The Government and I recognise that acute hospital scheduled care waiting lists are far too long, and that many patients are waiting an unacceptably long time for care. As part of efforts to address this, the Waiting List Action Plan (WLAP) multi-annual approach, was initiated in September 2021. The WLAP approach encompasses a combination of short-term actions to increase capacity and activity in the immediate term, and longer-term reform measures to sustainably reduce and reform hospital waiting lists and waiting times.
This WLAP approach is having a positive impact on hospital waiting lists, with each of the WLAPs to-date having achieved a reduction in the overall waiting list numbers (5.4% reduction from September to December 2021, and 4.1% and 2.7% annual reductions for WLAP 2022 and 2023 respectively). Significant progress was also achieved last year in relation to those waiting longest on hospital lists, as well as further reducing the number of people waiting longer that the Sláintecare wait time targets. Since the pandemic peak, and by the end of December 2023, there was a 27% reduction in the number of people waiting longer than the Sláintecare targets, which equates to nearly 170,000 people.
In 2024, €437 million has been allocated to help address waiting lists this year, which includes €360 million specifically for the WLAP. The 2024 WLAP – published in March - builds on the work done in previous plans and is targeting long waiters, a 10% reduction in the number of patients breaching the Sláintecare Time Targets (as of year-end 2023) and an overall waiting list reduction of almost 6% this year. Delivering the targets in this year’s WLAP will be underpinned by further increased activity in our hospitals.
As part of our commitment to improving hospital waiting lists, we are implementing a national strategy of elective ambulatory care, with the establishment of new dedicated Elective Hospitals in Cork, Galway and Dublin. The development of elective hospitals will change the way in which day case, scheduled procedures, surgeries, scans and outpatient services can be better arranged across the country, ensuring greater capacity in the future and helping to address waiting lists. The total additional capacity to be provided by the overall Elective Hospitals Programme (in terms of procedures, treatments and diagnostics) is estimated to be 977,700 annually. In the interim, the HSE is also addressing waiting lists in the shorter term by expediting the development of ‘Surgical Hubs’ at locations across the country. The Hubs in Dublin are due to become operational this year (2024) with those in Galway, Cork, Limerick and Waterford becoming operational in 2025. Once operationalised, each Hub will deliver over 25,000 day cases, minor operations and outpatient consultations annually.
We are also expanding capacity in our hospitals. For example, since 2020, this Government has opened 1,182 new acute inpatient beds. In addition, a further 91 acute beds are planned to open in 2024, with another circa 250 acute beds either under construction or have funding commitments to progress to construction over the next number of years. In addition to these circa 1,500 acute beds already funded or with committed funding, it is my ambition to progress rapidly to open a further 1,500 beds to meet the health needs of our growing and aging population.
The revised National Development Plan (NDP) capital allocations agreed by Government in March 2024 included an additional capital allocation of €245 million towards healthcare infrastructure. This increased allocation now brings our NDP Health capital investment to €1.46 billion for 2025 and €1.56 billion for 2026 and now allows the launch of Phase 1 of the next 1,500 Acute Bed programme. The Department of Health and the HSE are now progressing with plans for approximately 300 of these beds in Phase 1 of this new programme.
In addition to increasing capacity, one of my priorities was to increase the number of consultants working within the health service. I’m happy to report that since 2020 the number of consultants has increased by nearly a third, or an extra 1,000 consultants. There are now over 4,300 consultants working in the HSE. Several hundred more will be hired this year. I have set a goal of getting to 6,000 consultants by 2030 which we are on target for.
The introduction of the Public Only Consultant Contract (POCC) is also significant in terms of its impact on our health service. As of the 24th of April, 2,195 consultants have signed the POCC. This is made up of 462 new entrants signing the contract since it was introduced in March 2023 and 1,733 consultants who have switched from their existing contracts.
As more consultants are recruited or switch to the new contract, private activity in the public system will cease. With the increase in consultants on POCC, this increases the time that consultants are present on site enabling more decision- making, which as we know reduces admissions, reduces length of stay and reduces delayed discharge. The new contract also results in more patients being seen, with more outpatient clinics and theatre lists, including in the evenings and at weekends.