EXCLUSIVE: 'The system is broken' - Over 8,000 hospital appointments missed in Tullamore last year

In a shocking revelation, figures released by the HSE through request by the Freedom of Information Act 2014 show that over half a million of outpatient appointments were not attended last year at hospitals throughout the country. The Midlands Regional Hospital in Tullamore saw significant numbers in this report. 

The report detailed the figures of missed appointments, or DNAs (Did Not Attend), at each hospital in the country in 2024 and contained a breakdown by region. In total, there were over 525,320 appointments not attended last year.

The MRH Tullamore recorded a high number of DNAs in 2024 with 8,438. Given the size of the hospital, this is a significant figure of missed appointments. Not to mention, it is a sizable amount of the number of those currently on waiting lists at the hospital. As it stands, there are 12,938 patients on the waiting list at MRH Tullamore.

At the top of the list for the most DNAs in 2024 was the Mater Misericordiae University Hospital with 48,007. St. James's Hospital followed with 40,000 and then Beaumont with 39,398.Outside of the Dublin area, University Hospital Limerick also recorded high numbers of missed appointments with a total of 24,659 as well as University Hospital Waterford with 26,522.

Children's Health Ireland at Crumlin, Temple Street, Tallaght and Connolly all recorded a combined total of 17,419 unattended appointments last year also. 

Such staggering figures perhaps hold most significance when compared to the number of people currently on waiting lists for often critical and life-saving health services across Ireland. According to the latest figures from the HSE, there are over 575,716 people on outpatient waiting lists nationally. Of these, 500,637 are adults and 75,079 are children. 

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When the total number of missed outpatient appointments are put side by side with the total number of those still enduring the never-ending waiting lists, the figures are not worlds apart. Had even the majority of these appointments been attended, then perhaps there would have been a considerable dent made in these enormous waiting lists. 

To place this into further context, the Mater Hospital's number of missed appointments last year at 48,007 is almost 10,000 greater than their outpatient waiting list which currently stands at 38,254. Even worse, St James's figures from 2024 were almost double their current waiting lists of 23,950.

When asked to comment on the figures, the Mater pointed out that with a total of 291,495 patients attending the hospital last year, it is one of the busiest hospitals in the country. Additionally, they said: "It is worth noting that the community where the Mater Hospital is situated is recognised as an area of deprivation and many of the patients cared for have multiple morbidities and other social issues to contend with."

The hospital said they continue to encourage patient compliance with appointment attendance through a range of measures including sending appointment letters, text message reminders and validation of waiting lists to remove patients who no longer need appointments. 

A spokesperson for St James's Hospital explained that the high figures in the report are indicative of the volume of patients they see and the complexity of patient cases. However, in a statement from the hospital, they said they will "continue to evaluate and examine future measures that can potentially reduce the number of missed outpatient appointments."

For those faced with limbo on these waiting lists, these figures can seem like a slap in the face. However, it is important to not shift the blame simply on the patients but to instead ask how can the system be allowing such vast numbers of missed appointments without raising concern and what is being done about it? 

It cannot be expected that 100% of appointments be kept to: people's schedules change, things can happen, we can't always anticipate what comes next. We all accept that. However, over half a million appointments missed in one year is an extraordinary figure especially when it is held against our already extraordinary figure on waiting lists. So what is happening?

When asked to comment on the figures released by the HSE and the current situation with waiting lists in the country, the Minister for Health Jennifer Carroll MacNeill's office released a statement to say: "It is acknowledged that many patients are still waiting too long for hospital appointments and treatments." The statement continued: "The Minister for Health is conscious of the burden that this places on patients and their families."

The Minister's office pointed out the Waiting List Action Plan (WLAP) for 2025 was published in February which is designed to reduce the waiting times for patients and improve access to hospital care. So far, over €420 million has been allocated to the initiative. Part of this plan aims to address the issue of unattended appointments. 

Some of these initiatives designed to target DNAs include two-way messaging systems. The Health Minister's office also added: "enabling and facilitating scheduled care reforms, through the use of technologies and tools, including in relation to SMS messaging re appointments, referral processes, robotic process automation, application of insights from behavioural science, and further roll out of the HSE patient application."

A spokesperson for the Mid-West Hospital Campaign, Marie McMahon, has described the current situation in the region as "absolutely frightening." Seven years ago this month, Marie’s husband died on a hospital trolley in UHL. When discussing the dire figures from the HSE, Marie emphasised the real people behind those numbers, saying "a lot of families have had horrific experiences."

For Marie, the writing is on the wall: "Obviously, the system is failing." She acknowledged the complex reasons as to why the number of DNAs could be so high, however, as she points out: "There needs to be some understanding as to why this is. Why are they not investigating? How much is that costing? There has to be a huge cost."

She also pointed out that the current system of sending out letters and telling people they’ll be removed from the waiting lists if they don’t respond within a short timeframe is not suitable as not everyone has someone who can advocate for them, if they are not in the position to do so for themselves.

Then there’s also the issue of transport for vulnerable and rural people. Marie said: "If you don’t have access to transport and you don’t have someone to take you there, how are you going to get there? What are the provisions? That’s fine if you are urban based where there is a good transport network. But if you are rurally based, and a lot of Irish people are, then how do people get to their hospital appointment?"

Ultimately, in Marie’s opinion, these figures further demonstrate that "the system is broken." As Marie expressed, these latest figures are just one further example of a failure by the HSE in the broader picture of mismanagement of resources and treatment of patients wherein there will be "no accountability."