herald

Sunday 24 September 2017

Hospital wait times are down. Good news, right? Sadly, it's not that simple

We received some good news about the health service recently -- or did we?

The average waiting time for procedures in all hospitals is continuing to fall and is now only 2.5 months.

Thanks to the State-backed National Treatment Purchase Fund (NTPF), which buys, at the taxpayers' expense, private hospital treatment for public patients on waiting lists, waiting times for operations are at an all-time low.

You'd think there couldn't possibly be a downside to this 'good news story'. However, things are never that simple.

The NTPF has helped reduce inpatient waiting lists, which once stood at over 30,000 and which forced thousands of patients to wait for years for vital operations.

It has also taken over the counting of numbers on waiting lists from the Department of Health.

Worryingly, further reading of the NTPF's latest report shows that while waiting times may be coming down, the number of people on waiting lists remains stubbornly high and is actually starting to rise again, as demand continues to grow for a shrinking service.



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A total of 18,517 people were still on waiting lists for inpatient surgical and medical treatment at the end of last year.

And then there's the other waiting list you have climb aboard get on a waiting list for treatment -- the outpatient clinic list. The NTPF has made only a minor dent in that.

There could be up to 175,000 public patients on outpatient waiting lists, many waiting years for an appointment. Having so many waiting to access hospital care keeps the inpatient waiting list artificially low.

What would happen in the unlikely event that half of these 175,000 people were given outpatient appointments tomorrow? The system could collapse.

Health Minister Mary Harney has said the NTPF provides good value for money.

We would want to be getting value for our money, as it spent f90m last year organising operations that would have been performed in the public hospital sector if it was working properly. The public sector has for some time had to wash its hands of even pretending to meet the demands placed upon it.

In the meantime, Mary Harney and the HSE are happy to hive off the extra demands to the private hospital sector through the NTPF.

And in the recession, private hospitals are obviously glad of the money. But is this the proper way to run a health service?

It's fair enough to say that patients at the end of the day don't mind where a procedure is carried out as long as it gets done.

But there's a moral issue here in terms of how we organise and pay for our healthcare.

The taxpayer is paying on the double for this partial clearing of waiting lists. Firstly, for the public hospital system that through inefficiency, lack of real reform and lack of resourcing cannot cope with demand.

And then the taxpayer is asked to cough up again for the private system to do the work that the public system should be doing.

Are our public hospitals rapidly becoming hospitals in name only, stripped of beds and trying to cope as best they can with A&E demands?

The NTPF has been a good 'sticking plaster' approach to meet real needs, but many would query whether we should have it as a long-term solution.

We need a properly functioning, properly resourced and properly reformed public hospital system, backed up by a good community care network.

The public hospital service should be allowed do exactly what it says on the tin and provide a proper hospital service for the public.

Niall Hunter is Editor of irishhealth.com

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