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postcode lottery Ireland's hospital waiting list blackspots revealed as 617,448 outpatients in queue

Outpatient waiting lists are worst hit, with 617,448 adults and children in the queue, and 153,373 of those are waiting for more than 18 months.

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The emergence of hospital waiting list blackspots across the country shows that where you live can determine how soon you are treated.

As public hospitals recover from the pandemic and last year's cyber attack, the postcode lottery has deepened, according to analysis by the Herald.

The national picture shows outpatient waiting lists are worst hit, with 617,448 adults and children in the queue, and 153,373 of those are waiting for more than 18 months.

Another 75,463 are on inpatient and day-case waiting lists, 10,361 of whom are facing the longest delays.

But these figures hide the uneven access to patients waiting for the same procedure in different hospitals.

For adults who need a hip or other orthopaedic procedure, there is a waiting list of 171 in the Mater Hospital Dublin, with 29 in the queue for over a year.

Meanwhile, 867 are waiting in St James's Hospital for the same treatment, with 339 in the queue for at least a year.

University Hospital Sligo has 484 patients waiting for an orthopaedic operation, with 196 people waiting over a year.

Tullamore Hospital in Co Offaly, has a bigger queue of orthopaedic 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, as TDs were told of the suffering heaped on children.

Taoiseach Micheál Martin said delays in treatment for children with conditions such as spina bifida and scoliosis were "not acceptable", but he insisted it was not a matter of funding.

In relation to general surgery, involving operations for the gallbladder, hernia, varicose veins and other conditions, the numbers of patients with waits of at least a year vary from 225 in St Vincent's Hospital Dublin, 377 in St James's Hospital and 502 in Galway University Hospital.

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The failure to attract enough specialists has been pinpointed as a core reason for waiting lists by the Irish Medical Organisation and the Irish Hospital Consultants Association.

However, the differing figures across hospitals are also influenced by a legacy of underfunding and lack of beds, lack of specialist nurses and staff redeployment to Covid care.

Also playing a part is inadequate step-down facilities for medically fit patients, emergency department overcrowding and the inability to farm out less complex cases to neighbouring facilities.

Covid-19 impacted the hearts of some patients and there are 3,518 people waiting for cardiac procedures, but there are variations here also.

St James's Hospital, Dublin, has an inpatient and day-case cardiology list of 810, with 181 waiting more than a year.

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

Cardiologist Dr Angie Brown said the pandemic impacted negatively on many cardiac patients, leading to cancelled outpatient appointments, investigations and surgeries, as well as patients' reluctance to come to hospital.

"During the pandemic, many health professionals and particularly nurses were redeployed, for instance, from heart failure clinics," said Dr Brown, medical director of the Irish Heart Foundation.

Some appointments were done online but "for many, the lack of a face-to-face review has been problematic and for some patients this has led to a deterioration in their health".

Differences are also seen in the area of ophthalmology care, including cataract surgery. The Mater Hospital has 274 patients waiting over a year compared with 417 in Waterford University Hospital.

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

Professor Francis Finucane, consultant endocrinologist in Galway, said that before the pandemic, the list of bariatric patients with obesity who needed care was 400, with a wait of around a year. That has now risen to 900 and the delay has extended to two years.

"Some patients are waiting up to four years for an endocrine assessment, which involves hormone-related disease," he said. "We need to have better resources and look at how we do things to improve efficiency."

Meanwhile, the crisis in orthopaedic lists for children continues as desperate parents of young patients with scoliosis and spina bifida go public.

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

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

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