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Mental Health Commission publications: “The current approach is simply not good enough and is failing our youngest and most vulnerable patients.” Comment by spokesperson for the Irish Hospital Consultants Association (IHCA) on the publication by the Mental Health Commission of individual reports on the Child and Adolescent Mental Health Services (CAMHS) in the nine Community Healthcare Organisations (CHO):   “The reports published today underline once more the scale and severity of the deficits faced day-to-day in our child and adolescent mental health services. Details of individual cases and what those involved and their families have to experience are all too familiar to those of us working in this area.    “Regrettably, for consultants working in these services across the country, the capacity deficits in each region have been highlighted by us numerous times. We are trying to provide care in very complex and constrained conditions for young people who need care for urgent and severe mental health crises. Delivery of timely assessment, care and follow-on monitoring is critical but incredibly challenging in an under resourced service.    “Time and time again, Consultants and others in the service have raised the serious concerns about staffing and capacity shortages and highlighted the impact this has on young people’s mental health and their ongoing care needs. Lessons are not being learned. There is no shortage of reports but very little by way of meaningful action.    “Meanwhile, the growing deficits are stark. Currently CAMHS funding is approximately 0.63% of the overall Health Budget, at just €125.18m.    “CAMHS teams are significantly below the recommended staffing levels, some below 50% of recommended levels. Some of these services are missing a third of the required Psychiatry Consultants, as these permanent posts remain vacant or only filled on a temporary, agency, or locum basis.    “There are only 51 CAMHS inpatient beds operational across the country at any one time, falling well short of the 130 beds recommended in the Government’s ‘Vision for Change’ strategy.    “The very fact that our benchmarks for staffing and bed levels are rooted in a 17-year-old mental health policy, also points to a lack of priority given to addressing this issue over the past decade and more.   “The current approach is simply not good enough and is failing our youngest and most vulnerable patients. Our priority must be ensuring all our young people have the best chance of a good quality of life, whether they require lifelong treatment to make that happen or not – this should be the goal of our national health policy.    “There are many strands that have to come together, involving all pillars of the health system – GPs, Consultants, Allied Health Professionals - to ensure these highly vulnerable patients are cared for as required.    “Decision-makers need to use their leadership and resources to drive such a collaborative, whole-of-service approach to ensuring an end-to-end care pathway under the oversight of dedicated clinical leadership for CAMHS. Failure to do so will simply mean similarly stark reports into the future.”   ENDS   Media contacts – 360, A FINN Partners Company: Amy Couch | amy.couch@finnpartners.com | 085 816 6122

