Robert Watt saw ‘no prospective improvements’ in hospital waiting lists despite €350m action plan

Senior civil servant sought meeting with HSE chiefs in September as outpatient numbers hit record levels

Robert Watt, secretary general of the Department of Health, sent an email to some of the most senior HSE officials. Photograph: Dara Mac Dónaill

Senior civil servant Robert Watt told the HSE that the Department of Health could see “no prospective improvements” in the number of patients on hospital waiting lists despite an injection of “significant money” aimed at improving the situation.

The HSE expected it would miss all of the targets for reducing waiting lists set out in the Waiting List Action Plan last year, though the overall numbers waiting for care were due to fall when compared to the total at the end of 2021.

Minister for Health Stephen Donnelly announced the action plan at the end of February, promising that a €350 million investment would reduce waiting lists to their lowest level in five years. However, records released under the Freedom of Information Act indicate a level of concern within the department later in the year about the situation not improving.

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An email was sent by Mr Watt, the department’s secretary general, to some of the most senior HSE officials on September 6th, just days before there was media coverage of how the number of people waiting for a hospital outpatient appointment had reached record levels.

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Mr Watt wrote to then HSE chief executive Paul Reid, chief operations officer Damien McCallion and chief clinical officer Dr Colm Henry and included the department’s head of media relations David Leach in the correspondence.

“We received a briefing on waiting list performance yesterday which shows no prospective improvement in numbers waiting – and in particular no reduction in outpatient consultations waiting lists,” he said. “Significant money has been allocated and measures put in place which don’t as yet seem to be yielding additional activity.”

Mr Watt suggested having an “informal chat” about the issue that week. Other records suggest there was also a meeting between senior HSE officials and Mr Donnelly on the topic of waiting lists later that month.

The HSE also released a report on waiting list activity from November 15th which showed how it expected to miss the targets set out in the action plan. Its “likely scenario” would see a total of 708,909 cases across outpatient, inpatient and GI (gastro-intestinal) scope waiting lists. That was a reduction on the 720,056 on waiting lists at the start of last year, but was considerably higher than the 587,747 target in the action plan.

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The HSE told The Irish Times: “We acknowledge that patients are waiting too long... however, significant progress has been made in relation to reducing the number of patients waiting longer than the 2022 maximum wait-time targets set.”

It said this includes a 27 per cent reduction in the number of patients waiting longer than 18 months for an outpatient appointment and an 80 per cent reduction in the number of patients waiting more than 12 months for a GI scope.

The HSE said a number of factors affected waiting times including the continuing impact of Covid-19 on hospital services and “the sustained high level of attendances at our emergency departments”.

The department said in a statement that it, Mr Donnelly and the HSE have been “clear that addressing waiting lists is a critical priority” and that the efforts made had led to “significant progress in recent months, particularly around long waiters and outpatient department waiting lists”.

“While the targets indicated at the outset of the year have not been met, we have seen particular progress in many hospitals,” it said.

It listed 21 instances of improvements including falling numbers waiting more than 18 months for outpatient appointments at various locations including Cavan General Hospital (down 96.4 per cent), St Vincent’s University Hospital (down 57.1 per cent) and Connolly Hospital (down 41.8 per cent for children waiting for an appointment).

Cormac McQuinn

Cormac McQuinn

Cormac McQuinn is a Political Correspondent at The Irish Times