The health topics at the heart of the General Election

The health service is always a key topic in any general election, but not usually top of the list of concerns for people.

That appears to be the same case as the 2024 General Election campaign is under way.

Health matters to people - it affects every person and family in some way. So, it is a highly politically sensitive area.

The health topics of concern during this election campaign are likely to be familiar ones, hospital overcrowding, waiting lists plus staffing and service capacity.

Overcrowding

While hospital overcrowding continues on a daily basis, it has reduced somewhat. Each day, there are still several hundred patients waiting for admission to a bed.

Latest figures from the Irish Nurses & Midwives Organisation put the number of patients waiting for admission to a bed last month at 10,515 people. That compares with 10,538 for October last year, according to its own figures. The HSE figures show reduced levels of overcrowding also.

Of course, we have yet to enter the really testing period of December and January. Those will be the months that will show if the trend remains downwards. As with waiting lists, health officials often emphasise that the focus should be how long patients are waiting in emergency departments rather than the numbers.

Undoubtedly, during the election there will be a lot of attention on University Hospital Limerick and its particular well-documented difficulties. There is a review looking at whether a second emergency department is needed for the region and that will be a hot topic during the election campaign.

Waiting lists

Over 844,000 people are waiting for some kind of hospital care. The vast majority of these - over 595,000 - are waiting to be seen at an outpatient clinic by a consultant for the first time.

The Government has pointed to a reduction in the length of time people are waiting to be seen at an outpatient clinic and say length of time is where the focus should be, rather on the overall numbers.

An increased number of patients are also being treated.

A key issue that will undoubtedly come to the fore again during the election is scoliosis waiting lists. According to Children's Health Ireland, there were 249 patients on the spinal surgery waiting list at the end of September.

There were 11 children waiting 18 to 24 months and over seven waiting 24 to 48 months. Scoliosis waiting lists are a high-profile issue and politicians are all too aware of it.

A Paediatric Spinal Taskforce was set up earlier this year. Plans were announced for suitable children to get care in the US and UK so that the lists can be reduced. But it is clearly going to take quite some time. High-profile cases of children waiting, including those in pain, for crucial spinal surgery, will be a challenge for the Government to respond to.

Staffing

There are over 130,000 staff in the HSE. But doctors and nurses say that capacity needs to be increased further. Health unions have also expressed concern about the HSE's Pay and Numbers Strategy and how it may affect the recruitment of extra staff.

Health unions have also been holding lunchtime protests over staffing and this will be a pressure point during the general election campaign. Industrial action also looms.

The Department of Health has said an extra 1,729 staff have been hired to date this year by the HSE, including 1,338 nurses and midwives.

By August 2024, it said there were 27,901 more staff working in the health service than there were at the beginning of 2020.

HSE chief Bernard Gloster has pointed out that the health service has never had as many staff or as much money.

GPs

The number of people with medical cards, or GP Visit cards has increased in recent years. Plus, free GP care is available for children under 8. These developments have increased pressure on family doctors and the workload pressures have added to waiting times for patients.

Many GP s have closed their lists to new patients.

Patients can find it difficult to get a GP in good time and there can be a long wait for routine appointments. Rural areas are under particular pressure to serve their populations and fill posts when GPs retire.

While the Irish population has expanded, the number of GPs fell between 2019 and 2022 to 4,420. Doctors report overwork and burnout.

There are Government initiatives to increase GP training places and measures to have more international medical graduates work here. The HSE has also set up a Task Force on GP strategy. But improving the situation will take time.

New Children's Hospital

The issue of the new National Children's Hospital remains on the agenda following cost overruns and multiple delays in securing an official opening date. General election campaigns will always focus on the prudent use of taxpayer's money. No one can yet say when the facility will open and how much it will finally cost.

It has become an ugly blame game as the public have watched battles between the builders BAM and the National Paediatric Hospital Development Board, which was set up to design, build and equip the new facility.

The current estimates suggest it will cost more than €2.5 billion and may not open to the first patients until 2026.

Planning permission was first granted in 2016, and the original cost of the project was €650m.

The current Government has been facing sustained criticism from opposition parties on how it has allowed the project to go so awry. Delivering on major public projects on time and within budget is important for the perception of sound economic management.

Political agreement

The development of the health service is largely driven by the Sláintecare Plan, which was an all-party Oireachtas Committee report published in May 2017.

So, the direction of travel for the 10-year plan was largely agreed among the political parties.

During the election campaign, various parties may have a different emphasis on what should be prioritised and progressed faster, and where funds should go, but overall health policy is largely settled.