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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.

Government must reduce record 95% bed occupancy rates by rapidly delivering extra capacity in our hospitals if waiting lists are to be addressed; 41,000 appointments and operations cancelled in January and February alone will further increase pressure on Waiting List Action Plan for 2023;  885,600 people on some form of public hospital waiting list at end of March; an increase of 15,500 since the start of the year and an additional 300,000 (52%) compared with May 2017 when Sláintecare published; Consultant vacancies remain at record high of 915 permanent posts vacant or filled on a temporary basis;   IHCA President Prof Robert Landers: “Occupancy rates at this extreme level result in regular bed shortages, increased numbers of admitted patients being treated on trolleys, higher levels of healthcare acquired infections and cancellation of appointments in addition to growing waiting lists.”  The Irish Hospital Consultants Association (IHCA) has today (Friday 14 April 2023) warned that waiting list reduction targets for 2023 will never be met unless hospital bed occupancy rates are significantly reduced by rapidly delivering extra capacity in our public hospitals.

The Irish Hospital Consultants Association say delivering extra capacity in our hospitals requires “more than bricks and mortar” IHCA warns that 5,000 hospital beds are needed by 2030, with at least an additional 2,000 permanent Consultants;  Yet just 157 acute hospital beds were added to the system in 2022 and only 196 additional approved permanent Consultant posts were filled; Delivery of basic infrastructure alone is not enough and must coexist with plans to fully resource and staff proposed new hospital beds; IHCA President Prof Robert Landers: “Government must take a whole-of-service approach. To ensure this new initiative is successful, they must work in parallel with hospital management and medical specialists to put in place a clear, time-bound and fully funded staffing plan, so that when this new rapid build capacity comes on stream, there are the Consultants, doctors, nurses, porters and others needed to ensure we are providing care to patients in those beds from day one.”  The Irish Hospital Consultants Association (IHCA) has called on the Minister for Health Stephen Donnelly to clarify plans announced this week, which are aimed at rapidly delivering up to 1,500 new hospital beds across the country in 2023 and 2024.