Waiting lists, a symptom of consultant shortages

Filling vacant consultant posts and bed capacity key to reducing waiting lists, IHCA says

The Government needs to employ hundreds of more consultants and significantly increase bed capacity after the amount of people waiting for care reached record levels, the Irish Hospital Consultants Association has said (IHCA).

The IHCA was commenting after latest figures from the National Treatment Purchase Fund (NTPF) showed 613,000 people were waiting for hospital care — an increase of 59,383 since the start of 2020.

With more than 500 consultant posts waiting to be filled, IHCA President Prof Alan Irvine said: “Key to bringing down wait times continues to be more consultants and hospital capacity to care for patients.”

The NTPF data also showed that 844,719 people were now on some form of waiting list, an increase of 78,955 (10%) since the start of the year, while 612,817 outpatients were waiting to see a consultant — an increase of 235,315 (62%) in the past six years and 59,383 (10.7%) during 2020.

Compared with 2014, 203,814 more people were now waiting more than a year for a consultant outpatient appointment — a fivefold increase; while 74,860 patients were wating for essential inpatient/day case procedures, which was an increase of 8,297(12.5%) patients since the start of 2020.

The NTPF also confirmed there were now 18,361 patients waiting more than 12 months for essential inpatient/day case treatment — more than double the number at the start of the year.

“Month after month, waiting list records are getting worse yet we continue to fail to accept key flaws that are causing the problem,” Prof Irvine added.

“There is general acceptance that more consultants and more beds to care for patients is the solution.”

The latest waiting list figures were published a month after the Government announced record funding levels for healthcare in Budget 2021.

“While the Government has committed record funding levels in its recent Budget, until this money is channelled effectively and speedily to where it will make a difference for patients, we will continue to publish record waiting lists,” Prof Irvine said.

“In budgetary terms, for a fraction of the level of spending commitments made we could fix the core problem of vacant permanent consultant posts,” he continued.

“The immediate benefits this would have on patient care and waiting lists would also extend to other cost savings.

“Government can no longer ignore the fundamental requirement that the provision of timely hospital care to patients cannot be achieved with an insufficient number of hospital consultants and hundreds of vacant permanent consultant posts.

“No amount of investment in services will reduce waiting lists unless we recruit and retain the necessary number of consultants to deliver timely care.”

In addition to filling vacant consultant posts, Prof Irvine added that additional acute hospital capacity was also required urgently.

This required the expansion of acute and intensive care unit beds, operating theatre, and outpatient facilities, he mentioned.

Prof Irvine also confirmed the IHCA has requested meetings with the Minister for Health, Stephen Donnelly, and the Chief Executive of the Health Service Executive, Paul Reid, “to agree practical plans and workable solutions that will address the capacity deficits and in turn resolve the waiting lists and the impact of further Covid-19 waves”.

“The first and obvious step for the Government is to end the salary inequity imposed on consultants taking up contracts since 2012, so that hospitals can fill over 500 vacant permanent posts,” Prof Irvine said.

This would have an immediate impact in reducing waiting lists for outpatient, inpatient and day-case appointments, according to him.

“The consequences of not addressing the consultant recruitment and retention crisis is for the Government to perpetuate and exacerbate the deterioration in public hospital capacity to provide care to patients.”


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