Cancer potentially being missed as 77,000 wait for ENT appointments

The overall waiting lists for ENT show more than 20,000 additional people compared to 2015.

Cancer cases are potentially being missed among the 77,000 people waiting for ear, nose and throat care, hospital consultants have warned.

Analysis of waiting lists to see a consultant or receive treatment by the Irish Hospital Consultants Association (IHCA) shows these patients are among the worst affected of any group.

“One of the biggest concerns is the potential for missed cancer diagnoses,” warned ear, nose and throat (ENT) surgeon Dr Mary Bresnihan.

“People with voice or throat issues, for example, who may not seem urgent initially, could in fact be presenting with symptoms of a tumour that, without the chance for investigation or assessment, risk going undiagnosed while they sit on a waiting list deemed ‘non-essential',” she said.

Dr Bresnihan said tonsillectomies and other illnesses which are common in children could be managed with a day procedure if seen on time in many cases.

The analysis found 57% waiting longer than a year to see a consultant or receive treatment. In the last six years, the number of those waiting longer than 12 months to see a doctor has gone up by more than 29,000.

The overall waiting lists for ENT show more than 20,000 additional people compared to 2015.

“Ongoing severe consultant shortages mean that some people are waiting up to five years to be seen by an ENT specialist,” the analysis found.

Dr Bresnihan, an ENT surgeon with the Saolta Hospital Group working in Sligo and Letterkenny hospitals and speaking for the IHCA, said the lists are “our biggest challenge”. 

She said: “You sit on a waiting list for to be seen in outpatients, and then you may sit on a further waiting list for surgery if needed.” 

These patients are disadvantaged by being seen as non-urgent, meaning they are frequently bumped off surgery slots when an emergency case arrives, she said.

Dr Bresnihan warned that for children this could mean their development or education is set back. The surgeon called for “protected beds” to be staffed for ENT surgeries which could not be used by emergency cases, saying this would decrease cancellations.

If more day-beds were provided and staffed with the appropriate number of nurses, this would have a “huge impact” on the lists, she said.

“People are getting worse while they’re sitting on these lists, to the point where we can no longer reverse the problems like we could have if they had been operated on in a timely manner,” she said.

The IHCA also link the delays to staff shortages, saying one in five hospital doctor roles are not filled on a permanent basis.

Dr Bresnihan said there were 7,000 people on waiting lists for Letterkenny and Sligo hospitals alone, but just four ENT consultants.

“It’s an impossible task,” she said.

The IHCA called for the consultant contract discussions to deliver on the "unambiguous commitment" made by the minister for health to resolve the pay inequity issue which sees consultants hired after 2012 paid on a lower rate than their colleagues.