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Irish Hospital Consultants Association – Statement on Budget 2023 Announcement  The Irish Hospital Consultants Association (IHCA) today, Tuesday 27 September 2022, acknowledged the provisions in Budget 2023, but it warns that it does not address the decade-long public hospital capacity deficits that are the root causes of the unacceptable public hospital waiting lists, which now stand at almost 1 million people awaiting assessment and treatment.  

Prof Robert Landers appointed as President of Consultant body The Irish Hospital Consultants Association (IHCA) has announced that Professor Robert Landers, Consultant Histopathologist at University Hospital Waterford, has been appointed as the new President of the Association.

No waiting list plan will ever work without addressing shortage of Consultants Waiting lists may increase by over 20,000 in 2022 instead of target reduction of 132,000 (18%) despite €350 million Waiting List Action Plan;  Record 910,000 people on some form of public hospital waiting list – surpassing previous high set in September 2021; up more than 68,000 (8%) since August 2020; 49,500 people removed from waiting lists without any treatment in first six months of 2022 through ‘validation’ of lists at a cost of €3m;  Number of unfilled Consultant posts rises to over 900 for first time as spend on medical agency staff increases by 25% in first half of 2022 compared with same period in 2021; Urgent action needed to address public hospital capacity deficits and Consultant vacancies. IHCA President Prof Alan Irvine: “Not one of the 45 actions listed in the 2022 Waiting List Action Plan addresses the fundamental issue of the overwhelming shortage of Consultants, public hospital beds, theatre and other frontline resources. The Government and health service management needs to engage with the IHCA and agree a realistic and properly funded plan with ambitious waiting lists targets. This can only be achieved by addressing the ongoing and deteriorating Consultant recruitment and retention crisis and ending the pay discrimination imposed on Consultants appointed since October 2012.”

Commenting on today’s publication of the Medical Council’s ‘Medical Workforce Intelligence Report 2021’, the Irish Hospital Consultants (IHCA) said that the Irish health system is losing its highly trained specialists and future Hospital Consultants at an alarming rate, after the report revealed a quarter of all doctors who voluntarily withdrew their registration last year were specialists. 

Over six million people received care in the public hospital system last year by a Consultant, with 907,617 people still waiting to be seen;  IHCA says if Budget 2023 does not provide sufficient resources and deliver them in full, it could take some 15 years to clear backlog of deferred care.  Meanwhile, hospital Consultant vacancies at an all-time high of 882 permanent posts not filled as needed; At least 300 hospital beds not delivered under previous Budget, leaving people waiting longer for critical procedures and treatment; an estimated 5,000 additional beds are required by 2030.   IHCA President, Professor Alan Irvine: “Motivation to fix the problems in Ireland’s health system is waning, at a time when energy should be firmly behind implementing the solutions, which frontline hospital staff have repeatedly called for over the years. Our ask of the Government for Budget 2023 therefore is simple: deliver it. Give us the essential resources, the capacity and the Consultants to treat our patients on time.”   Speaking today (Monday 29 August 2022) at the publication of its pre-Budget submission, the Irish Hospital Consultants Association (IHCA) said that the frontline knowledge and operational learnings from the Covid crisis are not being capitalised upon, while the extreme shortage of hospital Consultants and beds mean rising patient waiting lists will continue.    Publishing analysis today, the IHCA highlighted that the consistent failure to deliver on plans, budgets and Ministerial promises is leading to the continued exodus of medical and surgical talent abroad and increased waiting times, with over 907,000 people now on some form of hospital waiting list across Ireland.  These numbers come at a time when more than 880 permanent hospital Consultant posts are not filled as needed.    The IHCA has previously pointed to the false economy created by the unilateral pay cut imposed by Government on Consultants appointed after 2012. They say that this discrimination, coupled with capacity and investment deficits in the system, has created unattractive working conditions and led to a recruitment crisis resulting in delayed care, poorer patient outcomes, and hundreds of millions in increased State compensation payments for clinical claims and higher agency/locum costs to partially fill vacant Consultant posts.    On beds, the IHCA pointed to promises to add an additional 1,146 beds by the end of last year have also fallen short, with an estimated 317 of these beds yet to materialise. In addition, an estimated 5,000 additional beds will be required by 2030 to provide timely care.   Some Consultants have pointed to what these serious capacity deficits mean for their ability to deliver critical services. Citing examples, of the adverse effect of vacant Consultant posts on patients, such as South Kerry CAMHs services and in hospitals throughout the country.   The IHCA highlighted how one Surgical Oncologist was appointed without access to an operating list or outpatient clinic for almost a year; while theatre capacity for a number of surgeons in another hospital was reduced to 50% compared to pre-Covid levels and has not been restored yet.    The Association projects that even with increased hospital activity compared with pre-pandemic levels, it may still take some 15 years to clear the backlog of deferred care built up during the pandemic.   Commenting, IHCA President, Professor Alan Irvine said: “Over six million people were provided with medical and surgical care in our public hospital system last year by hospital Consultants – we are stretched like never before. Despite the immense pressures placed on those on the frontline at the height of Covid, there was a semblance of hope that its impact would be a catalyst to finally tackle the obvious problems.    “Instead, motivation to fix the problems in Ireland’s health system is waning, at a time when energy should be firmly behind implementing the solutions.   “A year’s worth of time and momentum has been lost, resulting in worsening patient waiting times.    “We know what the problems are and we know what is required to fix them – we can indeed fix them. But we need the beds and the Consultants to treat the patients in a timely manner. There is nothing new here. We all know what is necessary. These core elements have been committed to in successive plans, budgets and Ministerial promises, but not delivered. The stressful, overstretched business-as-usual approach is not an option. It is time for the Government to stop expecting frontline medical and other staff and their patients to put up with unworkable conditions that don’t exist in public hospital services in developed countries.    “Our ask of the Government for Budget 2023 therefore is simple: deliver it. Give us the essential resources, the capacity and the Consultants to treat our patients on time.”   ENDS   For media enquiries, contact 360, A FINN Partners Company: Gerard O’Shea | gerard.oshea@finnpartners.com | +353 (0)87 413 7471 Niamh Kinsella | niamh.kinsella@finnpartners.com | +353 (0)87 921 9711

