High demand slows progress on waiting lists

At the launch of the Waiting Time Action Plan (WTAP) 2026, the Government was keen to highlight achievements made in the length of time people are spending on waiting lists.

However, there was also an important acknowledgement that hospital waiting lists are continuing to grow.

The latest figures show that by the end of December 2025, about 754,000 people were on active hospital waiting lists – an increase of nearly 12 per cent compared with the end of 2024. More patients are still being added to lists than removed, underlining the scale of the pressure facing the health system.

The WTAP 2026, which was published at the end of last month, sets out a new round of targets and reforms designed to reduce how long people wait for outpatient appointments, procedures, and diagnostic scopes. The plan continues an approach that was launched in 2021, and focuses on productivity, system reform, and additional treatment capacity.

The Department of Health points to real progress in reducing average waiting times. For example, the weighted average waiting time for an outpatient appointment reduced from 12.8 months in September 2021 to 6.8 months at the end of December 2025.

But the Department also accepts that demand is rising faster than expected. Last year alone, almost 1.93 million patients were added to waiting lists, up over 6 per cent on the previous year. Removals – meaning patients treated or otherwise taken off lists – rose by only about 2 per cent. Population growth, ageing, and pent-up demand after the Covid-19 pandemic are all cited as factors.

As a result, the anticipated progress towards WTAP waiting time reduction targets was not achieved by the end of 2025.

According to Minister for Health Jennifer Carroll MacNeill, the new plan is broader than a simple push for more activity.

“The Waiting Time Action Plan is a multi-faceted approach with one overarching aim, to ensure people get access to faster care and achieve better health outcomes,” she said.

“It will ensure that we build on the progress we have already made in reforming our health service and continue to boost productivity and efficiency, while developing alternative care pathways and shifting towards care in community settings.”

The plan contains 36 actions grouped under reform, enabling tools, and capacity optimisation. Measures include more centralised referrals, pooled waiting lists, expanded use of digital systems, artificial intelligence-supported list management, and greater use of community and virtual care. There is also a continued role for outsourcing through the National Treatment Purchase Fund (NTPF).

Infrastructure expansion is another pillar. Surgical hubs are a key part of the strategy. One hub at Mount Carmel in south Dublin carried out more than 3,700 procedures in its first year, with officials claiming it helped cut long waits in certain categories. Five more hubs are due to open this year, with two more in planning.

Minister Carroll MacNeill argued that higher activity must translate into shorter waits for those stuck longest in the system.

“In order to reduce waiting times, we need to see more activity that results in patients receiving care, particularly those waiting the longest,” according to the Minister.

“As detailed in the Action Plan, this will be achieved through a combination of measures including service reforms and innovation; increased productivity and improved performance; investment in infrastructure and staffing; embracing digital solutions; and supplemented by targeted additional capacity via the NTPF.

“These initiatives are already having real-world impact…. We can see how our growing infrastructure and expanding capacity results in people being treated faster and spending less time waiting.”

Long waiting lists, with long waiting times, have been an unacceptable feature of the Irish health service for too long. Progress should be welcomed. But without a sustained shift that matches rising demand with real, timely access to care, the problem will remain unresolved.