At the beginning of this year, Minister for Health Stephen Donnelly spoke about Ireland’s health system – stating things were “getting better, but we have a long way to go” in terms of improving services. It has been a year of criticisms and concerns, innovations and public health initiatives. Here’s a round up of some of the biggest health stories that dominated headlines throughout the year.
At the start of the year, as is the case every year, the number of people on trolleys was a hot topic, due to the spread of respiratory illnesses such as influenza and Covid-19. This year, however, the focus was on staffing – another area that raises its head regularly. At the end of 2023, the Health Service Executive (HSE) announced it was introducing a moratorium on recruitment for a number of post types due to budget overruns.
In January, The Irish Times reported on internal concerns in the health service that continuing the recruitment moratorium throughout the year would result in increased waiting times for patients, demoralising staff and providing poor value for public money.
The executive’s service plan announced methods it would use to reduce overruns, including a reduction of €275 million in pay costs as well as a reorganisation of senior management executives in order to reduce the number of top managers in the organisation.
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That same month came the landmark final report from the Citizens’ Assembly on drug use. Under its central recommendation, the State would respond to drug use and misuse primarily as a public health issue rather than as a criminal justice issue.
“While possession of controlled drugs would remain illegal, people found in possession of illicit drugs for personal use would be afforded, first and foremost, extensive opportunities to engage voluntarily with health-led services,” the report said.
Changes were a feature in the Department of Health in February when the then chief medical officer, Prof Breda Smyth, announced she was resigning from the role, 18 months after taking it up.
[ Chief medical officer Prof Breda Smyth to leave roleOpens in new window ]
Her resignation was another in a lengthy list, with the department having seen an exodus of senior staff in the aftermath of the Covid-19 pandemic. In the months before her resignation, Prof Smyth raised concerns about the workload within her office, due to a number of consistent vacancies at deputy chief medical officer level.
Prof Mary Horgan was appointed to the role on an interim basis in June 2024 by Stephen Donnelly.
A story that affected many countries around the world was an uptick in cases of measles. The news of a man dying from the disease in February resulted in concerns about the possibility of widespread transmission within the State. As a result, the Government announced plans for an urgent catch-up vaccination programme for the MMR (measles, mumps and rubella) jab for young adults.
But it wasn’t just the MMR vaccine people were seeking. Diabetes and obesity medications, such as Ozempic, skyrocketed in popularity as celebrities showed the significant impact they could have on weight loss.
But there are strict clinical guidelines to receive a prescription for one of these medications, leading to a surge in black market demand. The Health Products Regulatory Authority (HPRA) reported a significant rise in illegally obtained or falsified versions of the drugs being seized as people sought to obtain the jabs to help them lose weight.
Productivity is an issue both the Minister and the HSE have spoken about ad nauseam. The topic came to the fore in April when a significant report from the Irish Government Economic Evaluation Service and the Department of Health found large increases in healthcare funding and staffing in recent years had not been matched by similar activity in Ireland’s hospitals.
The public-only consultant contract was introduced in March 2023 in a bid to increase senior decision-makers on site on evenings and weekends. But senior HSE officials brought up the issue of productivity once again in April when they wrote to hospital chiefs highlighting the uptake of the contract, but stating there was not an equal increase in working seen at evenings and weekends.
This need for senior healthcare staff available outside of typical working hours was illustrated most acutely through a story that permeated health news throughout the year: the death of Aoife Johnston. Ms Johnston (16) died in University Hospital Limerick (UHL) in December 2022 after waiting more than 13 hours for antibiotics to treat suspected sepsis.
The inquest into her death, held in April, heard from clinicians and healthcare staff who described the conditions at the hospital. Over four days of evidence at Limerick Coroner’s Court, the same descriptors were used for the hospital’s severely overcrowded emergency department: “chaotic”; “unprecedented”; “like a war zone”.
Soon after the inquest concluded, which made a finding of death by medical misadventure, the Department of Health announced it was requesting the Health Information and Quality Authority to conduct a review into the need for a second emergency department in the midwest region to ensure capacity is sufficient to meet the needs of the population in the area.
Capacity is a topic that comes up time and time again, often touted as the biggest risk to patient safety. Too few beds means overcrowding and overrun staff. In May, Stephen Donnelly and Minister for Public Expenditure Paschal Donohoe announced the provision of almost 3,000 new inpatient hospital beds to be delivered by 2031. Though capacity has already increased in recent years, there remains a shortfall between what is available and the demand, resulting in overcrowding.
