News

876,968 people now on some form of NTPF waiting list;  Large increases in outpatient waiting lists for General surgery (34%, +11,412), Orthopaedics (17%, +10,951), Gynaecology (13%, +3,622) and Dermatology (12%, +4,888); 56% increase in the number of patients waiting for hospital pain relief treatment since pandemic began; over 1,700 now waiting longer than a year for treatment – more than a three-fold increase since February 2020; While 153,000 fewer outpatient public hospital appointments now expected in 2021 through National Service Plan;  Lack of a plan to fill over 700 permanent consultant posts. IHCA President Prof Alan Irvine: “Today’s NTPF waiting list figures, which confirm almost 877,000 people are now on some form of NTPF waiting list, again highlight the impact of hospital consultant shortages and capacity constraints on those waiting for an outpatient appointment and related treatment. Timely access to care is vital in ensuring effective treatment and care for patients.” 

IHCA analysis of HSE Service Plan for 2021 points to 200,000 fewer patient appointments this year 

Concern comes as HSE CEO Paul Reid admits that reducing waiting lists will be a ‘significant issue’ this year. Urgent action now needed to prevent secondary crisis of missed care as a record 860,000 people sit on waiting lists. No target set in new National Service Plan to fill 728 vacant consultant posts and insufficient commitment to increase acute bed capacity will impact ability to tackle lists and clear backlog of cancelled / postponed care in 2021.  Plan sees 153,000 fewer outpatient appointments and a reduction of 50,000 inpatient and day cases in 2021 compared with original expected 2020 activity; as well as reduced targets for those waiting longer than a year for their first outpatient and other appointments. Prof Alan Irvine, President, IHCA: “While government has committed record funding levels for health in 2021, until this money is channelled effectively and speedily to where it will make the most difference for patients – through the recruitment of additional Consultants with supporting teams and infrastructure – our public hospitals will continue to have record waiting lists and struggle to address the backlog of treatment due to Covid.” Following the publication of the HSE’s National Service Plan 2021 (Wednesday 24 February), the Irish Hospital Consultants Association (IHCA) has called on health officials to prioritise reducing record waiting lists and to outline a plan to enable public hospitals to cope in the coming months and next winter, in order to avoid another extremely challenging period for staff and patients.

Dr Gabrielle Colleran, IHCA Vice President said, “We are deeply saddened to learn of the passing of our colleague and friend, Dr Keshav Sharma last week.

Commenting on the latest National Treatment Purchase Fund (NTPF) waiting list figures, Professor Alan Irvine, President, Irish Hospital Consultants Association, said: 

