Health solutions 'hiding in plain sight' and must be funded under Budget 2022

• Irish Hospital Consultants Association launches Pre-Budget Submission; 
• Consultants say additional funding for Covid must be retained and redeployed as needed to fund significant deficits in acute public hospital care; 
• Failure to set, resource and achieve more robust targets is leading to longer waiting lists, with over 290,000 people waiting longer than a year to be assessed or treated by a hospital consultant; 
• 6,000 additional acute public hospital beds required under revised National Development Plan by 2030 – with half of these beds needed urgently within the next 3 years; 
• Fill the 1 in 5 vacant permanent consultant posts without delay and appoint additional consultants to urgently assess and treat the 907,617 people on hospital waiting lists across the country. 

IHCA President, Professor Alan Irvine: “The 2022 Health Budget needs to ensure that public hospital and mental health services have sufficient levels of current and capital funding to provide timely, high-quality care to patients. There is a high risk, in the aftermath of the extraordinary challenges we have all experienced since March 2020, that accumulated stress, health and general wellbeing problems will adversely impact on healthcare staff - and ultimately our patients. The solutions are ‘hiding in plain sight’. The Government must embrace them and implement them, so that our public health service is fit for purpose for the patients of today and in the years to come.”

The Irish Hospital Consultants Association (IHCA) has today (Wednesday 15 September 2021) said that it is critical Budget 2022 retains the additional funding for Covid allocated this year, and that the Government ensures the redeployment of funds goes towards addressing the severe deficits in bed capacity, hospital facilities and Consultant staffing across our acute public hospital services. 

With the number of people on hospital waiting lists now at 907,617, with over 290,000* people waiting longer than a year to be assessed and treated by a hospital consultant, the IHCA said Budget 2022 has to put in practice the political commitments made to the public and to healthcare professionals. 

Targets should be realistic but ambitious
In its submission, the IHCA says that there were almost 363,000 less outpatient hospital appointments last year compared with 2019, and that inpatient/day case activity in 2020 was down 255,000 appointments. 

While public hospitals attempted to catch up after the postponement of planned care in 2020, the targets for 2021 outlined in the HSE’s National Service Plan were still 194,000 short of 2019 levels. Consultants say the lack of robust targets, coupled with underinvestment in capacity and severe shortages in consultant staffing to meet targets, means that hospital waiting lists will only continue to grow.

Analysis in the Association’s Pre-Budget Submission suggests it may take over a decade to clear the backlog of deferred care built up during the pandemic and bring our unacceptable waiting lists under control.

The Association has called on the Department of Health to bring forward the long-awaited waiting list reduction plan and to provide realistic yet ambitious targets and timescales for the reduction of Ireland’s shocking waiting lists.

Bed capacity commitments must be delivered
As part of its submission, the Association says that 6,000 additional public hospital beds and 4,500 community step-down and rehab beds are required in order to alleviate pressure on the system. 

These beds must be delivered under the anticipated, revised National Development Plan by 2030; with half of the additional public hospital beds urgently needed within the first three years of the new plan. 

There is also a need to more than double current critical care capacity to over 640 ICU beds in order to avoid delays in ICU admission, cancellation of essential surgery, and to cater for any future increases in Covid-19 cases.  

Ending the consultant recruitment crisis
Consultants also say the persistent hospital consultant recruitment and retention crisis will continue to impact on achieving health targets unless action is taken to urgently fill the one in five vacant permanent posts and expand consultant numbers further. 

The low number of consultant posts in Ireland is preventing patients from receiving timely access to care, with 652,344 outpatients, including over 85,000 children, awaiting appointment to be assessed by a hospital consultant specialist. 

The IHCA points to the ongoing pay discrimination imposed on consultants contracted since 2012 as the root cause for the exodus of Ireland’s medical talent to other countries and the inability to attract Irish specialists working abroad back home. The Minister for Health has previously stated his unambiguous commitment to fully address this inequity. 

Matching ambition with investment 
To fund the provision of capacity, facilities and staffing, the Government must provide adequate investment under Budget 2022 and in the years to come. Analysis shows that Ireland currently has one of the lowest levels of acute hospital funding compared to our Northern European neighbours, with €1.588 billion per annum less funding for our hospitals in 2019 than other nations; spending €316.80 per head less than the average and €593.83 per head less than Denmark. 

The Association has set out 19 key recommendations in total for Budget 2022.

IHCA President, Professor Alan Irvine said: “The 2022 Health Budget needs to ensure that public hospital and mental health services have sufficient levels of current and capital funding to provide timely, high-quality care to patients. There is a high risk, in the aftermath of the extraordinary challenges we have all experienced since March 2020, that accumulated stress, health and general wellbeing problems will adversely impact on healthcare staff - and ultimately our patients. 

“Added to this, the cyberattack on the HSE and public hospitals has had a devastating impact on the health service’s ability to treat and manage patients. Returning to the stressful, overstretched past is not an option if we are to avoid an even worse workforce crisis than was the case pre-Covid.

“The public places trust in our politicians to create a health service that works; while placing their trust in their doctors to deliver that service when they need it. Unfortunately, the persistent lack of action by politicians means we are increasingly unable to treat our patients in a timely way and in the manner they deserve. 

“It really is now or never. The Government must act to honour its promises to the public and healthcare professionals. Commitments to end the inequity and address the deficits must be delivered on, otherwise Sláintecare risks amounting to little more than business as usual with growing numbers of patients awaiting care, month after month. 

“The solutions are ‘hiding in plain sight’. The Government must embrace them and implement them, so that our public health service becomes a more attractive place to work and is fit for purpose for the patients of today and in the years to come.”

ENDS

Notes for editors: 

* NTPF data; there were 290,891 people on various NTFP waiting list waiting longer than 12 months for assessment or treatment at the end of August 2021.

For the full submission and list of recommendations: 
IHCA Pre-Budget Submission 2022

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