Overview: a system under pressure
The TB care centre at St James’ Hospital in Dublin is confronting an alarming reality: it cannot meet current or future demand as tuberculosis cases rise. Officials say the emergency review process has doubled from 2023 to 2024, underscoring the strain on a service already operating at full capacity. The situation has prompted calls for urgent action across laboratory support, staffing, and infrastructure to prevent gaps in patient care.
What is driving the demand?
Health leaders point to multiple factors contributing to growing demand for TB care. Increases in detected cases, coupled with the need for comprehensive infectious disease management, place greater burdens on diagnostic labs, clinical teams, and care coordination. While the exact drivers may vary, the implication is clear: more patients require complex evaluation, prolonged treatment, and rigorous monitoring than the current system was designed to accommodate.
Laboratory challenges demand quick solutions
Central to the centre’s appeal for urgent action is laboratory capacity. Rapid, accurate TB testing is essential for timely treatment decisions and preventing transmission. The hospital warns that without expanded lab support — including staffing, equipment, and streamlined workflows — patient care could suffer as demand grows. Strengthened laboratory capacity would also reduce wait times for test results, enabling faster initiation of therapy for those infected.
Staffing and training under pressure
Alongside lab constraints, the hospital highlights staffing as a critical bottleneck. Adequate numbers of clinicians, nurses, microbiologists, and support staff are needed to manage the patient load and maintain high standards of care. Investment in recruiting and retaining skilled professionals, as well as ongoing training in TB management and infection control, will be essential to handle current volumes and any future increases.
Infrastructure and resilience for future demand
Infrastructure — from clinical spaces to ancillary services — must be resilient to surges in TB cases. The hospital’s leadership emphasises that expanding physical capacity, improving patient flow, and integrating care across departments will help reduce bottlenecks. Strategic planning now will pay dividends by ensuring the service remains capable of delivering timely, evidence-based treatment as needs evolve.
What this means for patients and public health
For patients, the consequences of constrained capacity can include longer wait times for diagnostic evaluation, delays in initiating treatment, and potential gaps in follow-up care. From a public health perspective, any delays in diagnosing and treating TB can affect transmission dynamics and long-term outcomes. The hospital’s message is clear: urgent, coordinated action now is essential to safeguard patient health and broader community wellbeing.
Looking ahead: a plan for action
Experts and hospital leaders are calling for a multi-pronged plan that combines increased laboratory capacity, expanded staffing, and targeted infrastructure investments. Collaboration with national health authorities, funding bodies, and academic partners will be key to delivering a sustainable solution. While specific timelines remain to be announced, the emphasis is on rapid progress to prevent service disruption and ensure high-quality TB care for all who need it.
Conclusion
The warning from Ireland’s TB care centre at St James’ Hospital reflects a broader challenge facing health systems as demand for complex, long-term infectious disease care grows. With emergency reviews doubling and capacity at its limit, the call for urgent, well-resourced action is timely. Addressing laboratory, staffing, and infrastructure needs now will help secure a resilient TB care pathway for Ireland’s current and future patients.
