'Urgent action' needed on hospital waiting times in NI and Republic

Both systems face shortages in key workforce areas and long waits for treatment

Urgent action is required to tackle hospital waiting times on both sides of the Irish border, according to the Economic and Social Research Institute (ESRI).

A report into the primary healthcare systems of Ireland and Northern Ireland found that both jurisdictions are experiencing similar problems.

These include workforce shortages and increasing expenditure.

On hospital waiting times the problem is worse in Northern Ireland.

The proportion of people on the waiting list in Northern Ireland for more than one year increased from 20% to 60%.

In the Republic of Ireland, during the same period between 2017 and 2021, the figure increased from 12% to 20%.

• NI health service 'still reeling from pandemic'

• Swann apologises for long hospital waiting lists

A key distinction between the healthcare systems is the absence of a universal healthcare system in Ireland, write the authors.

That means in Northern Ireland, all residents are entitled to a wide range of free health care services, while in Ireland, the majority pay to see their GP and for other services.

But despite this key difference, both systems are currently facing similar challenges, including shortages in key areas of the workforce and long waits for a range of healthcare services.

Limited collaboration

Cross-border collaboration in healthcare across the island is an interesting but contentious issue.

At present, according to the ESRI report, that work is relatively limited.

It points to a 2011 report which identified the potential benefits to be gained from increased co-operation in healthcare including collaboration in cystic fibrosis, ear, nose and throat surgery, paediatric cardiac surgery and acute mental health services.

However, this 2022 report concludes that despite some notable exceptions such as the Congenital Heart Disease Network and the North West Cancer Centre at Altnagelvin Hospital in Londonderry, "collaboration has been relatively limited".

When it comes to life expectancy and infant mortality, Ireland has experienced greater improvements than Northern Ireland in recent years.

There are also lower rates of some chronic conditions in Ireland.

While the reasons are not entirely clear, the report said this could reflect an increased likelihood among those in Northern Ireland to be diagnosed or to report particular health conditions.

Limited analysis

Lead author, Dr Sheelah Connolly, said similarities and differences between the two jurisdictions provided an opportunity to examine how different systems and policies influence outcomes.

Cross-border collaboration on healthcare provision has been limited, says the report

"The analysis carried out for this shared island research suggests that there have been improvements in population health indicators in Ireland in recent years, which have not been experienced to the same extent in Northern Ireland," she said.

"Further research should be undertaken to understand the reasons for these differences as this may provide evidence on how to improve population health."

Other findings include that for both socio-economic and health status, one system does not consistently do better than the other.

However, the report found that for some population health measures, including life expectancy and infant mortality, in recent years, Ireland has performed better than Northern Ireland.

The report concludes that the lack of comparable data on healthcare system indicators across Ireland and Northern Ireland significantly limits the type of analysis that could be undertaken.

For greater cross-border co-operation on health policy and planning, there would have to be significant changes in the way data was collected and shared, the report found.

Funding plans

In Northern Ireland, the Stormont draft budget, which was announced in December, proposed a 10% increase in health funding with an emphasis on tackling waiting lists.

However, BBC News NI understands ministers received legal advice that they cannot pass a budget in the absence of an executive following the resignation of the Democratic Unionist Party's Paul Givan in February.

Mr Givan had previously said he supported an increase in health funding, however, he accused the budget paper of lacking a detailed plan on transforming the health service.

Last month, the Irish government announced a €350m (£292m) plan to cut waiting times by the end of 2022.

It aims to reduce numbers by 18% by offering treatment to 1.7m people by the end of the year.

About €100m (£83m) of the money had previously been allocated to the National Treatment Purchase Fund (NTPF) for this year.