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Thursday 16 August 2018

Reilly plan to cut our waiting lists could turn into a terrible Irish joke

Heard the one about the Irish health minister who wanted to cut waiting lists by making them even longer? It's not quite as far-fetched as it seems.

The Health Minister's new waiting list initiative will, we are told, remove the scandal of waiting lists within three years and cut A&E trolley waits. However, the plan is short on detail and long on unanswered questions.

Anything that might improve people's access to care is welcome. But the Minister's special delivery unit could turn into the worst kind of 'Irish solution to an Irish problem'.

Try this for size -- an initiative designed to cut waiting lists which will, while the unit gets up to speed, actually increase the numbers waiting for treatment. This could lead to waiting lists spiralling out of control.

At least Dr Reilly was honest about this danger.



confidence

But his statement wouldn't exactly inspire confidence in the growing number of patients currently waiting for care.

And if this wasn't enough to potentially turn the whole thing into a bad Irish joke, there's more. The Minister's bid to cut waiting lists is in part copying a similar initiative in Northern Ireland.

Dr Martin Connor, who presided over big cuts in lists in the North, is heading up Dr Reilly's troubleshooting unit.

He had success in cutting waiting lists, but since he finished his work there in 2008, numbers on lists have spiralled.

At the moment, the number of people waiting for treatment over the border is, per head of population, higher than it is down here.

If you look at one of the main reasons why waiting lists up north started to rise again, you come across yet another snag.

Northern waiting lists increased when their equivalent of the HSE stopped sending public patients for treatment in private hospitals.

They opted instead to use the money to invest in public hospital capacity. While this happens, Northern Ireland waiting lists are continuing to rise.

This should be a clear sign to our Minister that if you don't have the capacity to do enough operations, either privately or publicly, waiting lists will grow.

At least up North they are spending on public hospital capacity. But in Dr Reilly's initiative, there is no mention of additional beds or staff -- there's no extra money on the table.

The only funding is what was previously used by the National Treatment Purchase fund (NTPF), to send people on public waiting lists for private care.

However, NTPF funds were only barely keeping a lid on waiting lists getting out of control as it was. And it has now been told to stop sending new patients for private treatment while Dr Reilly's delivery unit draws up its plans.

What's going to happen to those patients in the meantime?

With no new money, bed closures growing and staff numbers dwindling, cutting waiting lists will be like trying to make a silk purse out of a sow's ear.

You can talk a lot about making hospitals work leaner and smarter to cut treatment lists, but unless you address the capacity issue as well, you are facing an Everest climb.



stacked

We can only hope Dr Reilly's unit will deliver, but the odds seemed stacked against it.

The new Minister admittedly faces huge challenges at a time when the country is broke.

He will soon, however, have to stop telling us how awful Mary Harney's policies were and show more clearly how he will tackle the massive problems in our healthcare system.

After all, that's what people elected a new Government for.

Niall Hunter is editor of Irishhealth.com

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