Outpatient Waiting lists exceed 600,000 in July 2020 while COVID-19 cases rise

In July 2020, over six hundred thousand people, 601,362, were on waiting lists for outpatient procedures, according to data released by the National Treatment Purchase Fund (www.ntpf.ie).  Outpatient waiting lists have increased, year-on-year, since 2014, with the largest percentage increase between 2016 and 2017 (14.7 per cent), and an overall increase between 2014 and 2020 of 66.7 per cent (Chart 1).

Chart 1:  Outpatient Waiting Lists, 2014 to 2019 

Source:  Analysis of data from the National Treatment Purchase Fund, Outpatient / Waiting Lists, Group Hospitals, Various Years

Note:  Data relates to July each year

Of those on the July 2020 waiting list, almost a quarter are aged 65 and over (145,222) and 13.9 per cent are aged between 0 and 15 years old (83,298) (Table 1). 

Table 1:  Outpatient Waiting by Age Group and Length of Time, Number of People, July 2020

Source:  Analysis of data from the National Treatment Purchase Fund, Outpatient / Waiting Lists, Group Hospitals, July 2020

The distribution of waiting times is relatively even across all age groups (Chart 2), however there are currently a higher proportion of people in every age group waiting 18 months than in any other waiting time.

Chart 2:  Outpatient Waiting by Length of Time, by Age Group, July 2020

Source:  Analysis of data from the National Treatment Purchase Fund, Outpatient / Waiting Lists, Group Hospitals, July 2020

This is notwithstanding the Government’s commitment, referred to in the Euro Health Consumer Index 2017 (p.16) with reference to a memo from the HSE and Department of Health referred to in the Euro Health Consumer Index 2017 (p.16), in response to the 2015 publication, advised of to a programme to reduce waiting lists to no more than 18 months.  Even where that target is reached, the Index stated, it will still be the worst waiting time situation in Europe.  The number of outpatients on waiting lists for 18 months or more increased year on year to July 2020 (Chart 3).  The largest percentage year-on-year increase was between 2016 and 2017 (194.4 per cent).  Between July 2014 and July 2020, the number of outpatients waiting 18 months or more increased by over 2,000 per cent.  Thirty-nine per cent of all patients awaiting treatment for 18 months or more were children or older people.

Chart 3:  Outpatient Waiting List, 18 Months+, 2014 to 2020

Source:  Analysis of data from the National Treatment Purchase Fund, Outpatient / Waiting Lists, Group Hospitals, Various Years

Note:  Data relates to July each year

The largest cohort of outpatients (73,101 in total) were awaiting Orthopaedic treatment, followed by those awaiting Otolaryngology (ENT) – ear, nose and throat (68,182).  Apart from Small Volume Specialities (where there are less than five patients waiting in a particular speciality or hospital), Paediatric Oncology, Palliative Medicines and Radiology were the specialities least likely to have waiting lists (Table 2).

Table 2:  Outpatient Waiting Lists by Speciality, July 2020

Source:  Analysis of data from the National Treatment Purchase Fund, Outpatient / Waiting Lists, Group Hospitals, July 2020

As we look likely to be living alongside COVID-19 for the foreseeable future, it is clear that an over-reliance on acute care within a two-tiered healthcare system is not fit for purpose.  Investment in primary care teams and community healthcare networks must be prioritised in Budget 2021.