Hospital consultants have warned that it may take up to a decade to clear existing hospital waiting lists after the latest figures showed an increase.
Data for March, published by the National Treatment Purchase Fund (NTPF) on Friday, shows there were just over 463,000 people waiting outside 10- and 12-week Sláintecare targets. About half that number were within target waiting times.
The Department of Health said progress was being made in addressing long wait times, with a 3 per cent drop in numbers waiting outside its targets compared to the previous month.
Overall, since the pandemic peaks, it said there has been a 26 per cent reduction in the number of people waiting longer than the Sláintecare targets, which equates to approximately 164,000 people.
“Despite the significant challenges from the aftermath of the Covid-19 pandemic, emergency department pressures and other operational factors, including recruitment, our hospitals have delivered improvements which are making a real difference to patients,” the department said in a statement.
“Many individual hospitals have delivered impressive reductions in both their waiting lists and waiting times. The HSE is currently working to replicate this positive performance across the entire hospital system.”
However, the Irish Hospital Consultants’ Association (IHCA) pointed to an increase of more than 24,000, or 4 per cent, in the three main waiting lists for hospital appointments and treatments in the first three months of 2024 alone.
The department’s €437 million action plan for this year has set a target to reduce waiting lists for outpatient appointments and inpatient and day case treatment and procedures by 39,300, or 6 per cent, by the end of December compared with the number waiting at the start of the year.
This is an increase on the 3 per cent reduction achieved last year, and the Government says there is a targeted 10 per cent reduction in the number of patients breaching the Sláintecare time targets.
The IHCA said similar action plans in 2022 and last year had set ambitious reduction targets of 18 per cent and 10 per cent, but only cut waiting lists by 4 per cent and 3 per cent respectively.
Prof Gabrielle Colleran, the association’s vice-president, said a new waiting list action plan, published by the department two weeks ago, has “already fallen at the first hurdle”.
“While we welcome any funding which aims to cut these unacceptably long waiting lists and allow patients access to the care they require, perhaps it is time the Government takes a different approach, if it is doing the same thing over and over again and still expecting to get different results,” she said.
“The NTPF figures released today confirm Consultants’ grave concerns that these waiting lists may take a decade or more to get under control unless the opening of long-promised additional hospital capacity is fast-tracked by the Government, and simultaneously the one in five Consultant posts vacant or filled on a temporary basis are permanently filled.”
Sinn Féin’s health spokesman David Cullinane TD also expressed concern that waiting lists were going in the wrong direction.
“The Minister for Health’s waiting list plans have failed to make a dent in hospital waiting lists. The truth is the Minister can publish as many plans as he wants, but without adequate funding to increase capacity they are just meaningless words on paper,” he said.
Mr Cullinane said a recruitment embargo was biting hard, and lack of funding for new measures is holding the health service back.
“To properly and sustainably tackle waiting lists, the recruitment embargo should be lifted and the Government should fund the 1,500 rapid build beds that are needed. These are crucial to reducing waiting lists at pace and with ambition,” he said.
A leading Chinese investment bank has amplified calls for Beijing to bolster fiscal support to consumers and businesses, citing a relative gulf in effect for pandemic-era stimulative actions taken by China and the United States.
“The US had bigger fiscal expansion during the Covid years. China needs to crank up fiscal support in the near term to break the vicious spiral as weak economic fundamentals and weak confidence are feeding off each other,” said Kevin Liu, a managing director of CICC Research.
“More fiscal support can encourage consumers and the private sector to invest and expand,” he wrote.
Lawmakers will convene in the Chinese capital next week to review the year’s policy agenda and national economic targets.
Both China and the US engaged in monetary loosening during the Covid years, although they are presently in different cycles.
China’s M2 money supply – an aggregate value of a country’s liquid assets, including currency in circulation and private banking deposits – had double-digit growth for most of the last two years, CICC said, but it failed to disperse deflationary threats and jump-start private investment, as much of the money was in credit and loans.
More fiscal support the catalyst to revive China consumption, housing market
More fiscal support the catalyst to revive China consumption, housing market
In contrast, the US’ M2 supply was trimmed by about US$500 billion last year to tame inflation. However, the bank said, its economy still fared better, maintaining strong demand and consolidating its lead over China in terms of economic size.
“In the US, money reached people’s hands, while in China, the money [came] from banks and ultimately flows back to banks,” said the CICC report.
CICC added that much of the 42.6 trillion yuan in new loans disbursed for businesses between 2020 and 2023 did not help spur the country’s economic recovery, as they became deposits or were otherwise used to service old debts.
Credit support, compared to direct fiscal disbursement – which, per CICC, carries “almost zero cost” to revive consumption and investment – was designated as an option which generated additional costs and inefficiencies, as businesses tended toward lukewarm responses.
“In China, credit support becoming bank deposits suggested low investment return and tepid credit demand, and fiscal support remained inadequate,” the bank said.
When the private sector is unwilling or unable to expand, the CICC report estimated, the central government needs an additional leveraging of 5 to 6 trillion yuan in the first half of 2024. The bank said such an approach is necessary to bring up the “fiscal pulse”, a measure of the changing impact of the budget on the economy, to 4 per cent from its current three-year low.
China’s plan to grow economy with infrastructure is self-contradictory: analyst
China’s plan to grow economy with infrastructure is self-contradictory: analyst
Several economists and policy advisers have already issued recommendations for direct fiscal backing.
