Need to reduce orthopaedic waiting lists – Smith

I have repeatedly called for additional orthopaedic capacity to reduce waiting lists. Patients, in areas such as Cavan/Monaghan, in many instances have to wait far too long to have necessary assessments and follow up treatment carried out.

Further progress is needed in reducing waiting times.

Below reply to Parliamentary Questions I tabled to the Minister for Health –

For Oral Answer on : 13/07/2021
Question Number(s): 123,128 Question Reference(s): 28577/21, 28578/21
Department: Health
Asked by: Brendan Smith T.D.


* To ask the Minister for Health if additional orthopaedic capacity will be provided in 2021 to reduce waiting lists; and if he will make a statement on the matter.

– Brendan Smith T.D.

For ORAL answer on Tuesday, 13 July, 2021.

* To ask the Minister for Health if additional orthopaedic capacity will be provided at an early date in view of increasing waiting lists for adult and paediatric orthopaedic surgery; and if he will make a statement on the matter.

– Brendan Smith T.D.

For ORAL answer on Tuesday, 13 July, 2021.


(See attached file: NTPF OP and IPDC Orthopaedic Initiatives.xlsx)(See attached file: Orthopaedics_IPDC and OPD Waiting Lists.xlsx)
It is recognised that waiting times for scheduled appointments and procedures have been impacted in the last sixteen months as a direct result of the COVID-19 pandemic and more recently as a result of the ransomware attack.

While significant progress was made in reducing waiting times from June 2020 onwards, the surge in Covid-19 cases in the first quarter of 2021, and the resultant curtailment of acute hospital services, is reflected in the most recently available waiting list figures to 13th May 2021.

On 23 March 2021 the HSE published the “Safe Return to Health Services Plan”, outlining a three phased approach for the proposed restoration of services across Community Services, Acute Hospital Operations, Cancer Services and Screening Services. It sets target times for their safe return and details the conditions and challenges that will have to be met. However, the implementation of this plan has been suspended pending the resolution of the recent ransomware attack, which had a significant impact on acute hospitals.  

The HSE has been working since 14th May last to recover the effects of the cyber attack on its systems. The HSE advise that at present most systems are operational and services are returning to normal activity. There is a challenge in back entering data and there are still a number of areas of ongoing concern. The HSE was already seeking to recover from the Covid peak in the first quarter of this year and the ransomware attack has delayed this and had the effect of increasing access delays for services. My Department  does not have full access to information on the impact of this ransomware attack on elective waiting lists but will provide an update as soon as one is available.

Due to the ongoing IT issues triggered by the HSE cyber-attack, the National Treatment Purchase Fund (NTPF) has been unable to receive weekly national hospital waiting list data or downloads. The latest published waiting list information was collated by the NTPF on 13th May 2021

At the 13th of May 2021, nationwide there were 11,073 patients waiting for an adult or child orthopaedic IPDC procedure, a reduction of 19% (-2,569) compared to the same period last year. At the 13th May 2021 there were 75,799 waiting for a first outpatient appointment across all hospital groups, an increase of 6% (+4,379) compared to the same period last year.

Specifically in terms of hip and knee replacements, the NTPF have advised the Department that at the end of May 2020 there were 3,042 patients waiting for such a procedure. Through focused activity, and with the support of the NTPF, at the 13th May 2021 this figure had fallen by 26 % to 2,256 patients.

The NTPF have advised that they have provided funding for a number of Insourcing initiatives to reduce Orthopaedic waiting lists in 2021, which will see 15,385 patients receive appointments and procedures. Details of these initiatives are outlined in the attached document.

An additional €240 million has been provided in Budget 2021 for an access to care fund, €210m of which has been allocated to the HSE and a further €30m to the NTPF. This is to be used to fund additional capacity to address the shortfall arising as a result of infection control measures taken in the context of COVID-19, as well as addressing backlogs in waiting lists.

My Department, the HSE and the NTPF are currently working on a Multiannual Waiting List Plan to address waiting lists and bring them in line with Sláintecare targets over the coming years.