Hospital waiting lists in Northern Ireland over twice as long as in Republic, research shows

Figures underline extent of health service crisis in North, which is struggling with budgetary pressures and has no minister for health due to Stormont suspension

Hospital waiting lists in Northern Ireland are twice as long as those in the Republic of Ireland, according to research by the Department of Health.

Just more than 281,000 people per million are on a waiting list for appointments (inpatient and outpatient) in the North, compared to 138,000 per million in the South.

The disparity is even greater among those who have waited more than 12 months for an appointment, with 140,000 people per million on the list in Northern Ireland, four times as many as the 30,000 waiting in the Republic.

The analysis paper, provided to The Irish Times following a Freedom of Information request, reveals a stark gap between the size of waiting lists on either side of the Border.


It underlines the extent of the waiting list crisis facing the Northern health service, which is struggling with budgetary and other pressures and has no minister for health due to the ongoing suspension of the political institutions at Stormont.

It is also highly relevant to the conversation around Irish unity, where the nature of healthcare provision is a key debate and could influence how people vote, particularly in Northern Ireland where there is a long-standing attachment to the NHS.

The September 2023 report by the department analysed north-south and east-west waiting list trends according to inpatient/day cases and outpatients.

It was based on official data published by the Department of Health in Northern Ireland and by the National Treatment Purchase Fund in the Republic, and provides breakdowns according to inpatient/day case and outpatient waiting lists, as well as the overall figures.

In Northern Ireland more than a quarter of the population is on a waiting list, a figure substantially greater than in Britain or the Republic, where last year waiting lists fell for the first time since 2015.

According to the report, the number of patients waiting for an inpatient/day case appointment in Northern Ireland – 119,095 as at June 2023 – exceeded the number on the same waiting list in the Republic of Ireland, even though it has a much larger population of five million, compared to 1.9 million.

Compared to one another per million of population, the Northern figure for inpatient/day case appointments was three times greater than that in the South.

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The number of people per million on the waiting list south of the Border – 21,408 – was lower than in any of the UK nations.

The disparity increases when comparing those who have been waiting for an inpatient/day case appointment for more than 12 months, with 11 times as many people per million – 33,027 compared to 3,015 – on the list in the North compared to the South.

As has consistently been the case, Northern Ireland also performed worst in the UK and Ireland in terms of the wait for outpatient appointments.

Approximately 100,000 more people per million are waiting for an outpatient appointment in the North compared to the South, despite Northern Ireland’s lower population.

North of the Border, more than four times as many people per million – 107,022 compared to 27,427 – are waiting more than 12 months, compared to the figure in the South.

Polling carried out in 2022 by The Irish Times and ARINS – a joint research project of the Royal Irish Academy and the University of Notre Dame – showed that 50 per cent of Northerners were more likely to vote for a united Ireland if it were to adopt a NHS-style healthcare system, but 45 per cent would be less likely to vote for it there was a Southern-style system.

Freya McClements

Freya McClements

Freya McClements is Northern Editor of The Irish Times