The crisis with Northern Ireland’s hospital waiting times has highlighted the vast disparity between waiting times in Northern Ireland compared with those in Great Britain. However, the waiting times in Northern Ireland aren’t just atrocious in a UK context, but in an international context as well. Waiting times across the border are the worst of any nation state in Europe, and the situation in Northern Ireland is significantly worse.
The chart above shows the number of patients waiting over one year for inpatient admission for England, Wales, Northern Ireland and the Republic of Ireland. Data was unavailable for Scotland, and from 2014 to Q1 2016 data was unavailable for Northern Ireland; these figures were estimated from the over 26 weeks waiting time figures.
Compared with England and Wales, waiting times in both jurisdictions in Ireland diverged significantly from 2014 onwards. Northern Ireland and the Republic moved roughly in tandem with each other until 2017, from which point the situation in the south has stabilized, whilst the numbers in Northern Ireland have roughly doubled from 20% to 40% over the last two years.
The chart below shows data from the 2018 EuroHealth Consumer Index, showing waiting times for elective surgery across 35 European countries. A score of 1.00 means that over 90% of patients wait less than 90 days for treatment, and a score of 3.00 means that over 50% of patients wait longer than 90 days for treatment.
The Netherlands and Switzerland had the shortest waiting times, with Ireland having the longest. In 2018, 36.5% of patients waited less than 3 months for inpatient admission in the Republic, this has fallen to 35% for the year to date in 2019. In Northern Ireland only 21.7% of patients waited less than 13 weeks for inpatient admission in 2018, this had fallen to 20.1% for the first half of 2019.
With Ireland being the worst performing healthcare system hospital waiting times, and Northern Ireland performing significantly worse, the two healthcare systems in Ireland are the two worst in Europe.
There is a significant variation by region on both sides of the border. The chart below shows the number of patients waiting over a year for inpatient admission by hospital group in the Republic (in green) and by HSC Trust in the North (in blue).
Whilst waiting times are, on average, longer in the North, figures are better in the Northern HSC Trust (including Antrim Area and Causeway hospitals) than the rest of Northern Ireland. The Saolta University group, which includes hospitals in Galway, Sligo and Letterkenny, performs worse than other areas in the Republic.
With regards to A&E waiting times, the situation on both sides of the Irish border are among the worst in Europe, too. The chart below shows A&E waiting time data from the 2017 EuroHealth Consumer Index (the most recent for which A&E data was included).
I was unable to find more detailed or more recent A&E waiting time data for the Republic of Ireland, but the fact that Northern Ireland waiting times are so much worse in Northern Ireland compared with the rest of the UK suggests that the A&E systems on the island of Ireland are the continent’s worst. In October 2019, 83.6% of patients waited for less than 4 hours in A&E in England, the equivalent figure in Northern Ireland was 65.5%.
Either side of the Irish border, hospital patients experience the worst waiting times in Europe. Both lag far behind countries such as Albania or North Macedonia, both of which have GDP per capita figures that are less than a fifth of those in the Republic of Ireland. Whilst the situation in Northern Ireland is a catastrophe, hospital waiting times are an all-Ireland crisis.