Over 77,000 people waiting for hospital care in the Mid-West as 1 in 3 consultant posts remain unfilled

The Irish Hospital Consultants Association (IHCA) has  warned that the ongoing shortage of hospital Consultants across many specialties in the Mid-West1 and severe hospital capacity deficits are preventing patients from accessing the timely, high-quality medical and surgical care they need and contributing massively to unacceptable waiting lists and Emergency Department overcrowding in the region.

Across Limerick, Clare and North Tipperary, there are now 52,192 people waiting for public hospital inpatient/day case treatment, GI endoscopies or an outpatient appointment with a Consultant.2 Newly released figures confirm a further 25,113 people are awaiting CTs, MRIs or ultrasounds at hospitals across the UL Hospitals Group3, which means there are 77,300 people waiting for public hospital care across the Mid-West.

The IHCA says that the situation is compounded at UHL by severe Emergency Department (ED) overcrowding – the worst in the country – with a total of 1,596 admitted patients treated on a hospital trolley in November, a record for University Hospital Limerick (UHL) and the highest last month in any Irish hospital.4 So far this year, almost 17,500 patients have been treated on trolleys at UHL.5

HSE figures also confirm that one in every three (33%) approved permanent Hospital Consultant posts in the UL Hospitals Group are either vacant or filled on a temporary or agency basis – an all-time high of 68 out of 206 approved Consultant posts6 and an increase of 16 additional posts not filled as needed since November 2020.7 A further eight Consultant Psychiatry posts are not filled as needed in the three Mental Health Services of Clare, Limerick and Tipperary North, bringing to total number of Consultant posts that are vacant or filled by temporary staff to 76.

Limerick has one of the lowest number of Consultants both at a hospital and Hospital Group level, with a half to a third the number compared with similar Model 4 hospitals. A recent report carried out by management consultants Deloitte found that UHL has 38% fewer Consultants (WTEs) than the Mater Hospital and 52% less than St James’s Hospital.8

Meanwhile, analysis from the IHCA shows that from November 2015 to November 2022, an additional 18,100 (+64%) people have been added to outpatient waiting lists across the UL Hospitals Group, with a total of 46,320 now waiting to be assessed by a hospital Consultant.

UHL, the busiest hospital in the region, has the fifth largest outpatient waiting list in the country, behind Galway University Hospitals, the combined three Dublin paediatric hospitals in the CHI Group, CUH and the Mater Hospital.

The severe ED overcrowding at UHL is a direct result of significant bed capacity shortages across the Mid-West region. UHL has the lowest number of inpatient beds (481) compared with the number of its Emergency Department attendances, which were a record 76,473 in 2021 and are expected to reach 80,000 by the end of the year. In practice, that means for every 159 people who attend the ED, there is 1 bed – on a ratio basis.9

An additional 302 inpatient beds and 63 day case beds are needed by 2036 to address current shortfalls and meet increased patient demand, according to the Deloitte report.10 While a new 96-bed unit is under construction at UHL, it will only offer 48 additional beds, with half of the stock replacing old beds.

Commenting on the waiting lists and capacity deficits in the Mid-West, IHCA President Professor Robert Landers said:

“The extreme shortage of Consultants and worsening capacity deficits across the UL Hospitals Group are the main contributors to the unacceptable delays in providing care to patients in the Mid-West region. For those reasons, the ULHG is failing to meet the healthcare needs of the 77,000 people currently waiting to be assessed, diagnosed or treated by a Consultant.

“UHL clearly cannot meet the current demand within the region for essential scheduled or unscheduled emergency care, as evident by the record number of admitted patients treated on trolleys, the high bed occupancy rates, the cancellation of elective care and a stark Consultant recruitment crisis – all of which just further exacerbates the already unacceptable waiting lists.

“It is imperative that all vacant Consultant posts across the region are filled, as well as rapidly expanding the region’s hospital beds, operating theatres and other essential hospital facilities, if we are to effectively address the record hospital waiting lists and mitigate against the severe overcrowding challenges in this region.”