Hospital care backlog could take 15 years to clear, consultants warn

The pandemic-related backlog in hospital treatment could take 15 years to clear, as consultants warn of a looming “twindemic” of Covid-19 and flu in the coming months.

Bed capacity and medical expertise remain in short supply, according to the Irish Hospital Consultants Association (IHCA), which points out that Ireland has the second-lowest spending level on acute hospitals out of 11 comparable European countries.

Launching its pre-budget submission on Monday, the association said more needs to be done on pay equity in order to attract specialist doctors, with the number of vacant consultant posts now at 882.

The organisation said bed and consultant capacity is now 40 per cent below the European average.

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As the system struggles to cope with existing demand, doctors face more strains on capacity in the months ahead.

“We are very concerned about the forthcoming winter,” said Prof Rob Landers of University Hospital Waterford.

“We are coming off the back of a summer where we have seen record numbers of people on trolleys and we’re now facing a ‘twindemic’, if you like, of traditional flu and combined with a resurgence of Covid, most likely.”

Prof Landers said there were concerns that a base level immunity to normal flu is no longer in the community due to recent Covid restrictions, while the “particularly severe” Australian flu season offered a harbinger of things to come in Ireland.

The most recent data from the National Treatment Purchase Fund showed the number of people awaiting a first-time consultant appointment in public hospitals has remained at more than 600,000 for two years.

Whatever the demands facing the health service, the IHCA brings the debate back to filling consultant positions in order to bolster care capacity.

Data presented by the association on Monday showed Ireland has the lowest number of hospital beds in the European Union and needs an additional 6,000 by the end of the decade. Surgical capacity is also of concern — there are 211 operating theatres, one-third the level of other western European countries based on population.

“We [have ended up] with over 900,000 people on some form of waiting list,” said Prof Alan Irvine, IHCA president.

“These waiting lists are going up since May 2017 when Sláintecare was launched. So Sláintecare had aims of nobody waiting more than six weeks, but in fact on the fifth anniversary of Sláintecare waiting lists had gone up by 31 per cent.”

Describing this phenomenon as seemingly “completely unstoppable”, Prof Irvine said today there are 65 times more people waiting over a year for an appointment or procedure than there was a decade ago.

Prof Irvine said the management of the health service is often “extremely foolish financially” — the near €450 million paid out by the State Claims Agency in 2022 is comparable to the operating budget of St James’s Hospital in Dublin, the largest public facility in the country.

Conditions in the health service are linked directly to the export of doctors trained in Ireland — the IHCA believes about €27 million would bridge the pay equity gap, creating an environment that could begin to attract doctors back.

“People do not want to work alongside colleagues who are appointed earlier, who are doing exactly the same job [with] the same responsibilities, the same risk of being sued and get paid 20, 30 or more per cent less,” Prof Irvine said.

The IHCA said it is happy ongoing contract talks have progressed and are due to continue this week.

In a statement the Department of Health said the Programme for Government commits to continuing investment in health. It said €236 million revenue and €40 million capital expenditure were provided as part of the winter plan and Budget 2021 to fund 1,146 additional beds in acute hospitals. As of the August 18th 2022, the winter plan / Budget 2021 has provided 896 non-ICU acute beds to the hospital system over the number available in January 2020. It said a further 332 acute beds were due to be delivered in 2022 and 2023.

It said the Government is committed to addressing the long-standing deficit in critical care capacity. It said very significant funding of €77 million has been provided across 2021 and 2022 to add an additional 85 critical care beds. The Department of Health said “negotiations in relation to the Sláintecare contract are ongoing and it would not be appropriate to comment further at this stage”.