The full extent of the crisis over hospital waiting lists has been laid bare as it emerged 49,000 public patients have been "hidden" from official figures.
And a leading orthopaedic surgeon Martin Murphy warned some of his patients are in such pain they have spoken of "jumping off a building".
Martin Murphy of Tallaght Hospital said six patients are in despair to the point where they felt like "walking into the middle of the road or jumping in the river".
The human cost comes as it was confirmed many patients are not even documented in the monthly inpatient and day case waiting lists, which currently stand at 81,015, according to an RTE Investigates programme aired last night.
The true number of patients who are in the queue for surgery and other procedures is over 130,000.
When these are added to the 437,558 people who are on outpatient lists it brings the total number waiting to a staggering 567,558.
The unseen patients include those who have received dates for their operations as well as those who have had surgery but still need follow-up hospital care.
The bleak picture has emerged following confirmation that thousands of patients are bypassed in calculating waiting lists which have spiralled in the past year.
The National Treatment Purchase Fund (NTPF) defended its method of measuring the numbers waiting.
But it said a review is now under way following an exposé in the 'RTÉ Investigates - Living on the List' programme aired last night.
The programme highlighted the pain endured by patients who have serious medical conditions and are parked on waiting lists for over a year as their health deteriorates.
Health Minister Simon Harris said he was ashamed at the deeply moving accounts given by patients.
"The experiences they describe are absolutely inexcusable," he said.
The NTPF said it is responsible for collecting, collating and validating information on people waiting for public hospital treatment.
"Patient waiting-list data is extremely fluid with people coming on to and going off the lists all the time as their procedures are scheduled and performed," said a spokesman.
As of December 30, there were 81,015 patients awaiting an inpatient or day case procedure and 17,401 patients awaiting an endoscopy. However, 'pre-admit' and 'pre-planned' patients are not counted.
There are 22,927 pre-admit patients from across the country waiting up to 18 months for surgical procedures.
These are patients who have been given an appointment but who have not yet undergone treatment.
The pre-planned patients have undergone surgery but need to return to hospital for further follow-on care.
This can include surgical pin or cataract removal, hip replacement and corrective spinal surgery.
The list also includes patients who had endoscopies but need more scopes at regular intervals in the future.
When the endoscopy figure is discounted, the numbers on the unpublished lists come to almost 49,000.
This is 60pc higher than the figure that was published by the NTPF.
The NTPF said its reporting guidelines were developed in accordance with international best practice, including systems in Canada and Sweden.
The HSE said it is aiming to ensure that by the end of June this year no one will be waiting more than 18 months.
Asked if he is aware of cases like that of Darragh who was featured in the programme, whose scoliosis is rapidly deteriorating as he awaits surgery, Mr Harris said he was aware that the crisis in waiting lists was happening on his watch.
"I am aware that it's happening and I know the stress that it puts families through," he said. "That is why I unapologetically put €2m worth of additional funding in 2016 into scoliosis operations."
We are still in the midst of another winter trolley crisis in our hospitals - but behind the scenes and the frontline, the quiet suffering of more than 500,000 on public waiting lists has endured.