Consultant shortages will see waiting list targets being missed, warn consultants association

The Irish Hospital Consultants Association (IHCA) has warned that Government’s inaction to urgently address the root causes of hospital consultant shortages and capacity deficits will mean the targets set out in its Waiting List Action Plan for 2022 will not be achieved.

The latest figures from the National Treatment Purchase Fund (NTPF) released recently show significant increases in the number of people waiting for care at the midpoint of the Action Plan – instead of heading towards the target of reducing public hospital waiting lists by 132,000 people by the end of the year.

The €350 million plan set out a target to reduce waiting lists for outpatient appointments, inpatient and day case treatment, and GI (gastrointestinal) endoscopies by more than 18% by the end of the year compared with the number waiting at the start of 2022.

However, six months into 2022 and instead of an expected reduction of around 66,000 people, the latest NTPF figures released today confirm that over 11,300 additional people have in fact been added to these three main waiting lists since the start of the year – a 77,500 shortfall.

The IHCA says that outpatient appointments have seen the biggest increases in the number of people waiting – a further 6,454 people added to the list in 2022, instead of the pro rata target reduction of 64,800 people expected at the halfway point of the Action Plan.

Consultants have raised concerns that outpatient waiting lists will need to decrease by an average of 22,700 per month between now and the end of 2022 if the overall Waiting List Action Plan target of reducing the number awaiting an outpatient appointment to 487,000 is to be achieved.

The warning from consultants over the Government and HSE’s unrealistic waiting list targets comes as NTPF figures confirm there are 903,400 people on some form of hospital waiting list. This is an increase of 86,000 (11%) in the past two years. There was no NTPF waiting list data published for June 2021 due to the cyberattack on the HSE.

The waiting list increases come as separate new figures from the HSE reveal that the number of approved Consultant posts that are vacant or filled on a temporary, locum or agency basis has reached another all-time high of 882 posts.

This is an increase of 155 approved Consultant posts, or 21%, not filled as needed since May 2021.4

The new HSE figures, analysed by the IHCA, confirm that as of 3 May 2022 a total of 473 permanent Consultant posts are vacant, with an additional six posts of unknown status and likely vacant. A further 342 permanent Consultant posts are filled on a temporary or locum basis, with an additional 61 approved posts currently filled on an agency basis.

Following several urgent calls by the IHCA over the past 6 months, Consultant contract talks have resumed in recent weeks following the appointment of an Independent Chair.

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IHCA President Prof Alan Irvine said: “The 2022 Waiting List Action Plan has reached its halfway point but is nowhere near achieving the reduction targets set for the end of the year. The NTPF figures released today confirm our fears that without addressing the very obvious shortages of consultants, hospital beds, theatres, diagnostic and other facilities the Government will not address the core problems facing our public hospitals. Unfortunately, more failed health targets are leaving patients waiting longer.”

Consultants have renewed their call on Government to effectively address the record hospital waiting lists by ending the pay discrimination introduced in 2012 against Consultants contracted after that date.

Consultants say this is a critical step towards re-establishing trust and making our public hospitals more competitive in recruiting and retaining highly skilled medical and surgical specialists we need to address the shortage of Consultants.

Commenting on recent NTPF figures and Consultant vacancies, IHCA President Professor Alan Irvine, said: “The 2022 Waiting List Action Plan has reached its halfway point but is nowhere near achieving the reduction targets set for the end of the year. The NTPF figures released today confirm our fears that without addressing the very obvious shortages of Consultants, hospital beds, theatres, diagnostic and other facilities the Government will not address the core problems facing our public hospitals. Unfortunately, more failed health targets are leaving patients waiting longer.

“It is imperative that the 882 approved Consultant posts are filled as needed with permanent appointees if we are to effectively address the record public hospital waiting lists.  

“The fact that so many posts cannot be filled as needed is an unequivocal signal to Government and health service management that the current conditions in our public hospitals do not create an environment in which skilled medical and surgical specialists want to work and which is driving our trained specialists abroad to pursue their careers.

 “The latest Consultant vacancy data confirms that the capacity of our public hospitals to provide quality, timely care to patients is seriously lacking and consequently leaves them facing poorer health outcomes.

 “The ‘unambiguous commitment’ made by the Minister for Health to end the pay discrimination imposed on Consultants contracted since 2012 must be honoured if the health service is to recruit and retain the increased number of hospital Consultants required to provide timely care to patients and bring our waiting lists down,” Mr Irvine said.