Black spots on hospital waitlists illuminate zip code lottery

The emergence of hospital waiting lists across the country shows that where you live can determine how quickly you get treatment.

As public hospitals recover from last year’s pandemic and cyberattack, the postcode lottery has deepened, according to analysis by the Irish Independent.

The national picture shows that outpatient waiting lists have been hit the hardest, with 617,448 adults and children queued, of whom 153,373 are waiting longer than 18 months.

Another 75,463 are on inpatient and day case waitlists, of which 10,361 are facing the longest delays.

However, these numbers hide inconsistent access to patients awaiting the same procedure at different hospitals.

:: For adults requiring hip or other orthopedic surgery, there is a waiting list of 171 at Mater Hospital Dublin, of which 29 have been in the queue for over a year;
:: In the south of the city, 867 are awaiting the same treatment at St. James’s Hospital, 339 have been awaiting them for at least a year;
:: Sligo University Hospital has 484 patients awaiting orthopedic surgery, with 196 waiting over a year;
:: Tullamore Hospital, Co Offaly has a larger queue of orthopedic patients than Sligo at 654 but 186 face a delay of over a year.

The issue of waiting lists was raised in the Dáil last week when TDs were told of the suffering inflicted on children.

Taoiseach Micheál Martin said delays in treating children with conditions like spina bifida and scoliosis were “unacceptable,” but he insisted it was not a question of funding.

For general surgery, including gallbladder, hernia, varicose vein and other surgery, the number of patients with waiting times of at least one year varies between 225 at St Vincent’s Hospital Dublin, 377 at St James’s Hospital and 502 at Galway university hospital.

The Irish Medical Organization and the Irish Hospital Consultants Association have cited the lack of sufficient specialist doctors as the main reason for waiting lists. However, the disparity in numbers across hospitals is also being influenced by the legacy of underfunding and shortages of beds, shortages of specialist nurses and the reallocation of staff to Covid care.

Inadequate step-down facilities for medically healthy patients, overcrowding in the emergency room, and an inability to outsource less complex cases to neighboring facilities also play a role.

Covid-19 has affected the hearts of some patients and there are 3,518 people awaiting heart surgery, but again there are variations.

St James’s Hospital Dublin has a roster of 810 inpatient and outpatient cardiologists, 181 of whom are on hold for over a year.

Galway University Hospital has a larger queue of 877 but has managed to keep the longest waiters at 124.

The cardiologist Dr. Angie Brown said the pandemic has negatively impacted many heart patients, leading to canceled outpatient appointments, checkups and surgeries, and patients’ reluctance to come to the hospital.

“During the pandemic, many healthcare professionals and nurses in particular have been transferred from heart failure clinics, for example,” said Dr. Brown, Medical Director of the Irish Heart Foundation.

Some appointments have been made online, but “for many, the lack of face-to-face verification has been problematic and for some patients, this has led to a deterioration in their health.”

There are also differences in the field of ophthalmological care, including cataract surgery. Mater Hospital has 274 patients waiting over a year compared to 417 at Waterford University Hospital.

In the field of gynaecology, Cork University Maternity Hospital has 151 women waiting over a year compared to 27 in Coombe, Dublin.

Professor Francis Finucane, consultant endocrinologist in Galway, said that before the pandemic, the list of obese bariatric patients requiring care was 400, with a waiting time of around a year. That has now increased to 900 and the delay has been extended to two years.

“Some patients wait up to four years for an endocrine evaluation, which looks at hormone-related disorders,” he said. “We need to have better resources and look at how we’re doing things to improve efficiency.”

Meanwhile, the crisis in children’s orthopedic lists continues as distraught parents of young scoliosis and spina bifida patients go public.

The HSE has now allocated €4 million a year of recurring funding to Crumlin and Temple Street hospitals to help reduce waiting times.

A spokeswoman for Children’s Health Ireland said all children with long waits will have a plan this year and the investment will make a difference.

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