These are unprecedented times for the health service in terms of investment, with an additional €4 billion in spending made available in the last budget.Yet waiting lists, instead of shrinking, are continuing to grow, due to the combined effects of the Covid-19 pandemic and the ransomware attack on the Health Service Executive last May. The inpatient waiting list has increased by more than 10,000 since the end of 2019 and outpatient numbers have also risen.
Some progress had been made before the pandemic in cutting the inpatient waiting list, through targeted funding initiatives coordinated by the National Treatment Purchase Fund. It had been hoped this list would fall to about 40,000 by the end of this year; instead, it currently stands at about 77,000. Meanwhile, a record 630,000 people are waiting for an outpatient appointment.
Previous governments have thrown money at waiting lists and seen numbers shrink, only for them to grow again once the funding was removed. A more sustainable solution is needed.The Sláintecare plan for the future of the health service envisages the elimination of waiting lists, but it was hampered in its early years by a lack of funding. This is no longer the case.An additional 1,100 beds are being created, and 3,500 additional community staff appointed but it will be next year before the new posts are filled.
It is unfortunate, but understandable, that waiting lists are growing again due to the cataclysmic consequences of the pandemic. Repeated waves of Covid-19 have forced the cancellation of operations and appointments, and forced large numbers of staff off work due to infection or being a contact. Processing patients through normal procedures has been more complicated.
The ransomware attack on the HSE was also unfortunate, but perhaps more predictable, given the parlous state of its IT systems before they were targeted by cybercriminals. Three months on, it continues to cause disruption within the system and we are warned that this will not end completely until next year.
Despite widespread vaccination, the pandemic continues to make life difficult for health staff. Yet pathways to treat non-Covid patients are now well established. Cases are not translating into serious illnesses to the extent formerly seen. The worst is probably over. The health service needs to get back to normal business, including the elimination of waiting lists. The good news is that it now has the funding to achieve this, to go with the cross-party support for the Sláintecare plan. How exactly this will be implemented remains to be spelled out, however.
Planning for the future may have been very difficult at the height of the pandemic. but it now becomes essential to ensure the significant resources being spent yield a result.