Trolley crisis worsens as HSE records deficit of €322m in August

Trolley numbers and hospital waiting lists continued to rise in August, despite the provision of extra funding to alleviate pressures on the health service, the latest monthly report from the HSE shows.

The month saw over 3,000 patients wait more than 24 hours in an emergency department, over 11,000 patients wait longer than 18 months for an outpatient appointment and more than 1,000 wait longer than 18 months for inpatient or day case procedures - all in breach of official targets.

The HSE was €321.8 million in deficit by the end of August, according to the monthly performance report, and is likely to accumulate a €600 million deficit by the end of the year.

The report blames the pressures caused by having to deal with high trolley numbers and long waiting lists, as well as difficulties in sourcing staff and the knock-on effects of the Portlaoise maternity services report for the upward pressure on pay costs.

It said additional costs for drugs, lab tests, and medical supplies have far outweighed saving made in procurement.

Minister for Health Leo Varadkar said the report highlighted challenges facing the health service for the rest of the year.

Scheduled inpatients admissions and outpatient attendances were ahead of target and more patients have had an operation or clinic appointment than were planned at the start of the year, he said.

“Despite the increased activity and better performance, we are acutely aware of the challenges we face. For example, the report points to continued issues with long waiting times for scheduled or elective procedures, and financial penalties have been identified for those Hospital Groups who have the most patients waiting in excess of 18 months. This is on top of the €51 million allocated to hospitals to tackle waiting times.”

During the month, an average of 96 people a day waited over nine hours in emergency departments for admission, compared to 92 in July and an overall target of 70.

A total of 3,330 patients waited more than 24 hours in the emergency department during August, of whom 859 were aged 75 years or over.

This is in spite of the fact that emergency department attendances and admissions are down slightly over the same period last year.

Mr Varadkar has set a target of 18 months for the maximum wait for inpatient or outpatient appointments from the end of June, and 15 months at the end of September.

The latest figures show these targets are further away than ever from being achieved.

During August, 1,368 patients were waiting more than 18 months for inpatient or day case procedures, while 4,705 were waiting more than 15 months.

In relation to outpatients, 11,235 patients were waiting greater than 18 months for an appointment and 34,003 were waiting longer than 15 months.

Efforts are being made to address this backlog by outsourcing over 16,000 appointments to the private sector.

Waiting times for child and adolescent mental health services have improved following an initiative by Minister of State for Mental Health Kathleen Lynch. The number of young people waiting over 12 months for a first appointment dropped from 479 in March to 241 in August.

More than 80 per cent of breast and lung cancer patients as well as those requiring radiotherapy were seen within target times but only 60 per cent of men with prostate cancer were offered an appointment within the target time of 20 working days.

The number patients who discharge from hospital has been delayed because of a lack of other care options also grew, from 557 in July to 577 in August. This compares to 728 delayed discharges in January.

Mr Varadkar pointed out that the figure has since dropped to 542 on October 20th.