Hospital waiting lists longer than ever at halfway point of 10-year Sláintecare plan, say Consultants
Limited progress made as public hospitals still decades away from achieving Sláintecare wait time targets due to growing capacity deficits
- 898,000 people on some form of NTPF waiting list; up more than 314,000 (54%) since publication of Sláintecare Report in May 2017;
- Government’s landmark plan pledged no-one should wait more than 10 weeks for a public hospital outpatient appointment, yet 345,000 currently on outpatient waiting lists for over 6 months — with almost a 3-fold increase in patients waiting +18 months in past five years;
- Sláintecare target wait time of just 10 days set for a public hospital diagnostic test; latest figures reveal 143,000 waiting more than 3 months for vital CTs, MRIs or ultrasounds with over 57,000 waiting a year or longer;
- Stalled Consultant contract talks must be reconvened with an agreed replacement Independent Chair to address Consultant recruitment crisis and bring waiting lists down.
IHCA President Prof Alan Irvine: “The first five years of the 10-year Sláintecare plan have shown that its waiting list targets are not achievable because public hospitals have a severe shortage of Consultants, theatres, acute beds, diagnostic and other facilities. The continuing deficits in hospital Consultants and public hospital capacity means it could be decades before the waiting time targets set out in Sláintecare can be achieved.”
The targets that no-one should wait more than 12 weeks for an inpatient procedure, 10 weeks for an outpatient appointment and 10 days for a diagnostic test will not be met within the lifetime of the Sláintecare plan, Consultants have warned.
The Irish Hospital Consultants Association (IHCA) has today (Friday, 13 May 2022) said that at the mid-point of implementing the 10-year Sláintecare plan, waiting lists have significantly deteriorated rather than improved since the report’s publication in May 2017.
The latest National Treatment Purchase Fund (NTPF) figures released today show that more than 898,000 people were on a waiting list for hospital appointments or treatment at the end of April, an increase of more than 314,000 people (54%) over the past five years.1
According to the IHCA, when the additional 236,000 awaiting diagnostic scans are included, the total number of people on hospital waiting lists is well over 1 million.
The Government’s landmark plan, Sláintecare, pledged no-one should wait more than 10 weeks for a hospital outpatient appointment.2 However, currently more than 345,000 people have been on an outpatient waiting list for over six months, which is a 49% increase since May 2017. The number of people waiting either more than a year or 18 months for an outpatient appointment has increased almost 2-fold and 3-fold respectively over the same period.
The target to have all inpatient/day case procedures caried out within 12 weeks also remains decades away, given there are 32,600 patients currently waiting 6 months or longer for treatment. More than half of these patients (17,041) have been waiting longer than a year for their procedure.
Sláintecare also set a maximum wait time of just 10 days for diagnostic tests such as MRI scans or radiology. Separate new HSE data reveals that 143,000 people were waiting more than 3 months for vital CTs, MRIs or ultrasounds at the end of March, with over 57,000 of these waiting a year or longer.3
The IHCA says that there were almost 380,000 fewer inpatient/day case procedures carried out over the past two years compared with 2019 activity, and 483,000 less outpatient hospital appointments in 2020 and 2021 combined.4
While the health service may not have to catch up on all of these missed appointments and procedures, such a volume suggests it could take decades to clear this backlog of deferred care which has yet to present and bring our already unacceptable waiting lists under control.5
This bleak assessment comes as 838 or 22% of all approved permanent Consultant posts were either absolutely vacant (419), plus a similar number of posts filled on a temporary or agency basis (419) at the beginning of March.6
The IHCA said the shortage of Consultants due to the difficulty in filling permanent Consultant posts and decade long capacity deficits in our public hospitals are the root causes of the unacceptably long waiting lists. These deficits make reaching the Sláintecare wait time targets unachievable without ending the pay discrimination introduced in 2012 against Consultants contracted after that date and increasing the attractiveness of posts in our public hospitals.
Commenting on today’s waiting lists, IHCA President Professor Alan Irvine, said:
“The first five years of the 10-year Sláintecare plan have shown that its waiting list targets are not achievable because public hospitals have a severe shortage of Consultants, theatres, acute beds, diagnostic and other facilities. The continuing deficits in hospital Consultants and public hospital capacity means it could be decades before the waiting time targets set out in Sláintecare can be achieved.
“Targets to reduce public hospital waiting lists need to be resourced properly to address capacity deficits that are the root causes of delays in treatment. Sláintecare is failing on these important factors.
“It is extremely concerning, although unfortunately all too predictable, that public hospitals have almost 900,000 people on some form of a waiting list to be assessed or treated by a Consultant. This is the highest the NTPF waiting lists have reached since last October, reversing marginal reductions seen late last year, and comes despite the HSE having been allocated more money than ever before for outsourcing treatment.
“It is imperative the 838 vacant Consultant posts are filled if we are to effectively address the record public hospital waiting lists. To achieve that, the Minister for Health, Mr Stephen Donnelly, must appoint a replacement Independent Chair in agreement with the representative organisations to restart the hospital Consultant contract talks that have been stalled for five months.
“In addition, the health service management must engage with the IHCA in a genuine effort to improve our competitiveness and agree practical solutions to resolve the decade long deficits in Consultant staffing.”
1. Analysis based on latest NTFP data available, as at 28th April 2022: https://www.ntpf.ie/home/nwld.htm
2. Sláintecare Report, Committee on the Future of Health, May 2017: https://assets.gov.ie/22609/e68786c13e1b4d7daca89b495c506bb8.pdf
3. PQ Response from Minister Stephen Donnelly to Deputy David Cullinane, 26 April 2022: https://www.oireachtas.ie/en/debates/question/2022-04-26/1354/?highlight%5B0%5D=diagnostic
4. HSE National Service Plans 2021 and 2022: https://www.hse.ie/eng/services/publications/
5. Inpatient/day case waiting list and backlog for hospital treatment are estimated at 460,405, comprising the current inpatient/day case waiting list of 79,943 and the 380,462 fewer hospital treatments in 2020 and 2021. Outpatient waiting list and backlog are estimated at 1,107,738, based on a reduction of 482,965 outpatient appointments over the past two years compared with 2019 outturn and a current outpatient waiting list of 624,773. If inpatient/day case and outpatient activity were both increased to 103% of 2019 levels (an additional 52,260 IP/DC procedures and 100,650 OP appointments), the waiting lists and backlog may not be cleared for a further 9 and 11 years respectively. The additional €200m allocation under the Department of Health’s 2022 Waiting List Action Plan intends to fund the assessment or treatment of just 136,000 additional patients.
6. HSE NDTP PQ Response to Deputy David Cullinane, 24 March 2022: https://www.ihca.ie/_fileupload/PQ%20ref%2012721%2022%20Cullinane%20Consultant%20Posts%2024%20March%202022.pdf