Consultants warn it could take 14 years to get hospital waiting lists under control

The IHCA estimates outpatient backlogs could take until the middle of 2027 to become manageable if activity is increased to 105% of 2019 levels but warns it could take until as long as 2035 if the backlog is cleared at a slower pace. 

The estimate is based on current waitings lists, consultant numbers and bed capacity. The IHCA has based its assessment model on one carried out recently by the NHS in Britain. 

Waiting lists were already growing before Covid-19 and the ICHA, in its pre-budget submission, said they have spiked further, with patients delayed over the past 20 months due to the pandemic.

It estimates the Covid backlog alone may not be cleared until the fourth quarter of 2023. 

Vacant consultant posts

The IHCA's analysis of the waiting lists shows a "clear linear trend and relationship" between growing waiting lists and an increasing number of consultant posts that are either vacant or not filled on a permanent basis. 

The submission notes: “If our acute public hospitals only match the pre-pandemic levels of activity seen in 2019, waiting lists will continue to grow.” 

It highlights the “poor physical infrastructure” of many hospitals and demands the "fast track" opening of an additional 6,000 hospital beds.

IHCA president Professor Alan Irvine said: “It’s demoralising when you code referral letters and see someone gets a routine appointment and you know that means they will be seen in three years, or four years or never.” 

Prof Irvine, consultant dermatologist in Children's Health Ireland (CHI) and St James's Hospital, said the Government must act “so that our public health service is fit for purpose for the patients of today and in the years to come". 

The submission includes figures from the HSE showing permanent staff could not be found for 17% of the 3,466 consultant positions as of February this year. Of those posts, 255 were vacant, 358 were filled by locums or agency staff, and five were of “unknown status”.

IHCA vice-president Gabrielle Colleran said: "I hear people talking about wanting to run elective lists in the evenings and at the weekends. We don’t have enough consultants to fully staff our MRI scanners across the normal working day, every day.” 

'Children are suffering'

Dr Colleran, head of the department of radiology at the National Maternity Hospital and consultant paediatric radiologist in CHI at Temple Street, said shortages have a direct impact on patients, adding “children are suffering”. 

“It has an impact on their ability to go to school, their ability to play,” she said. “These kids are waiting and they are waiting far too long. Some of them are waiting three to four years for studies that will also impact their ability to get access to other services.” 

The pre-budget submission also criticises the money spent on hiring temporary doctors instead of upgrading contracts and conditions to attract permanent staff.

The IHCA also points out that more than a quarter (26%) of the 174 hospital consultant posts advertised over a 20-month period in 2019 and 2020 received either none or just one single applicant per post.

Patient care is also being delayed by underinvestment in IT services, which impacts laboratories doing tests, according to IHCA vice-president Professor Rob Landers.

“We are now operating in a system that is not compatible with Windows 10, security updates are lacking and the interaction with other systems are deficient or lacking completely,” Prof Landers, consultant pathologist at Waterford University Hospital said.

“This has dragged on for years and there is huge frustration on the ground. It just needs somebody to grasp it and deliver it.”