Urgent action needed to prevent secondary crisis of missed care – IHCA

Following the publication of the HSE’s National Service Plan 2021, the IHCA has called on health officials to prioritise reducing record waiting lists and to outline a plan to enable public hospitals “to cope” in the coming months and next winter.

This week HSE CEO Mr Paul Reid admitted that reducing waiting lists and clearing the backlog of care postponed during the pandemic will be a “significant issue” this year.

The expanded HSE National Service Plan 2021 is welcome but does not match the scale of the problem or meaningfully address current hospital waiting lists that are “spiralling out of control”, says the IHCA.

While the HSE has reiterated its plan to hire an additional 16,000 staff this year, no target has been set for the number of additional hospital consultants due to be appointed and in post during 2021. The IHCA said this was a major concern as there are over 700 permanent consultant posts not filled in public hospitals.

Meanwhile, there are currently over 860,000 people waiting for some form of treatment and specifically 620,000 waiting to see a hospital consultant.

The Service Plan also reduces the official target for the percentage of people waiting less than a year for their first outpatient appointment from 80 per cent to 75 per cent. The 80 per cent target was met for less than six in 10 people in 2020.

Similar reductions in targets have been set for 2021 for the percentage of women admitted for hospital treatment within three weeks of diagnosis of breast cancer (from 95 per cent to 90 per cent), access to community palliative care services within seven days (from 90 per cent to 80 per cent), and in the waiting times for assessments such as orthodontics (from 46 per cent to 22 per cent of patients seen within six months).

Expected activity levels for 2021 provides for 153,000 fewer outpatient appointments and a reduction of 50,000 in inpatient and day cases compared with expected activity for 2020 outlined in last year’s National Service Plan. 

These waiting lists and the ongoing risks revealed by Government in its updated Covid plan, suggest a hospital system which will be “pushed to breaking point once again if current long-term capacity issues are not resolved”, according to the Association.

Prof Alan Irvine, President of the IHCA, said: “The plans announced this week to navigate the pandemic and the delivery of healthcare in the months ahead reveal Government’s own concerns that Covid-19 will continue to challenge our system in the months ahead. With full awareness of this risk, it is now not only prudent but essential to address long standing hospital service delivery deficits.

“While the expanded resources in the HSE National Service Plan are welcome, it does not go far enough to reduce the significant waiting lists we face and that continue to grow. This is a major concern given that the number of patients waiting over a year or longer for hospital treatment is now double the figure prior to the Covid-19 pandemic and for those waiting longer than 15 months it is 250 times higher than in 2014.

“The appointment of additional, permanent consultants without further delay and providing them with the necessary hospital facilities are essential to ensure effective solutions that will improve waiting times for patients.

“While Government has committed record funding levels for health in 2021, until this money is channeled effectively and speedily to where it will make the most difference for patients – through the recruitment of additional Consultants with supporting teams and infrastructure – our public hospitals will continue to have record waiting lists and struggle to address the backlog of treatment due to Covid.”