Government set to miss end of year targets as three main waiting lists at virtual standstill

• Over 878,500 people on some form of NTPF waiting list at the end of November;
• NTPF significantly exceeds its target activity levels for 2023, but main waiting lists fall by just 2,600 due to increased demand for treatment; reduction is offset by increases in other hidden lists;
• Waiting List Reduction target missed by almost 66,400;
• IHCA President Prof Rob Landers: “There is nothing to suggest we won’t be in the same position come December 2024, looking back at another year of waisted opportunities to put in place realistic bed and theatre capacity to address unacceptable waiting lists.”

With just weeks until the end of the year, the Irish Hospital Consultants Association (IHCA) has today (8 December 2023) warned that the Government’s €443 million Action Plan for 2023 will not achieve its target to reduce waiting lists for appointments and hospital treatment by 10% (-69,000), compared with the number waiting at the start of 2023. 

The release of the latest National Treatment Purchase Fund (NTPF) figures confirm that the three main waiting lists are at a virtual standstill, reducing by a modest 2,600 this year – a shortfall of almost 66,400.¹ This reduction is offset by increases in other so-called ‘hidden lists’, such as the 3,490 additional people placed on the Outpatient Suspensions list in the last month alone.  In total over 878,500 people were on some form of hospital waiting list at the end of November.

Consultants are calling on the Government to expedite plans promised earlier this year by the Minister for Health, Stephen Donnelly TD, to urgently put in place 1,500 additional rapid build acute hospital beds and four elective hospitals in parallel with its planned surgical hubs to realistically address lengthening waiting lists. 

These additional 1,500 hospital beds were not funded in Budget 2024, despite calls for expressions of interest having been issued internationally by HSE officials over eight months ago for the modular builds.

Analysis from the IHCA shows that the NTPF exceeded its target activity levels for 2023 by the end of September, commissioning at that point 44,551 inpatient or day case procedures, 21,931 gastrointestinal (GI) scopes and 164,460 outpatient appointments.² It had targeted to arrange 40,000 inpatient/day case procedures, 18,500 GI scopes and 110,000 outpatient appointments in public and private hospitals this year.³ 

Despite treating significantly more patients than planned, waiting lists have remained at a virtual standstill, due to a higher-than-expected level of patient demand. The inability to accurately forecast this additional demand has contributed to the recently announced €1 billion supplementary budget for Health in 2023.

The 2023 Action Plan also wanted to cut the number of people on waiting lists by 146,100 without any treatment, through an NTPF ‘validation’ programme. This target, which was more than double the previous 60,000 validation target for 2022, is unlikely to be met and will impact the year end waiting list figure.⁴ 

Commenting on today’s waiting lists and the need for the additional hospital capacity, IHCA President Prof Rob Landers, said:

“In April, the Minister for Health’s announcement of a rapid build programme to open 1,500 additional hospital beds across 15 acute public hospital sites in 2023 and 2024 was welcomed.⁵ The Government needs to implement that plan immediately and commit the promised €1 billion capital budget to open these beds as indicated.

“A significant €407 million has been allocated for next year’s Waiting List Action Plan, which is currently being finalised. However, there is nothing to suggest we won’t be in the same position come December 2024, looking back at another year of waisted opportunities to put in place realistic much increased bed and theatre capacity to address these unacceptable waiting lists and increasing number of admitted patients being treated on trolleys in EDs.

“Consultants, and the patients they treat, need and deserve sustainable solutions to help alleviate the distress caused by being treated on trolleys and lengthy waiting lists. Concrete measures, as already announced, are needed to prevent poorer outcomes as a consequence of waiting too long for care.” 

ENDS
1.    Latest NTFP data: https://www.ntpf.ie/home/nwld.htm.
2.    Dáil PQ response from Minister Stephen Donnelly to Deputy Richard Bruton, 9 November 2023: https://www.oireachtas.ie/en/debates/question/2023-11-09/82/ 
3.    2023 Waiting List Action Plan: https://www.gov.ie/pdf/?file=https://assets.gov.ie/249526/8b203212-06b9-4ddc-96f7-9938b0707e19.pdf#page=null 
4.    34,375 outpatients were removed due to NTPF validation exercises in the first four months of 2023, which would equate to around 103,000 removals in a full year; Dáil PQ response from Minister Stephen Donnelly to Deputy Jim O’Callaghan, 23 May 2023: https://www.oireachtas.ie/en/debates/question/2023-05-23/842/
5.    Oireachtas Select Committee on Health, 19 April 2023: https://www.oireachtas.ie/en/debates/debate/select_committee_on_health/2023-04-19/3/

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