Consultants urgently needed to address waiting list backlog – IHCA

The IHCA has urged Government to permanently fill more than 740 vacant consultant posts in hospitals nationally to help address patient waiting lists.

In a stark warning, the Association claimed it could be up to 14 years or mid-2027 before outpatient waiting lists and backlogs are cleared unless action is taken. More than 907,000 patients nationally are currently on waiting lists for healthcare. 

A separate estimate stated the inpatient and day case backlog would not be cleared until early 2025. 

In its pre-Budget submission, the IHCA outlined a number of longstanding issues, such as the salary inequity, hospital bed capacity, consultant recruitment and retention, capital investment and waiting lists, which must be tackled. In total, it makes 19 recommendations.

According to the submission, there were almost 363,000 fewer outpatient hospital appointments in 2020 compared to 2019. Inpatient/day case activity in 2020 was down 255,000 appointments. 

The IHCA added that the targets for 2021 outlined in the HSE’s National Service Plan are still 194,000 appointments short of 2019 levels.

Data compiled by the Association shows a “linear trend and relationship between growing waiting lists and vacant consultant posts”. 

Consultant posts vacant or unfilled on a permanent basis have grown from around 350 in 2014 to 748 in 2021.

During the same time period, the numbers on outpatient waiting lists have grown from around 380,000 to 650,000. 

Meanwhile, ongoing consultant contract talks aimed at attracting more consultants to hospital posts are a “long way from a successful conclusion”, IHCA President Prof Alan Irvine said. 

Ireland has the lowest number of specialists per 1,000 population in the EU and one-in-five hospital consultant posts are vacant or unfilled permanently. Type A contacts in psychiatry and emergency medicine have the largest vacancies. 

According to the IHCA, more than one quarter of posts advertised by the Public Appointments Service over a 20-month period in 2019 and 2020 had zero or one applicant. 

Meanwhile, they argued that the costs of employing temporary or agency consultants was twice that of those directly employed, creating “a false economy”. 

The submission claims that it would cost just €25.7 million or 4 per cent of the 2020/21 Winter Plan to resolve the pay disparity in place since 2012. 

More than 6,000 extra hospital beds are needed, half within the next three years, the submission notes, including a doubling of ICU bed capacity. 

According to Prof Irvine, Consultant Dermatologist at Children’s Health Ireland (CHI) and St James’s Hospital, Dublin, it is “now or never” for Government action. 

“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.”