Failure to ensure timely care for young patients due to capacity deficits as 1 in 12 children remain stuck on stubbornly high waiting lists – says IHCA   100,800 children on some form of NTPF waiting list; with 1 in 5 (20,600) waiting longer than a year for treatment or assessment in public hospitals; Additional 8,900 children awaiting diagnostic scans at the three Dublin children’s hospitals not included in NTPF waiting lists;  Over 4,400 children on CAMHS waiting lists – almost double the number compared with the start of 2020;  IHCA President Prof Robert Landers: “Thousands of children are not getting the care they need in a timely way. There is a real possibility that they will suffer serious health and developmental issues that could have been reversed or mitigated against if only they were seen in time.”   The Irish Hospital Consultants Association (IHCA) has today (Friday 11 August 2023) expressed its continuing concern at the excessive number of children waiting for an appointment to be treated or assessed in public hospitals.   The warning from Consultants comes as the latest National Treatment Purchase Fund (NTPF) figures released today reveal that 895,700 people were on some form of hospital waiting list at the end of July, including almost 100,800 children and young people.1   While a recent report highlighted the extent of extreme capacity shortages in Ireland’s Child and Adolescent Mental Health Services (CAMHS), the IHCA’s analysis shows that similar capacity deficits are resulting in lengthy waiting lists across a number of paediatric specialties, including Ear, Nose & Throat (ENT), Dermatology, Orthopaedics and Cardiology – with some being forced to wait months or years for assessment or treatment.    The IHCA said that difficulty in filling permanent Consultant posts and growing hospital and mental health capacity deficits against increases in demand are the root causes of the unacceptably long child waiting lists. One in five (20,600) children are waiting longer than a year for treatment or assessment by a hospital Consultant. Latest HSE data reveals the number of unfilled permanent Consultant posts has risen to a record 933.2 This is the highest Consultant vacancy rate ever.    Hospital diagnostics are not included in NTPF data which accounts for an additional 8,916 children awaiting CTs, MRIs or ultrasounds at the three Dublin paediatric hospitals alone, bringing the total number awaiting care to almost 110,000 – or 1 in 12 children in the country.3   In addition, a near record 4,421 children4 were on separate CAMHS waiting lists at the end of May 2023 – 128 (3%) additional children added so far this year.5 The CAMHS waiting list has increased by almost a quarter (+865 or 24%) since the start of 2022 and has almost doubled (+2,094 or +90%) since the start of 2020.6   Despite the Government’s €443 million Waiting List Action Plan, which set a target to reduce waiting lists by 10% by the end of the year, the number of children on NTPF waiting lists has actually increased by 3,800 (4%) since the start of 2023, instead of reducing by an expected 5,600 by the end of July. The Association warns that these lists are expected to increase further over the coming months due to a predictable surge in autumn and winter respiratory illnesses and a potential new wave of Covid, leading to further cancellations of schedule care.    Commenting on today’s waiting lists, IHCA President Professor Robert Landers, said: “The monthly NTPF figures have recorded over 100,000 children on waiting lists for hospital care for the fifth consecutive month, with one in five of these children waiting longer than a year to be treated or assessed in public hospitals. This is resulting in thousands of children not getting the care they need in a timely way, and the real possibility that they will suffer serious and lasting health and developmental issues that could have been reversed or mitigated against if only they were seen in time.   “Every single number is an individual child or young person who could be experiencing pain, and a family that may be suffering psychological distress at not knowing when their child will be able to receive treatment. This is a wholly unacceptable situation. Young patients and their parents should not have to fight for care.    “As Consultants, we need and want sustainable solutions to help alleviate this distress and provide the care these children so desperately need. However, we have unresolved hospital capacity deficits and Consultant vacancies that is not being addressed urgently enough. These twin deficits must be addressed by the Government in October’s Budget.”   ENDS Notes: 1. Latest NTFP data as at end July 2023: https://www.ntpf.ie/home/nwld.htm 2. HSE PQ response to Deputy David Cullinane, 23 June 2023: https://www.ihca.ie/_fileupload/NDTP%20Response%20to%20PQ%2027483%2023%20Deputy%20David%20Cullinane%2023062023.pdf   3. Dáil PQ response from Minister Stephen Donnelly to Deputy David Cullinane, 4 May 2023: https://www.oireachtas.ie/en/debates/question/2023-05-04/249/#pq_249 4. HSE PQ response to Deputy Róisín Shortall, 27 July 2003; https://www.ihca.ie/_fileupload/HSE%20PQ%20response%20CAMHS%20by%20CHO%20age%20category%20and%20time%20waiting%20R%C3%B3is%C3%ADn%20Shortall%2027072023.pdf 5. HSE PQ response to Deputy Peadar Tóibín, 31 January 2023; https://www.hse.ie/eng/about/personalpq/pq/2023-pq-responses/february-2023/pq-4887-23-peadar-toibin.pdf 6. Appendix to HSE PQ response to Deputy to Peadar Tóibín, 23 November 2022; https://www.ihca.ie/_fileupload/PQ%2058978-22%20Deputy%20Peader%20Toibin%20re%20CAMHS%20Wait%20list%20for%20past%205%20years%20Appendix.pdf   Media contact:  Niamh Kinsella | niamh.kinsella@finnpartners.com | +353 (0)87 921 9711  

Comment by the Irish Hospital Consultants Association (IHCA) on today’s (26 July) publication of the independent report by the Mental Health Commission into the Child and Adolescent Mental Health Service (CAMHS).

Mid-point of Action Plan shows increases in waiting lists, as new data reveals worsening Hospital Consultant staffing crisis – IHCA 890,800 people on some form of public hospital waiting list; up more than 20,700 this year and by an additional 307,000 people since Sláintecare; 17,165 added to three main waiting lists in the first half of 2023, missing Government reduction target by 51,650; €443m Waiting List Action Plan unlikely to meet target of reducing waiting lists by 69,000 (10%) by end of 2023;   Number of unfilled Consultant posts rises to 933 – a 28% increase (+206) in vacant or temporary filled posts in just two years; Urgent action needed to address public hospital capacity deficits and Consultant vacancies, say Consultants. IHCA President Prof Robert Landers: “The 2023 Waiting List Action Plan has reached its halfway point but is nowhere near achieving the reduction targets set for the end of the year. The Government needs to urgently increase public hospital capacity to treat the increasing number of patients on waiting lists.” The Irish Hospital Consultants Association (IHCA) has today (Friday 14 July 2023) warned that inaction by the Government to urgently address the root causes of hospital capacity deficits and Consultant shortages will mean the targets set out in its Waiting List Action Plan for 2023 will not be achieved. 

