OVER 1.5 MILLION people will be added to hospital waiting lists this year due to “normal additions and an acceleration in presentations due to deferrals caused by Covid”, the Secretary General of the Department of Health Robert Watt will confirm today.

In his opening statement to the Oireachtas Health Committee, Watt, who has been the centre of controversy in recent weeks over the scale of his salary, states that a plan to deal with hospital waiting lists this year will be brought to Government next week. 

The plan will set out actions to reduce waiting lists and address backlogs, he said. 

It will set out where additional funding of €350 million will be allocated, stating that €200 million is to support waiting list initiatives and €150 million is to go to the National Treatment Purchase Fund (NTPF) – an increase of €50 million on 2021.

“Each year the number of new additions to waiting lists increases significantly. Hence, the challenge is to increase activity both to reduce the stock of people waiting too long and address the new additions.

“In 2022, it is estimated that over 1.5 million people will be added to the Waiting Lists. This reflects normal additions and an acceleration in presentations due to deferrals caused by Covid,” Watt will tell the committee. 

Under this proposed plan, the HSE and the NTPF propose to deliver services to remove many more patients from active waiting lists.

Speaking in the Dáil last night, Health Minister Stephen Donnelly said that reducing waiting lists is a “top priority” for him. 

Significant reduction

Watt is due to say: “We estimate that this will be the largest level of activity ever delivered and will result in a significant reduction in these waiting lists. It is hoped that that by the end of 2022, the number of patients on active waiting lists will be at its lowest point since the beginning of Covid.” 

In order to reduce the waiting lists, Watt says further capacity enhancements will be needed, highlighting that new elective hospitals in Cork, Galway and Dublin will cater for up to 940,000 planned procedures and operations every year. 

He will tell committee members that “on-going change and reform to increase productivity” will also be needed.

Demand continues to exceed capacity 

HSE chief executive Paul Reid will also appear before the committee.

Though the HSE delivers approximately 3.3 million outpatient appointments, over one million day cases and 82,000 elective discharges each year, demand continues to exceed capacity in many specialties, Reid will tell the committee. 

“I fully accept that patients are waiting too long to be seen,” he says in his opening statement. 

During the pandemic, outpatients waiting lists grew by 98,000 (18%), inpatient/day cases waiting lists grew by 9,000 (14%) and endoscopy waiting lists grew by 10,000 (47%).

Reid will state that the Waiting List Action Plan published in October 2021 managed to reduce the outpatient waiting list by 35,000 by December, with a 21% reduction in those waiting 18+ months.

“There was only a slight decrease in the Inpatient/Day Case waiting list due to the significant affect cancellation of elective surgeries due to Covid-19 and ED pressures had; and a decrease of 5.4k (-17%) in the Endoscopy Waiting list,” he says in his statement. 

Watt will state that in order for the waiting lists to be reduced they will need to ensure that all patients are treated in public hospitals on the basis of need and not their insurance status.

“This will free up capacity in public hospitals but also ensure a more equitable system.

“Removing private income from public hospitals will require legislation and further discussions with the consultant bodies. Talks are ongoing with representative bodies on the implementation of the Sláintecare Consultant Contract, which will pave the way for the removal of private care from public hospitals, ensuring that patients are treated on the basis of clinical need and not ability to pay.”

Controversy last year

Late last year, questions were asked about the future of the Sláintecare which aims to introduce universal healthcare in Ireland following after a number of high-profile resignations.

Gastroenterologist Professor Anthony O’Connor left the Sláintecare Implementation Advisory Council (SIAC), following in the footsteps of chairman Dr Tom Keane and executive director Laura Magahy.

However, both the health minister and Watt pushed back against the idea that the Government is not committed to Sláintecare.

Watt will update the committee today on Sláintecare Oversight, telling members that a new Sláintecare Programme Board oversees the plan’s implementation. Watt and Reid both co-chair the board.

The board reports directly to Health Minister Stephen Donnelly, has met twice since December and will meet on a bi-monthly basis going forward. 

As part of healthcare reform, the Government has also planned to establish Regional Healthcare Areas, with Watt stating that the current Hospital Groups and Community Healthcare Organisations do not align geographically, nor do they overlap in terms of management, clinical oversight, or budgets.

He said the new RHAs will ensure the alignment and integration of hospital and community services at a regional level, based on defined populations and local needs.

“The Government approved the geographies of the regions in the months preceding the pandemic,” he is due to tell the committee, adding that a memo for a Government decision is being drafted based on this work, “which Minister Donnelly will bring to Government in the coming weeks”.