Dysfunctionality writ large with one in eight people waiting for access to a public hospital

Health system faces new pressures due to industrial action

The mess that is the State’s public hospital system continues its downward spiral. Early next month patients who have already suffered because of cancelled operations must now face the effects of double industrial action by nurses and hospital support staff. And those on waiting lists for a first appointment will have their waiting times extended.

One in eight people in the Republic are now waiting for access to a public hospital. The recent discovery of “shadow” waiting lists – meaning that in reality there are at least 630,000 patients waiting for either a consultant appointment or a date for admission for treatment – has further eroded public confidence.

In truth even these revised figures are inaccurate. The only correct way to measure waiting times in a health service is from the moment a family doctor refers a patient to secondary care to the time they are assessed or treated in hospital. Our antiquated health service IT systems cannot accurately record this data. However that does not excuse the creation of hidden “proxy” lists with the data that is available.

The fallout from these revelations and a media spotlight on the avoidable suffering of patients with scoliosis saw the Minister for Health and the Health Service Executive (HSE) turning on each other.


Simon Harris has threatened to sanction underperforming HSE managers, something his predecessor, Leo Varadkar failed to do. If the current Minister believes he has evidence of poor managerial performance, political credibility demands he must act.

The HSE appears incapable of providing a fair and evenly distributed basic system of healthcare with the substantial resources it has available to it. The organisation’s fundamental problem is one of a poor management culture that fails to put the patient first.

Sanctioning – and even sacking – underperforming managers is a small but essential first step in tackling this cultural deficit. And while the system needs additional capital resources, it would be folly to invest further money in a continually dysfunctional HSE.