Outpatient waiting lists at hospitals in the Mid-West region have almost doubled (+94%) since 2015; Number of 'long waiters' on list to be assessed by a Consultant has increased five-fold to almost 19,000 in past 7 years; New figures reveal Consultant recruitment crisis in region’s hospitals is root cause of delays in providing care, with record 1 in 3 permanent Consultant posts vacant or not filled as needed; At least 200 additional beds and significantly increased operating theatre facilities needed in ULHG to bring capacity in line with other Model 4 hospitals. IHCA President Prof Alan Irvine: “The severe shortage of Consultants and the number of vacant posts across the UL Hospitals Group are the main contributors to the unacceptable delays in providing care to patients in the Mid-West region. Meeting the healthcare needs of the 58,700 people currently waiting to be assessed or treated by a Consultant will only be possible by urgently filling the one in three permanent approved Consultant posts that are currently unfilled and rapidly expanding the region’s hospital beds, operating theatres and other essential hospital facilities.” 

Shocking figure of 7,600 deaths last year in Northern Ireland likely to be replicated for those on hospital waiting lists in Republic, warn Consultants 907,000 people on some form of NTPF waiting list, up almost 75,000 (9%) since July 2020; Waiting list crisis long predates pandemic, with 267,000 people added to outpatient waiting lists since 2014 – a 74% increase;  Significant 65-fold increase in the number of patients waiting longer than a year for inpatient or day case treatment over the past decade; Long waiting lists a direct result of Consultant recruitment and retention crisis and years of underinvestment in capacity. IHCA President Prof Alan Irvine: “Irish patients are not getting the hospital treatment that they need. Many thousands are being added to an ever-increasing waiting list for assessment and treatment, which is leading to poorer outcomes. This is unfortunate and unacceptable. The shocking figures revealed this week in Northern Ireland – which has half the number of patients waiting for an outpatient appointment compared with the Republic – shows that in many cases, patients died while awaiting treatment.”

101,000 children on some form of NTPF waiting list, with almost 1 in 3 waiting longer than a year for treatment or assessment by a hospital Consultant  Concerns that thousands of children facing years of waiting for care due to staffing and capacity shortages; Additional 8,300 children awaiting diagnostic scans at the three Dublin children’s hospitals; Hospital Consultant recruitment and retention crisis worsens with 882 permanent posts (22% of the total) not filled as needed; Professor Stephanie Ryan: “If a child needs a scan, I just wish we could provide the service and not have them waiting for years.” The Irish Hospital Consultants Association (IHCA) has today (28 July) warned that the failure of staffing and capacity resourcing to keep pace with medical advances over the past quarter of a century has left Ireland’s public hospitals lagging behind in their ability to deliver timely care to children.

New data reveals worsening hospital staffing crisis as 882 Consultant posts now unfilled  903,440 people on some form of public hospital waiting list; up more than 86,000 (11%) since June 2020; 11,300 people added to three main waiting lists in the first half of 2022, missing Government reduction target by 77,500; €350m Waiting List Action Plan unlikely to meet target of reducing waiting lists by 132,000 (18%) by end of 2022;   Number of unfilled Consultant posts rises to 882 – a 21% increase (+155) in vacant or temporary filled posts in just one year; Urgent action needed to address public hospital capacity deficits and Consultant vacancies, say Consultants. IHCA President Prof Alan Irvine: “The 2022 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 NTPF figures released today confirm our fears that without addressing the very obvious shortages of Consultants, hospital beds, theatres, diagnostic and other facilities the Government will not address the core problems facing our public hospitals. Unfortunately, more failed health targets are leaving patients waiting longer.”

Orthopaedics, Dermatology, Gynaecology, and Rheumatology outpatient waiting lists in North-East hospitals increase by 41%, or almost 4,500 additional people, in past seven years;  15,365 people awaiting assessment by a Consultant in Orthopaedics, Dermatology, Gynaecology and Rheumatology at Cavan, Drogheda, Dundalk and Navan hospitals; One in four approved permanent hospital Consultant posts in the North-East are not filled as needed, which is the root cause of delays in providing timely care to the 38,000 people on waiting lists in the region; False economy as North-East hospitals spent €9.6 million on medical agency doctors last year – more than 10% of the national total. IHCA President Prof Alan Irvine: “The severe shortage of Consultants across the North-East region is the main contributor to the unacceptable delays in providing care to patients. The Government must make good on its promise to deliver the extra beds, extra Consultants and extra facilities so badly needed to meet the healthcare needs of the 38,000 people in the North-East currently waiting to be assessed or treated by a hospital Consultant.”