Yao Yang, director of Peking University’s National Development School, has for years suggested direct cash allowances for low-income residents.
“The most effective way to encourage consumption is to issue cash [coupons],” he told Chinese media outlet Yicai.
“A one-dollar cash coupon will multiply to three to five dollars of spending.”
Segun Idowu, the city’s chief of economic opportunity and inclusion, said in an interview that the new research consultants will help the city streamline the process and study how Black Bostonians have been impacted by slave-trade policies, from 1620 through today.
“There is no roadmap for reparations, but the fact that … there’s a clear path forward is monumental work,” Idowu said. The research will help guide “an open dialogue with the community to better understand people’s sentiments and the direction reparations needs to go.”
The city tapped the research team behind the African American Trail Project at Tufts University and historians at the Royall House and Slave Quarters in Medford to study Boston’s role in the trans-Atlantic slave trade and its overarching influence during the time from 1620 to 1940.
Separately, a cohort of Northeastern University scholars will research slavery’s longstanding legacy through inequality within the Boston Public Schools, Boston Police Department, Boston Fire Department, and Boston Housing Authority in the era after 1940.
The city has set aside $500,000 for the research, using federal COVID-19 relief funds and also city funds, and the work will be used for a detailed report on a reparations program in Boston.
A little-known poll by the Health Equity Compact and MassINC last spring showed that three out of every four Black respondents supported monetary reparations to address racial health disparities and other inequities, and so did two-thirds of Latino respondents. Half of Asian respondents in the poll said they support reparations, while only 40 percent of white respondents did — 44 percent said they opposed reparations.
The work on reparations in Boston follows efforts at the community level as well as in other municipalities and at the State House to explore how Massachusetts can reckon with its past, part of a nationwide movement to recognize and make reparations for the impact of the slave trade. Advocates in other states such as California, New York, and Illinois have been leading the effort, and created commissions in those states through new laws. Officials in Evanston, Ill.have also expanded that city’s first-in-the-nation direct-cash reparations program.
But in Massachusetts, the effort has moved at a far slower pace. Last year, state Senator Liz Miranda of Dorchester filed legislation that would create a Massachusetts reparations study commission. She also proposed creating a reparations fund using a portion of excise taxes imposed on “specified applicable educational institutions.” The Legislature’s joint judiciary committee held a hearing on the legislation in early December, though no action has been taken since.
In Cambridge, the City Council agreed in December by a unanimous vote to create an American Freedmen Commission, whose members would be paid to investigate how racist policies have harmed descendants of American chattel slavery. The commission is the first in the nation to focus specifically on descendants of slavery. However, the city has yet to name any of the commissioners, and no work has begun.
And Harvard University, through its Legacy of Slavery initiative, recently solicited proposals for solutions that would affect people harmed by slavery. But no work has begun.
Meanwhile, 40 community members in Boston, frustrated with the lack of progress by the city’s task force, formed their own, an independent, grass-roots effort to weigh reparations in the city. The commission is organized by the New Democracy Coalition, which has led efforts to rename Faneuil Hall and has pushed the city to issue a formal apology for its role in the trans-Atlantic slave trade.
“As the city of Boston moves forward exploring reparations for those affected by lack of opportunity and systemic racism, all voices need to be heard,” the group wrote in a press release.
The city’s task force has encountered several disruptions since it was first formed. Two of its original 10 members have stepped down, citing time constraints, and the vacancies have gone unfilled. (One of the members to step down is Kerri Greenidge, one of the Tufts scholars selected to study slavery’s legacy in Boston from 1620 to 1940.)
Moreover, a part-time project coordinator for the task force was fired in May, after trespassing into City Hall offices after hours several times and resisting arrest.
David Harris, a former task force member and former managing director of the Charles Hamilton Houston Institute for Race and Justice at Harvard Law School, said the task force’s earliest moments were tedious, with many logistical issues to work out and limited consensus on how repair would be defined. But he insists the work was necessary.
“It’s taken a year to get where we are today. … There were growing pains,” he said. “The city’s process might be cumbersome to some, but it’s sound.”
Harris said the research consultants can help “yield a piece in the puzzle for conversations about reparations in Boston.”
But, Harris added, “The hard work will be around what reparations could look like.”
The task force sought proposals from consultants on how to shape the research; the request for proposals specifically asked applicants to study wrongs committed against African Americans over six time periods, from 1620 to today. At least five consultants submitted proposals, according to a Globe review.
The proposals reflect the varying definitions of reparations, and who exactly could qualify, a topic that became a central and divisive question in the five public meetings the task force held since last spring. At times, the meetings were tense, with attendees debating who exactly should receive compensation for past wrongs.
An attendee at one meeting decried the racist policies that all Black Bostonians, whether they descended from American chattel slavery or not, had borne for generations. Another told the crowd that Black people who came to the United States on their own from Caribbean islands should seek to settle their claims with their home countries.
The divides among community members show the challenges that the task force will face in identifying who will qualify for any reparations. But Harris, the former task force member, said that however Boston proceeds, the city must incorporate all community perspectives.
”Whatever happens, it’s going to be in the name of the city as a whole,” Harris said.
Tiana Woodard is a Report for America corps member covering Black neighborhoods. She can be reached at tiana.woodard@globe.com. Follow her @tianarochon.