Hospital list ‘long waiters’ on the rise again as increased capacity becomes more critical

The Government has a real opportunity to address overcrowding and start to tackle extreme waiting lists in Irish hospitals within the next two years, Consultants have said.

Commenting on latest waiting list figures for end April, released by the National Treatment Purchase Fund (NTPF), the Irish Hospital Consultants Association (IHCA) said that with the forecasted strong exchequer performance, Government can put in place credible, funded, time-bound plans which could address the growing demand for hospital and step-down care in the next two years and support the reduction of waiting list on a sustainable basis.

Latest HSE figures confirm that the number of Emergency Department (ED) attendances increased by 104,000 compared with pre-pandemic levels.3 This has resulted in the cancellation of more than 41,000 hospital operations and appointments in the first two months of 2023 alone and led to an increase in people waiting longer than a year for assessment and treatment.4

‘Long-waiters’ increase

While 2022 saw some inroads made into cutting the number of those waiting longer than 12 months for an outpatient appointment or inpatient treatment, many of those gains have been lost due to hospital and step-down capacity deficits. New IHCA analysis reveals a 12% increase in the number of inpatient/day case ‘long-waiters’ since the start of the year and a 22-fold increase over the past decade.

Such long waits for treatment are associated with worse patient outcomes and can lead to additional demands on healthcare resources due to the additional treatments required to manage symptoms.

Capacity challenge

The Minister for Health recently announced a rapid build programme aimed at delivering 1,500 additional beds in acute public hospitals over 2023 and 2024, and while welcomed by the IHCA, Consultants are urging the Government to commit the promised €1 billion capital budget to deliver this additional capacity in the Budget this October.

They say this would account for just a fraction of the Government's forecast budget surpluses of €26 billion this year and next, yet has the potential to rapidly address the fundamental shortage of acute hospital beds.5 In addition, outpatient facilities, theatre access, diagnostics and step-down care capacity will also need to be expanded rapidly. Consultants say that with this capacity, and the additional required staffing in place, Ireland’s hospitals will be better equipped to start tackling the country’s excessive waiting lists and work towards the targets set out in the Waiting List Action Plan.

Hospitals and step-down care facilities are essential for enabling treatment and flow of patients from hospitals and allowing the transfer of around 570 patients which Consultants have deemed fit for discharge and who are waiting months for step-down care to be arranged.6

Commenting on today’s NTPF figures, IHCA President Professor Robert Landers said: “There is a real opportunity to make significant improvements to our hospital capacity challenges over the next two years. To do this, Government must commit the necessary capital spend in the Budget in October to deliver the additional expedited bed capacity announced by the Minister for Health.

“The State’s forecasted surplus should and must be used for the betterment of patient care – across the totality of the health service, from hospitals to stepdown and homecare services.

“Only when capacity is increased and additional Consultants are appointed will we see treatment volumes in public hospitals match demand and effectively reduce current unmanageable waiting lists on a sustainable basis.

“Consultants believe at least 700 extra hospital beds need to be delivered and opened every year for the next 7 years, whilst appointing around an additional 300 permanent Consultants on an annual basis, in order to keep patients off trolleys and bring down waiting lists for hospital treatment.”