There are approximately 250 Consultant Radiologists in full time practice in the Republic of Ireland. The number of consultant and trainee posts in the public sector is controlled by the central health authorities. The ratio of consultants to population is low in comparison to some of our neighbouring countries, and the numbers of studies performed by individual consultants is quite high by international standards. Understandably, this places great pressure on practicing radiologists and radiation therapists, but despite this, the research output of our trainees and consultants is consistently very high, as evidenced by the high level of participation in international meetings including ECR. The development of Academic Medical Centres on best practice international lines will, it is hoped, help the strategic evolution of Imaging Research.
The standard of equipment in diagnostic and therapeutic departments in the country is relatively high, but variable. Equipment purchase and replacement is the function of a central health service authority and budgeting is not based upon a depreciation model. Therefore, replacement of old equipment is haphazard and not planned in advance. The principle service issues facing our specialties, particularly in times of economic decline, are the need to increase consultant numbers (and to achieve commensurate increase in trainee numbers to keep pace) in order to ensure safe delivery of timely service to patients, and a need to budget for development of departments and replacement of equipment in a more planned fashion.
Current government policy in Ireland is to centralise cancer care in 8 regional cancer centres. This policy is presently being implemented for breast cancer care; planning is underway for similar centralisation for management of other cancers. The implications for delivery of first-class diagnostic services are significant; at present, many forms of cancer are managed to a high standard in particular hospitals which have evolved very experienced teams in specific niche areas. Movement of staff and expertise may be required to achieve the political goal of centralisation. It remains to be seen if the resources necessary to implement these changes will be available in recessionary times. Like many western countries, Ireland’s healthcare budget is being cut dramatically, and major new developments are in doubt at present.
A major issue for the Faculty of Radiologists is to inform the development of uniform, best practice, Quality Assurance Programmes across the country. This must obviously be done with patient safety at its core. There is however a parallel process of educating and informing society so as to set realistic expectations.