A perfect storm appears to be brewing in Ireland in the health system, which is having perhaps its greatest impact on hospital waiting lists.

New figures released by the Health Service Executive (HSE) for a written question in the Dail (Irish Parliament) show that in April over 14,000 hospital appointments were cancelled.

The figures for May are expected to be as bad, according to opposition parties.

According to reports the problem is being put down to huge numbers of patients attending emergency departments, particularly older people.

There are not enough beds in the health system to deal with the surge.

Also, some patients can not be discharged from some hospital beds because there is no room in the community, or in nursing homes.

The bottom line is that last month the Mater Hospital in Dublin cancelled 1,092 appointments; St James’s cancelled 853 appointments and St Vincent’s cancelled 841.

At Limerick University Hospital, 765 appointments were cancelled.

Among the treatments affected were new outpatient appointments, chemotherapy and dialysis.

It has emerged that 13 hospitals are either not reporting cancelled appointments data, or are partially reporting the data, so the situation is even worse for people waiting for surgery now or other procedures or assessments.

The head of the HSE Paul Reid has said that the situation is likely to continue for the next while, while measures are taken to help the hospitals most under pressure.

Health officials say the long-term answers include more hospital beds, greater care in the community, including diagnostics, better home care, to reduce pressure on emergency departments.

But this is going to take a very long time to build up and for many people who may need hip or knee surgery, cataract treatment, gastroscopy checks and a rang of other care, they must wait.

It seems inevitable then that many more people will need to avail of healthcare abroad and the cross border directive in the months and years ahead.

Apparently initial data to be published soon from the census of population taken recently in Ireland will show a population now of over 5.2 million people.

The sheer growth in the population will in itself will add to the pressures on the health system.