The number of people waiting for treatment in Irish hospitals has hit a new record high.
Figures from the National Treatment Purchase Fund show over 718,000 people were waiting to be seen or treated by a doctor at the end of August.
The figures include more than 48,000 children - one-third of whom have been waiting for over a year.
According to the figures, 514,585 people were waiting for an outpatient appointment while 74,189 were waiting for inpatient or day case procedures.
Almost half of those on the outpatient list and over 30,000 of patients on the inpatient list have been waiting for over six months.
Nearly 12,000 patients were "suspended" from the lists for a variety of reasons.
The inpatient list has fallen by 2,000.
It comes amid reports that a major overspend at the Department of Health has dashed plans for tax cuts or increased spending in next month's budget.
Galway University Hospital was recorded as having the biggest waiting lists for inpatient, day case and outpatients with more than 50,000 people waiting.
Spokesperson for the Irish Patients Association Stephen McMahon, says that tackling overcrowding is one way to potentially deal with the issue.
"If you can sort out the emergency department overcrowding that means then that patients who have been on elective lists waiting for the hip replacement or other treatments can actually get access on the day that it was planned and that they don't get a last minute cancellation much to their detriment and indeed whatever family arrangements they may have had," said Mr McMahon.