a budget increase of 108%. "I am sorry to say that the increased activity is only 16% and there is more to do in Cork to get the best value and the best deployment of all of the resources that it has been given," she added.
The minister said it is for Cork to make "decisions as to what those priority posts" are within its own budget, adding: "I would suggest radiology is a priority, [...] but I am not the hospital manager. I am the minister looking at the whole country and looking at the comparative analysis of how resources are being used."