General practitioners are warning that patients are being struck off outpatient waiting lists because they don't respond to HSE letters in time.
The number of people waiting for their first hospital outpatient consultation fell by 1,000 in November - however there are still more than half-a-million patients waiting.
As part of its efforts to reduce the numbers of people on the lists, the HSE routinely writes to patients to find out if they still need an appointment.
Dr Andrew Jordan, chair of the National Association of General Practitioners (NAGP) said anyone who does not receive the letter - or fails to respond - is automatically scratched off the list.
"You are crossed off the list and you are now gone off the system," he said.
"You are now no longer a patient waiting so you are not on a waiting list at all.
"You have been waiting for two years to have your foot looked at, you have missed the letters so now you have to start all over again and be re-referred and start again.
"You are now at the bottom of the pile."
Validation
He said numerous patients have reported being removed from the list adding, "that is the first they know of it, they got no letter prior to that."
He said it is "perfectly reasonable" to run a validation process - as patients can die while on the list or turn to private practice for treatment - but warned that patients must receive follow up phone calls they have moved, become homeless or have trouble reading.
Ministerial engagement
Dr Jordan said the Health Minister Simon Harris seems to be ignoring the concerns of doctors.
"The minister for whatever reason doesn't seem to feel that it is worth his while to engage with people on the ground," he said.
"We had a scheduled meeting with the minister on September 12th which for no explainable reason he cancelled.
"That was to discuss a number of different things but obviously this would have been one of the things on the agenda from our point of view."
The waiting list figures to the end of November were published yesterday.
The number of people waiting for an inpatient or day-case hospital procedure was just under 71,000.
The number waiting for an outpatient procedure was 515,360.
Reporting from Kacey O'Riordan
