Over €4bn in capital funding required to meet Government commitments on public hospital capacity

Budget 2024 must provide sufficient funding for credible, time-bound plans to rapidly increase acute hospital capacity as one fifth of the population on some form of hospital waiting list – IHCA

• Previously announced plans for 1,500 rapid build acute hospital beds, six surgical hubs and four new elective hospitals will require over €4bn in capital funding yet to be allocated;
• 5,000 additional public hospital beds should be funded by the end of 2030 – or 700 extra hospital beds each year for the next seven years;
• Government must urgently fill the record 930 permanent Consultant posts currently not filled as needed and also appoint 2,000 additional Consultants by 2030 – or an extra 300 annually;
• More than 1.1 million people on waiting lists for hospital care, with number set to increase in 2024 if the capacity is not urgently expanded;
• Seven in 10 Consultants experienced symptoms of burnout in the past 12 months due to workload pressure; while hundreds of specialists emigrate to work abroad;
• IHCA President Prof Rob Landers: “Successive health budgets have failed to address the root causes of the rationing of care to patients and unacceptable public hospital waiting lists, caused by significant hospital capacity deficits and shortfalls in Consultant staffing, both of which are having a detrimental impact on patients and healthcare staff alike.”

The Irish Hospital Consultants Association (IHCA) has called on the Government to commit the estimated €4 billion in capital funding needed to build and open essential hospital improvements already announced by the Minister for Health that promises to significantly increase the number of acute hospital beds and theatre capacity in our public hospitals.

In its Pre-Budget Submission 2024, published today (11 July 2023), the Association said a minimum of 5,000 additional public hospital beds should be funded and opened by the end of 2030 – or 700 extra hospital beds each year for the next seven years. This must start with the rapid delivery of the 1,500 acute beds the Minister for Health Stephen Donnelly committed to open across 15 hospital sites in 2023 and 2024 at a cost of €1bn.

In addition, the IHCA estimates that €3bn could be required for the four elective hospitals in Cork, Dublin (two sites) and Galway, which are not expected to become operational until 2028 at the earliest, despite being first proposed in Sláintecare in 2017. A further €100m-€120m capital funding is required for the planned six surgical hubs, the first of which, the Minister has pledged, will open before the end of this year. No capital funding has been provided as yet for these essential hospital developments, which are likely to cost over €4bn to deliver.

Worsening waiting lists
There are almost 900,000 people on some form on NTPF waiting list, while a further 250,000 people are waiting for an essential diagnostic scan such as an MRI, CT or ultrasound – bringing the total number of people now on public hospital waiting lists to over 1.1 million. This is a fifth of the entire population.

In its submission ahead of Budget 2024, the IHCA warned that with 160,000 additional people expected to attend Emergency Departments this year, compared with 2019, a proportion of these are likely to require a follow-up outpatient appointment or inpatient or day-case procedure. This will have a further impact on waiting lists into 2024, which will deteriorate if credible, fully funded, time-bound plans are not immediately implemented by the Government, say Consultants.

Vacant Consultant posts
There is also an onus on the Government to ensure that the required funding is included in Budget 2024 to address the ongoing staffing crisis in public hospitals. This includes filling the record 930 permanent consultant posts which remain vacant or filled on a temporary basis and appointing 2,000 additional consultants by 2030 – or around an extra 300 Consultants annually. 

The stress of trying to maintain an effective and efficient service with inadequately staffed medical teams is a major factor in Consultants deciding to leave to work in the private sector or abroad, with emigration figures at record levels. This, together with the hospital overcrowding crisis and extreme work demands, is behind the finding that seven in 10 (69%) Consultants experienced symptoms of burnout in the past 12 months. 

IHCA President, Prof Rob Landers, said: “Successive health budgets have failed to address the root causes of the rationing of care to patients and unacceptable public hospital waiting lists, caused by significant hospital capacity deficits and shortfalls in Consultant staffing, both of which are having a detrimental impact on patients and healthcare staff alike.

“As predicted, we are witnessing a significant increase in the number and acuity of patients who may have deferred their care during the pandemic and are now presenting for assessment and treatment, often through emergency departments, resulting in further pressure on already overstretched public hospital facilities and staff. 

“The increasing number of emergency admissions is contributing to the cancellation of thousands of hospital procedures every month, pushing waiting lists up even further in a continuing ‘vicious cycle’ in our health service. We are facing the real prospect of 250,000 hospital cancellations and a record 135,000 patients treated on trolleys in 2023 if public hospital capacity is not expanded urgently to match growing patient demand for care. 

“It is imperative that the 2024 Health Budget provides credible, funded, time-bound plans to increase public hospital and mental health service capacity, to ensure timely care for patients and to adequately address the challenges presented by demographic changes, technological requirements, unmet health need, cost increases and other pressures on the system.

“We are urging the Government to increase frontline hospital and community capacity and staffing levels to provide timely hospital care, and transfer medically discharged patients to community step-down facilities and services. Together, the key actions outlined in our Pre-Budget Submission focus on the development priorities our hospitals need urgent Government commitment and delivery on, so practical, workable solutions are put in place without delay. The health budget must inspire confidence, energy and momentum.

“Obvious and straight-forward solutions like this have been promised for a long time but never delivered on. We cannot afford yet another budget which amounts to more words and inadequate action.”

ENDS

Notes to Editors:

IHCA Pre-Budget Submission 2024: LINK to members' section

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