Under HSE validation processes, patients on inpatient and outpatient waiting lists are sent letters asking them to confirm within 14 days that they still require an appointment.
If they do not confirm within the timeframe, they are struck off the list. The process is undertaken every six months.
However, doctors have highlighted that some patients have literacy issues or health problems that delay or impede them from responding within the timeframe.
More than 500,000 individuals are currently awaiting an outpatient department appointment, while almost 80,000 are waiting for an inpatient/day case procedure.
But as many patients who are genuinely seeking appointments are struck off lists as they have not responded within the timeframe, there are fears the waiting lists could be much higher.
According to the HSE, it is up to the patient to confirm they still require an appointment or procedure.
On Twitter, NAGP President Dr Maitiú Ó Tuathail drew attention to the plight of an elderly patient with literacy problems who failed to respond within the timeframe, labelling the situation as an “absolute disgrace”.
GP Dr Dermot Shearer described the move as “deliberate gaming with lives to massage HSE statistics”. He said that, in the UK, 25 per cent of the population is functionally illiterate.
According to the National Adult Literacy Agency (NALA), almost 18 per cent of Irish adults (550,057) are at or below level 1 on the literacy scale. At this level, a person may be unable to understand basic written information.
GP and GP trainer Dr Stephen Murphy, who has raised his concern with the HSE, described the process as “hospital sweepstakes hurdles” and the “GP referral letter shuffle”.