These beds – the majority of which are as yet unfunded – are in addition to the 1,015 hospital beds under construction or already committed, bringing the total number of new hospital beds to 4,367 in the next eight years.
The need for new beds has been well flagged. So too, has the need for electronic patient health records, which have now been promised in the new digital framework announced during the summer. Under the framework, there will be a roll-out of electronic health records, a patient mobile phone app and increased telemedicine.
This is a significant step forward for the State’s digital healthcare offering, an area in which it has traditionally been viewed as a laggard.
But being innovative and moving forward has a price tag. And finances, or, to be more specific, staying within a budget, is something the HSE has traditionally struggled with.
In Budget 2024, Bernard Gloster, chief executive of the HSE, raised concerns that funds allocated to the health service would be insufficient. In July last, his concerns were proven to be true.
The Government agreed to provide an additional €1.5 billion in health funding in 2024 and to allocate a further €1.2 billion in 2025 to maintain existing levels of services.
It was this month, also, when the freeze on recruitment was lifted, though many of the unions argue that the way in which recruitment is restricted means, in essence, a freeze remains in place.
In July, the HSE announced that an annual review into baby and maternal deaths would begin, in a bid to learn from the deaths and improve maternity services. Campaigners and families have long called for such a review. The HSE will look at the years 2021 to 2023, before adding annual data going forward.
[ Review into baby and maternal deaths will begin this year, HSE confirmsOpens in new window ]
That same month, the free contraception scheme was expanded to 32- to 35-year-olds, having previously only been available to those aged 31 and younger. This was a big step for women in their 30s, many of whom felt the initial age cut off was unfair, though the Department and Minister had always indicated they would scale up the scheme.
One story that feels ever-present in the health news cycle is the new National Children’s Hospital. This year, the public learned the cost of the project would now be €2.2 billion, significantly higher than the original estimated cost of €800 million in 2014.
Later in the year, Bam, the main contractor, informed the National Paediatric Hospital Development Board (NPHDB), the body overseeing the project, that it would once again not meet the substantial completion date for the project.
[ BAM begins High Court proceedings against board of national children’s hospitalOpens in new window ]
This made it the 14th target date that would not be reached, according to the NPHDB, with the current substantial completion date to be June 2025.
Families and parents have long raised concerns about the length of time children with scoliosis and spina bifida wait for life-changing surgery.
Following months of negotiations, the Department of Health announced some children would be able to undergo their surgery in the UK and the US in a bid to reduce waiting times and lists in the State.
The issue of UHL raised its head again in September, following the publication of Frank Clarke’s independent report on the death of Ms Johnston. The report concluded that her death was “almost certainly avoidable”.
A second report was published on UHL at this time, conducted by a review team led by Grace Rothwell, who spent four weeks examining the hospital in a bid to tackle overcrowding. The report made a number of recommendations, concluding it is “unclear” who is operationally in charge of the healthcare facility on any given day.
There were reports aplenty in the latter half of the year. The Department of Health published an expert report on medical negligence costs, which show the estimated €5 billion due in wider negligence payouts could escalate by multiples unless changes are made.
But there has been good news in the health service, too. Hormone replacement therapy will be made freely available to those who need it. The scheme, which will come into effect in January, will ease the financial burden on women experiencing debilitating symptoms of menopause.
[ Free HRT to be available from next January under Cabinet plansOpens in new window ]
In Budget 2025, further good news emerged for individuals struggling to conceive. Free in-vitro fertilisation, made available in the previous year’s budget, will now be expanded to include donor-assisted IVF and to assist couples experiencing “secondary infertility”, which is when couples have an existing child but are having fertility issues.
Children’s Health Ireland (CHI), which operates paediatric medicine in the State, faced criticism throughout the year with regard to scoliosis surgeries, management and preparedness for the new hospital. It was dealt another blow in November, when both the acting chief executive Fiona Murphy and acting deputy chief executive Stephen Flanagan resigned from their posts.
However, soon after, the healthcare group announced a permanent chief executive had been appointed – Lucy Nugent.
In terms of prominent health figures no longer retaining their position, this was felt most acutely at the end of November when Mr Donnelly lost his seat in the Wicklow constituency in the general election.
But there is lots more going on behind the headlines every single day in the health service. Waiting lists, which were once as high as just under one million people, are falling – though from a high base. Patients’ waiting time is also falling, having almost halved. However, two thirds are still waiting longer than target times.
The number of people on trolleys has improved, despite the increased demand and attendances, as well as increasing complexity of patients due to an ageing population.
It has been a busy year for the health service, and there’s no doubt 2025 will be just as busy, with further challenges and advancements.
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