- 9,137 added to public outpatient and inpatient/day case waiting lists in May, as 808,447 now on some form of NTPF waiting list;
- Around 1 in 5 of the Irish population find themselves waiting for public hospital care;
- Programme for Government must include clear financial commitments to open additional beds and fill hospital consultant posts to tackle the waiting list backlog and plan for continued delivery of care in a COVID-19 environment.
IHCA President Dr Donal O’Hanlon: “COVID-19 presents major challenges for the provision of timely care in our acute public hospitals and acute mental health units. The Government and the health service management must engage with the IHCA and its hospital consultants to develop realistic, practical plans to provide public hospital care in the coming months and agree on how best we can meet the challenges ahead.”
The Irish Hospital Consultants Association (IHCA) has, today, (Friday 12 June 2020), warned of unprecedented challenges in the months ahead unless realistic practical plans are developed and implemented urgently to expand our public hospital capacity and community step down services to provide care to non-COVID and COVID-19 patients.
The IHCA has highlighted concerns that Ireland’s health system could soon see up to 1 million people on a National Treatment Purchase Fund (NTPF) waiting list, as 39,683 have now been added to the NTPF lists since the start of 2020.
Despite a decade of denial, it is clear Ireland has one of the lowest numbers of public hospital beds and hospital consultants in the EU, adjusted for population levels. According to hospital consultants, while the immediate threat of COVID-19 has reduced, Ireland’s acute public hospitals continue to suffer from significant capacity deficits, making it imperative that election promises to hire more consultants and open more public hospital and community beds are now acted upon by the next Government.
With a new Programme for Government due to be agreed by the three negotiation parties, the IHCA is calling for realistic, practical plans to provide public hospital and community care in the coming months. This is essential for the delivery of timely care to patients in our acute public hospitals and must be top of the government’s agenda. It is now accepted that the pace of implementing the 2018 Capacity Review and the National Development Plan has been far too slow and needs to be accelerated to open the recommended additional 2,600 acute public hospital beds and the additional 4,500 community step down and rehab beds in the shortest possible timeframe.
Previously closed acute hospital beds, that were reopened in the past 3 months to cater for the Covid-19 crisis, need to remain open on a permanent basis. The Government also needs to fund between 1,500 and 2,000 additional intermediate care or step-down beds, which are being commissioned. These beds are required to urgently free up public hospital capacity to treat patients suffering from delayed care due to the pandemic and those on legacy waiting lists.
The recommendation, a decade ago, to double the number of public hospital ICU beds was not implemented as quickly as it should have been and must be achieved on a sustainable basis before the winter. It is essential that the hundreds of improvised ICU beds open in recent months are now fully equipped and staffed on a permanent basis as recommended in 2010.
Consultants have cited reports that several hospitals are seeing a reduction in general bed capacity availability, with Limerick, Kilkenny and the Children’s Hospital Tallaght, listed by the HSE as having no vacant beds for patients on Tuesday of this week.
The consultants’ warning comes as latest waiting list figures (for May 2020) show:
- 808,447 people are now waiting on some form of NTPF waiting list, an increase of 39,683 since the start of 2020;
- 575,863 outpatients nationally are waiting to be seen by a consultant, an increase of 8,534 (1.5%) on last month and of 22,429 (4.1%) since the start of the year; with
- 86,946 now wating for inpatient/day case treatment, an increase of 603 or 0.7% on last month but an additional 20,241 (30.3%) patients since the start of the pandemic in March.
The unmet need for hospital care by tens of thousands of people, which resulted from those with non-COVID-19 illnesses largely staying away from acute public hospitals, is now beginning to materialise.
The postponement of procedures and treatment since the start of the COVID-19 outbreak, while a necessary response at the time, has amplified even further the unacceptable long waits patients must endure. This requires an ‘emergency’ response from the Government which matches the urgency which was shown in tackling the pandemic in recent months.
This requires significant investment and a singular focus in addressing public hospital capacity deficits and resourcing issues – opening the promised additional 2,600 public acute hospital beds and immediately filling the 500 empty permanent consultant posts which currently exist across our public hospitals by ending the pay discrimination imposed on new entrants. These two aspects must be the immediate health priority for the next Government.
A joined-up and collaborative approach between the government, health service management and the IHCA and hospital consultants is required to develop a realistic practical plan which will protect and support patients and ensure timely access to care.
Commenting on today’s waiting list figures Dr Donal O’Hanlon, President, IHCA, said:
“COVID-19 presents major challenges for the provision of timely care in our acute public hospitals. The Government and the health service management must engage with the IHCA and its hospital consultants to develop realistic, practical plans to provide public hospital care in the coming months and agree on how best we can meet the challenges ahead.”
“We came into 2020 with our public acute hospital service on life support – short on beds, short on consultants and short on financial supports to address it. We cannot continue with those gaping deficits.
“The impact of the COVID-19 crisis means we now face the worrying prospect of having 1 million people on NTPF waiting lists for treatment in our public hospitals. Adding the over 190,000 people currently on diagnostic waiting lists, which are not recorded by the NTPF, already brings the figure to almost 1 million people waiting for hospital care.
“Blaming this situation on the Covid-19 virus, does not represent the truth.
“Years of persistent underinvestment in bed capacity and consultant recruitment and retention has led us to the point where our acute public hospitals are simply unable to cope with the demands they now face. The ongoing risk from COVID-19 adds further urgency and must now focus the minds of Government to work with hospital consultants to develop realistic practical plans that fix these issues, as the clock ticks down to next winter.
“Consultation and cooperation with hospital consultants and the IHCA is now key. We need to learn from past mistakes and avoid repeating them.
“The Government and health service management must develop plans on how it proposes to deliver hospital care in the coming months, in consultation with hospital consultants to ensure real effectiveness to meet the challenges ahead.”