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.

Region has a third fewer hospital beds than national average and is struggling to fill almost one in three permanent Consultant posts 34,300 people awaiting care on hospital waiting lists in Midlands; an increase of over 800 (2.5%) this year alone; 30,000 people waiting for an outpatient appointment at Mullingar, Portlaoise and Tullamore Hospitals, a fifth of whom (5,900 or 20%) are waiting longer than a year; Regional Hospital Mullingar sees ‘long-waiters’ for outpatient appointments and inpatient/day case procedures increase by 17% and 20% respectively in the first five months of 2023; Midlands region has one of the highest Consultant vacancy rates in the country, with 29% of Consultant posts vacant or filled on a temporary or agency basis. The Irish Hospital Consultants Association (IHCA) has today (5 July 2023) warned that a lack of public hospital capacity and hospital Consultants across the Midlands region1 is resulting in increasing waiting times for treatment that is impacting on patient outcomes.

893,600 people on some form of NTPF waiting list; and a further 250,000 people waiting for diagnostic scans; Hospital cancellations could exceed 250,000 this year if rate continues; with 85,000 operations and appointments already cancelled to end of April; ED attendances increased by 461,000 (38%) over the past decade, with average wait times now approaching 12 hours – double the target in 2013;  It is the first time in six months that the number of people on the outpatient waiting list has totalled over 600,000; IHCA President Prof Robert Landers: “The Minister for Health recently announced a rapid build programme to deliver 1,500 additional beds in acute public hospitals to be opened this year and in 2024. The Government needs to commit the promised €1 billion capital budget for the additional capacity urgently.” Patients have been subjected to a decade of overcrowding in our emergency departments (EDs) which continues to drive up waiting lists for hospital treatment and negatively impact patient outcomes, Consultants have warned.

A spokesperson for the Irish Hospital Consultants Association (IHCA) said:

While number of people waiting more than 12 months for hospital treatment starts to climb again, Government can deliver immediate improvements – say Consultants ED attendances up 104,000 compared with 2019, leading to 41,000 cancellations in first two months of 2023; Over 1.1m people waiting for some form of hospital care - with 888,600 people on NTPF waiting lists1 and a further 250,000 people waiting for diagnostics2; Number of 'long-waiters' for treatment has increased by 12% since start of the year; and has risen 22-fold over the past decade;  IHCA President Prof Robert Landers: “It is only when hospital and step-down care capacity levels are increased sufficiently, and additional Consultants appointed, will we see treatment volumes in public hospitals match demand and effectively reduce current unmanageable waiting lists on a sustainable basis.” The Government has a real opportunity to address overcrowding and start to tackle extreme waiting lists in Irish hospitals within the next two years, Consultants have said. 

Public hospitals in Saolta University Health Care Group have unmanageable waiting lists with over 131,000 people waiting for care;  Waiting lists for outpatient appointments, inpatient/day case treatment and procedures in the region have increased by 3,400 (3%) since start of the year; and by 39,000 (42%) since 2015; 2,850 appointments and operations cancelled at hospitals in Saolta Group between December 2022 and January 2023; No additional acute hospital beds planned in 2023; just 7% of all new inpatient beds opened nationally since 2020 have been in the West/North-West, despite region accounting for one sixth of the national population;   IHCA President Prof Robert Landers: “There is a serious concern that unmanageable waiting lists for care are severely impacting healthcare outcomes for some of our most vulnerable patients. Government needs to agree, fund and timetable plans to expand hospital capacity and Consultant staffing in the West and North-West region.” The Irish Hospital Consultants Association (IHCA) has today (9 May 2023) warned that the growing shortage of essential acute hospital beds and Consultants across the West and North-West region is resulting in waiting lists for treatment that is impacting on patient outcomes.