Fund criticises management of children's hospital waiting lists

PUBLIC ACCOUNTS COMMITTEE:THE MANNER in which waiting lists are managed at Our Lady's children's hospital in Crumlin, Dublin, has been sharply criticised by the chief executive of the National Treatment Purchase Fund (NTPF), Pat O'Byrne.

He told the Dáil Public Accounts Committee yesterday he was not happy either with the level of engagement that the children’s hospital has had with the NTPF. “It’s patchy, to say the least,” he said.

As a result some children were waiting for treatment at the hospital, Mr O’Byrne indicated, when the treatment could be arranged privately for them by the fund.

He confirmed there were now 406 children waiting three to six months for surgery at Crumlin, 498 waiting six to 12 months and 71 children waiting more than a year.

The Galway West Fine Gael TD Pádraic McCormack put it to him that there were 840 children on the surgical waiting list at Crumlin last April and these latest figures indicated the numbers waiting had increased.

“It probably did,” Mr O’Byrne responded.

He added that overall there were 2,744 children waiting more than three months for surgery in the State. Some 230 were waiting a year or more and 188 of these were waiting at Crumlin and Temple Street hospitals.

The Cork South Central Fianna Fáil TD Michael McGrath said the admission by the fund that patients were being left on waiting lists in Crumlin and Temple Street, when they could be dealt with by the fund, was “an absolute scandal” and an indictment of hospital management. The hospitals should be called before the committee to explain this “professional negligence”.

Crumlin hospital later in a statement rejected the criticism. It said the NTPF put a limit of 450 on treatment slots for the hospital in 2009 and all slots were used. It added that it remained fully committed to working with the fund.

Meanwhile the committee was told that in 475 cases last year, consultants who had no time to treat patients in public hospitals ended up taking the same patients off waiting lists by treating them privately when paid by the fund to do so. Mr McCormack said this was extraordinary.

Mr O’Byrne stressed that the consultants did this private work in their own time. He added that in a small number of cases, it was in the best interests of patients to be treated by the same consultant under the treatment purchase fund as the one who had originally put them on the waiting list. This happened in only 1.7 per cent of cases it funded last year, he said, down from more than 3,000 a couple of years ago.

Separately, secretary general of the Department of Health Michael Scanlan told the committee there were no national outpatient waiting-list figures but he believed the suggestion in a report from the Comptroller and Auditor General last year that there were 175,000 patients awaiting outpatient appointments was an underestimate.

The comptroller had also reported one hospital closing its outpatient appointments book in order to bring waiting times under control. Committee chairman Bernard Allen of Fine Gael said this meant there was a third hidden waiting list of people waiting to get on the outpatient waiting list, which effectively meant waiting-list figures were being massaged.

Mr Scanlan rejected the suggestion lists were being massaged but said he was not aware of the practice of hospitals closing appointment books. It was not acceptable and the HSE was following it up.

Data collection was improving in the HSE, he added, but choices had to be made in line with resources on which data should be collected. This included outpatient waiting list data.

Meanwhile ,Mr Allen said the failure by the HSE to provide the public accounts committee, as promised, with data on the public/private workload of individual consultants and their waiting lists, was hindering the work of the committee.

Mr Scanlan said he understood the delay may have to do with data-protection concerns.