Patients across Midlands face poorer health outcomes due to hospital capacity deficits, say Consultants

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.

At the end of May there were 34,284 people waiting for an outpatient appointment, inpatient/day case treatment or procedure at the three Midland Regional Hospitals in Mullingar, Portlaoise and Tullamore.² This is an increase of an additional 7,634 (+29) since 2015. 

Outpatient waiting lists have increased as follows:

Of the almost 30,000 people waiting for an outpatient appointment at Mullingar, Portlaoise and Tullamore Hospitals, a fifth (5,900 or 20%) have been waiting longer than a year. Regional Hospital Mullingar alone has seen its ‘long-waiters’ for outpatient appointments and inpatient/day case procedures increase by 17% and 20% respectively in the first five months of 2023.

Bed capacity and waiting lists in the region
Despite dangerously high hospital bed occupancy rates in the region (up to 95.3% at Regional Hospital Mullingar³, well above the recommended maximum of 80-85%), the Midlands is being ignored in the Government’s limited bed capacity expansion plans. 

Out of the 970 additional inpatient hospital beds opened nationally since the start of 2020, just 25 beds were in the Midlands – all of these at Regional Hospital Tullamore.⁴ 

As a result, more than 800 people have been added to the three main hospital waiting lists in the region since the start of the year, which is an increase of almost 2.5% and in the opposite direction to Government’s Waiting List Action Plan for 2023 - which should equate to a reduction of approx. 3,400 people from lists in the Midlands.

But because the shortage of beds is so severe in the region, acutely ill patients are admitted, and essential surgical and other care is cancelled due to the significant capacity deficits. More than 3,700 operations and hospital appointments were cancelled in the first four months of 2023 alone at the three Midland hospitals.⁵

The region also has one of the highest Consultant vacancy rates in the country, with 29% of permanent Consultant posts (51 posts) vacant or filled on a temporary or agency basis – 10 more post not filled as needed compared with a year earlier.⁶

The IHCA said patients will unfortunately continue to languish on trolleys and unacceptable waiting lists, and suffer poorer outcomes as a result, until the Government implements credible, funded, time-bound plans which address the growing demand for care in the Midlands. 

Commenting on the waiting list and hospital beds analysis IHCA Vice President Prof Anne Doherty said: “The increasing waiting lists for care continue to impact healthcare outcomes for some of our most vulnerable patients. Government must commit the necessary capital spend in the Budget in October to deliver extra capacity for patients in the Midlands.

“The Midlands has one of the lowest numbers of acute beds on a population basis in Ireland at 2.13 beds per 1,000 population.⁷ The hospitals need about 240 additional beds to bring us up to the national average of 2.89 beds per 1,000 population, which is too low to start with, and an extra 860 acute hospital beds to bring the region up to the EU average. That’s more than a doubling in the number of public hospital beds at the three Midlands hospitals – or the equivalent of St James’s Hospital in Dublin.  

“Unfortunately, the Government’s current plans for four new elective hospitals and six surgical hubs will not result in any additional capacity in the region,” said Prof Doherty

The IHCA has welcomed Minister Stephen Donnelly’ s plans to expedite capacity expansion through a rapid build programme and calls on the Government to urgently commit the promised €1 billion capital budget to open these beds as indicated, including in the Midlands.
ENDS

Notes: 
1.    The Midlands region includes Midland Regional Hospital (MRH) Mullingar, MRH Portlaoise and MRH Tullamore, and the mental health services in Laois/Offaly, Longford/Westmeath, and Midlands. 
2.    Latest NTFP data as at end May 2023: https://www.ntpf.ie/home/nwld.htm.
3.    HSE PQ response to Deputy David Cullinane, 30 March 2023; https://www.ihca.ie/_fileupload/PQ%2012388_23%20Deputy%20David%20Cullinane%20Bed%20Occupancy%20Jan%20Feb%202023%2030032023.pdf. 
4.    HSE PQ response to Deputy Jim O’Callaghan, 15 February 2023; https://www.hse.ie/eng/about/personalpq/pq/2023-pq-responses/january-2023/pq-4772-23-jim-o-callaghan.pdf.
5.    HSE PQ response to Deputy David Cullinane, 12 May 2023; https://www.ihca.ie/_fileupload/Cancellations%20Jan%20-%20April%202023%20PQ%2020869_23%20%2020870_23%20Deputy%20Cullinane.pdf. 
6.    HSE 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; and HSE PQ response to Deputy David Cullinane, 16 September 2021; https://www.hse.ie/eng/about/personalpq/pq/2021-pq-responses/september-2021/pq-43289-21-david-cullinane.pdf.  
7.    The three Midland Hospitals collectively had 676 inpatient/day case beds in December 2022; HSE PQ response to Deputy David Cullinane, 14 February 2023; https://www.ihca.ie/_fileupload/Available%20and%20Funded%20Beds%202022%20pq-4965-23-david-cullinane%20plus%20Attachment.pdf. The population of the Midlands region is 317,999 (CSO) which gives a ratio of 2.13 beds per 1,000 population. 

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