More than 21,700 people waiting to see a respiratory consultant, up 7% since start of the year; paediatric respiratory inpatient/day case waiting list up 39% in 2020; 122% increase in number of respiratory consultants needed to address current shortfalls and meet HSE-predicted demand by 2028; Leading respiratory physician and Irish Hospital Consultants Association (IHCA) member calls for new healthcare approach to respiratory disease diagnosis and treatment; Covid-19 having direct and indirect negative impact on provision of respiratory disease care to patients; IHCA calls on government to end consultant recruitment and retention crisis and fill over 700 vacant permanent posts. One of Ireland’s leading respiratory physicians has called for a dedicated long-term national respiratory strategy to address the unmet needs of the growing number of chronic lung disease patients, combat the country’s worsening rates of lung cancer mortality, and the after-effects of the Covid-19 pandemic.   Dr Aidan O’Brien, a consultant in respiratory medicine at University Hospital Limerick and president of the Irish Thoracic Society, says that the strategy would need to be grounded in both community healthcare and through essential resourcing of dedicated respiratory units in each of our acute hospitals, where congestion is occurring.   Such investment would allow a teamed approach to managing respiratory care where those patients whose condition allows for community treatment, can avail of it in their community and those patients with the more severe forms of the disease can be treated in specialised respiratory units in each of the acute hospitals.    The proposed strategy comes in direct response to the growing number of respiratory patients awaiting diagnosis and treatment.   According to latest figures, at the end of November 2020 there were 21,767 people on inpatient/day case and outpatient waiting lists for respiratory medicine and paediatric respiratory medicine, an increase of 1,330 people (7%) since the start of the year.1 The paediatric respiratory medicine inpatient/day case waiting list increased by an additional 281 (39%) in 2020, with more than 1,000 children now awaiting hospital treatment for lung conditions.   Ireland has just 3.3 specialists in respiratory medicine per 100,000 population compared to an EU average of 5 – a third less.2 According to the HSE’s ‘Demand for medical consultants and specialists to 2028’ report, there will be a need over the next 8 years for Ireland to more than double (122%) the current number of respiratory medicine consultants to address current shortfalls and meet increased patient demand.3    Meeting this level of staffing will require the recruitment of 94 additional consultants, or almost 12 respiratory physicians per year from now until 2028.   Lung disease and Covid-19 in Ireland Ireland has a high proportion of lung disease. Approximately 450,000 people suffer from asthma and over 500,000 from chronic obstructive pulmonary disease, or COPD, a progressively worsening condition whose symptoms include severe shortness of breath and an ongoing productive cough.   Hospital admission rates for asthma and COPD together in Ireland is 329 per 100,000 population (49.6 for asthma and 288 for COPD), which is 46% above the OECD average.4 Ireland has the highest hospitalisation rate for COPD of all OECD countries, and COPD is the most common disease-specific cause of emergency hospital admission among adults.5   EU figures suggest that this year Ireland will have the second-highest incidence of lung cancers per 100,000 population, with an estimated 3,271 cases. The same figures project that as many as 2,232 deaths from lung cancer will occur, the seventh highest mortality rate on a population basis in the EU.6   Ireland’s respiratory disease crisis has been worsened by Covid-19, which can have lasting effects on the lungs. So-called ‘long Covid’, about which much remains to be learned, can lead to, among other things, a shortness of breath, a feeling of chest tightness, and a lingering cough for weeks or months after initial infection.    The lockdown itself is also having a material impact on the health service, resulting in even greater delays in access to care for patients with lung conditions or suspected lung disease.   “The ability to address the burden of lung disease in Ireland has been even further restricted by Covid-19 guidelines, because we cannot have our clinics staffed the way we previously did, the number of patients we can assess and our diagnostics have been greatly reduced,” said Dr O’Brien. “When our clinics did reopen, they were greatly restricted.”   Ending the recruitment and retention crisis The IHCA has repeatedly warned the government that Ireland’s ongoing consultant recruitment and retention crisis has left the health service unable to provide timely, quality care to patients.   The IHCA has called on the Government and HSE to immediately fill the 728  hospital consultant posts that are now vacant (or filled on a temporary, locum, or agency basis), across all medical specialties, and fast-track the opening of thousands of beds needed across the public hospital system.    “We had significant waiting lists before Covid-19 even happened, these have increased even further and now our ability to deal with it has been greatly reduced,” said Dr O’Brien.    Through a long-term national respiratory strategy in place, Dr O’Brien argues, additional consultants in the acute hospital system could further support community-level respiratory hubs across Ireland, increasing the speed of access to care and the overall quality of patient outcomes.   “This approach to healthcare provision would lead to a meaningful impact on quality of patients’ lives and also on the patients themselves by empowering them to deal with their disease,” said Dr O’Brien.

9,248 added to adult general surgery outpatient waiting list in 2020; 4,133 more waiting over a year to see a consultant since start of year, an increase of 152%;  Paediatric surgery outpatient list has more than doubled since start of the year, with 2,107 more children waiting to see a hospital consultant; 2,419 (25%) additional patients waiting for inpatient/day case general surgery; 40% increase in paediatric surgery inpatient/day case waiting list since the start of the year; More than a fifth of all hospital consultant posts are now vacant or not filled as needed.  IHCA President Prof Alan Irvine: “Today’s NTPF waiting list figures again highlight the impact of hospital consultant shortages and capacity constraints on those waiting for an outpatient appointment and related surgery and treatment. Each statistic represents a person waiting for the care they desperately need, while potentially deteriorating clinically or living in pain.” 

In same week HSE confirm 728 unfilled permanent consultant posts, Medical Council report finds: