Over 58,000 people now waiting for care across hospitals in the Mid-West as 1 in 3 Consultants posts remain unfilled

• 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.” 

The Irish Hospital Consultants Association (IHCA) has today (22 August 2022) warned that the ongoing shortage of hospital Consultants across many specialties in the Mid-West¹ and severe hospital capacity deficits are preventing patients from accessing the timely, high-quality medical and surgical care they need and contributing massively to unacceptable waiting lists in the region. 

Across Limerick, Clare and North Tipperary, there are now 58,774 people waiting for public hospital inpatient/day treatment, GI endoscopies or an outpatient appointment with a Consultant.²

New figures released by the HSE confirm that one in every three (33%) approved permanent Hospital Consultant posts in the UL Hospitals Group are either vacant or filled on a temporary or agency basis – an all-time high 68 out of 206 approved Consultant posts3 – an increase of 16 posts not filled as needed since November 2020.⁴ A further eight Consultant Psychiatry posts are not filled as needed in the three Mental Health Services of Clare, Limerick and Tipperary North, bringing to total number of Consultant posts that are vacant or filled by temporary staff to 76.

The scale of the Consultant vacancies in the region has directly contributed to some of the longest hospital waiting lists in the country. Analysis from the IHCA shows that from July 2015 to July 2022, an additional 25,421 (+94%) people have been added to outpatient waiting lists across the UL Hospitals Group, with a total of 52,513 now waiting to be assessed by a hospital Consultant.

An additional 4,168 patients are on inpatient/day case waiting lists across the Group, with a further 2,063 people waiting for GI (Gastrointestinal) endoscopies – a 60% increase in this waiting list since 2015. 

The worst affected specialties

University Hospital Limerick (UHL), the busiest hospital in the region, has seen the greatest growth in its outpatient waiting list with an additional 25,616 (+147%) people awaiting an appointment with a Consultant increase since 2015, and an increase of almost 780% in the number of people waiting longer than a year for an outpatient appointment over that same period.

Some of the longest waiting lists across the Group are for routine, planned care particularly in Orthopaedics, ENT, Ophthalmology, Dermatology, Neurology, Urology, Gynaecology and Cardiology, as well as General Surgery. 

Many of the vacant or temporary filled Consultant posts are also in these specialties. For example, attempts to hire a Paediatric Neurologist at UHL in 2020 and 2021 proved unsuccessful, with not a single applicant for the post when it was advertised last year.⁵ This has meant EEGs for Limerick children having to be interpreted by a Consultant in Temple Street, Dublin. A gap analysis of neurology services in the Mid-West has further identified the need for five additional Neurology Consultants to bring ULHG into compliance with the national clinical care programme.⁶ 

To make matters worse, UHL has experienced some of the worst overcrowding nationally in recent months with a total of 1,268 patients treated on a hospital trolley in July alone and a record 126 patients on trolleys and awaiting admission to a bed on 21 April – the highest number in any Irish hospital on any single day in 16 years of data.⁷ As a result, over 4,300 essential inpatient and day case procedures had to be cancelled at University Hospital Limerick in 2021,⁸ which in turn impacted further on growing waiting lists. 

This is a direct result of significant bed capacity shortages across the Mid-West region. UHL has the lowest number of inpatient beds (530) compared with the number of Emergency Department attendances it is responsible for providing care to (a record 76,473 in 2021). On that basis and when compared with other large Model 4 hospitals, it would need an additional 200 (38%) acute hospital beds to bring it in line with an already insufficient national average.⁹ The UL Hospital Group also has a relatively low number of operating theatres (22 OTs) in use.¹⁰

Commenting on the waiting lists, IHCA President Professor Alan Irvine, said:

“The severe shortage of Consultants across the UL Hospitals Group is the main contributor to the unacceptable delays in providing care to patients in the Mid-West region. Growing waiting lists demonstrate the impact of years of Consultant shortages and underinvestment in capacity across these public hospitals.

“We have a chronic recruitment and retention crisis with one in five (882) permanent hospital Consultant posts across the country and one third (76 posts) in the Mid-West either vacant or filled on a temporary basis.

“The increases in patient waiting lists and the number of permanent Consultant posts that need to be filled have arisen due to flawed Government policies despite the dedication and hard work of Consultants, management and all staff across the 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.

“The Consultant contract talks which resume at the end of August must end the pay discrimination introduced in 2012 against Consultants contracted after that date if the record hospital waiting lists are to be effectively addressed. This is a critical step towards re-establishing trust and making our public hospitals in the Mid-West and throughout the country more competitive in recruiting and retaining the highly skilled medical and surgical specialists we need to address the shortage of Consultants.” 

ENDS

Notes:
1. The Mid-West region includes the UL Hospitals Group with the following hospitals: University Hospital Limerick, Croome Orthopaedic Hospital, Ennis Hospital, Nenagh Hospital, St John’s Hospital, Limerick and the University Maternity Hospital, Limerick; Also included are the Mental Health Services of Clare, Limerick and North Tipperary.
2. Analysis based on latest NTFP data as of 28 July 2022: https://www.ntpf.ie/home/nwld.htm
3. HSE National Doctors Training and Planning (NDTP) PQ response to Deputy David Cullinane, 28 June 2022: https://www.hse.ie/eng/about/personalpq/pq/2022-pq-responses/june-2022/pq-31525-22-david-cullinane.pdf
4. HSE NDTP response to IHCA, 4 November 2020: https://www.ihca.ie/_fileupload/NDTP%20response%20to%20IHCA%20on%20Consultant%20Establishment%20-%20Vacancies%20and%20tenures%20Nov%202020(1).pdf
5. UL Hospitals Group PQ response to Deputy David Cullinane, 21 February 2022: https://www.hse.ie/eng/about/personalpq/pq/2022-pq-responses/february-2022/pq-6059-22-david-cullinane.pdf
6. UL Hospitals Group PQ response to Deputy Richard O’Donoghue, 5 July 2022: https://www.hse.ie/eng/about/personalpq/pq/2022-pq-responses/june-2022/pq-33415-22-richard-o-donoghue.pdf
7. Trolley Watch data.
8. UL Hospitals Group PQ response to Deputy Richard O’Donoghue, 16 February 2022: https://www.hse.ie/eng/about/personalpq/pq/2022-pq-responses/february-2022/pq-5481-22-richard-o-donoghue.pdf
9. UL Hospitals Group PQ response to Deputy Richard O’Donoghue, 17 June 2022: https://www.hse.ie/eng/about/personalpq/pq/2022-pq-responses/june-2022/pq-28556-22-richard-o-donoghue.pdf
10. HSE PQ response to Deputy David Cullinane, 24 March 2022: https://www.hse.ie/eng/about/personalpq/pq/2022-pq-responses/march-2022/pq-12816-22-david-cullinane.pdf

For media enquiries, contact 360, A FINN Partners Company:
Gerard O’Shea │ gerard.oshea@finnpartners.com │ +353 (0)87 413 7471