Single-specialty rheumatology ‘required to reduce waiting lists’

The commitment many consultant rheumatologists are required to make to general internal medicine is significantly contributing to long patient waiting lists, according to Irish Society for Rheumatology (ISR) President Dr Sinéad Harney.

Speaking to the Medical Independent (MI) ahead of the ISR Spring Meeting on 12 April, Dr Harney said a number of smaller hospitals had single-specialty rheumatology and more appropriate waiting list times as a result.

However, in the bigger hospitals, rheumatologists have a commitment to general internal medicine. In Cork University Hospital (CUH), where Dr Harney is a Consultant Rheumatologist, the outpatient waiting list for rheumatology is 28 months for routine appointments and 11 months for urgent appointments.

 “We have a 28-month waiting list in Cork and that is probably one of the worst in the country,” Dr Harney told MI.

“So whether rheumatologists should be doing general medicine at all is where we are angling. Cork and Dublin and the biggest hospitals are all doing general medicine, which really limits our ability to do to our specialty. It is a big, big issue.

 “The general medicine is consuming our time to do rheumatology. To me, that is our biggest issue at the moment — the negative impact of general medicine [workload]. I don’t dislike it, it is just taking up too much time.” Currently, there is a shortage of consultant rheumatologists “with probably the worst ratio of rheumatologists-to-population…  down this end of the country”.

Meanwhile, there is still no dedicated space for rheumatology at CUH, a matter Dr Harney raised in an interview with MI ahead of last year’s ISR Autumn Meeting. “We don’t have a rheumatology space dedicated in CUH where you could do a lot of things [efficiently]; other hospitals are better than our hospital; there are better places.”

Last year, Dr Harney also reported that lack of capacity at CUH meant patients requiring six-monthly infusions were being pushed out to nine months. This issue “has gotten worse” with Dr Harney referring to patients getting infusions at nine- and ten-month intervals.