Clearing hospital waiting lists exacerbated by Covid-19 could cost €1bn - ESRI

The cost of clearing public hospital waiting list backlogs exacerbated by Covid-19 could amount to more than €1 billion, according to projections by the Economic and Social Research Institute (ESRI).

Spending requirements for public hospitals overall are expected to double in the next 15 years, it says, rising from about €6 billion to as high as €14.4 billion.

A report published on Wednesday explains that wage costs will be the main driving factor, and will account for between €2 billion and €4.1 billion by 2035 when the population rises by almost one million people.

“In nominal terms, we project gross expenditure requirements for public acute hospital care of between €10.8bn and €14.4bn by 2035, compared to expenditure of €5.9bn in 2018,” it says.

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That will represent an increase of between 3.6 per cent and 5.4 per cent on average every year.

The report – Projections of Expenditure for Public Hospitals in Ireland, 2018–2035 – covers both acute hospitals and adult psychiatric in-patient services and contains, according to its authors, the “most comprehensive mapping of Irish public hospital expenditure to have been published”.

It predicts the population will increase by up to 920,000 by 2035, with the share of those aged 65 and over rising from one-in-seven to one-in-five. Increases in demand and the cost of delivering care will help drive the escalation in spending.

“We estimate that the cost to the public acute system of tackling waiting-list backlogs, exacerbated by Covid-19, and maintaining manageable waiting times, would be €1.1bn over 5 years. This could be partially offset through shifting certain appropriate care, currently delivered in public hospitals, to the community over time.”

Such numbers could have implications on the policy side. The ESRI says it would affect capital investment, staffing and resource planning, but some of this could be offset by improving productivity.

“Certain care currently delivered in hospitals could, in line with current Sláintecare reform proposals, be more appropriately delivered in the community,” it says.

Among other cost increases are emergency departments, rising from €420 million in 2018 to between €680 million and €880 million.

Outpatient department attendances is estimated at €680 million, rising to between €1.1 billion and €1.4 billion; and public acute adult psychiatric services from estimated €180 million to between €300 million and €400 million.

“This report examined the drivers of projected public acute hospital expenditure in terms of both demand and cost,” said lead author Dr Conor Keegan.

“Projected changes to the size and structure of the population will increase demand for hospital services while the labour-intensive nature of healthcare delivery means the cost of delivering these services will be particularly sensitive to future trends in pay.”