Analysis:The National Treatment Purchase Fund may have cut waiting lists but the system has had its difficulties. Barry O'Keeffe reports
There will always be waiting lists, despite the National Treatment Purchase Fund's (NTPF's) apparent success in reducing the waiting time from two-five years to two-five months for the most common surgical procedures.
By its own admission, some patients are waiting for a year or more - for various reasons, including patients just not being ready for particular procedures.
However, while the NTPF may be happy with the headline figures, the sharp differences of opinion between consultants and the NTPF underlines the fact that the system is not without its difficulties and tensions.
The NTPF was set up in 2002 to try to tackle the waiting lists for surgical procedures, a problem at the time which its chief executive, Pat O'Byrne, acknowledged yesterday was not unlike the current A&E controversy.
The NTPF finds spare capacity in the system (both public and private) and uses it to arrange operations for patients who have been waiting three months or more already before contacting the fund.
O'Byrne said yesterday that Cork University Hospital, in particular, Sligo and, to a lesser extent, Beaumont Hospital were not referring as many patients as they could for treatment. He said there seemed to be a problem in Cork in referring geriatric patients, in particular.
He said he had asked why this problem had arisen and had been told patients on the hospital's waiting list were "very complex".
O'Byrne said he did not accept this.
"We deal with minor and major problems," he said. "I would question what people are being told locally," he said.
"Some people are being told it would complicate things [if they were to use the NTPF] and a lot of them are elderly."
O'Byrne said he would question why Cork University Hospital in particular had such a low number of referrals. "I have never got a satisfactory answer," he said.
The HSE, when asked about this, said the majority of hospitals were taking part in the fund: "However, we are aware that this is not the case for a small number of hospitals. This places patients at a disadvantage and the HSE finds this unsatisfactory. On that basis we will be following up with the small number of hospitals and discussions will take place."
Health Minister Mary Harney suggested that the fund might liaise more directly with GPs, but urged all sides to co-operate.
The Irish Hospital Consultants Association (IHCA) rejected the charges by O'Byrne, expressing disappointment at his comments.
For its part, the Irish Patients Association said that in the absence of hard data, it believed that many thousands of patients had been affected. It urged the public to contact the fund if they had been waiting for more than three months.
O'Byrne also said that referrals from Sligo General Hospital had been "poor" and that referrals from Beaumont Hospital in Dublin "have been less than we would like".
O'Byrne also urged people to call the fund directly.
The top procedures performed under the NTPF last year were cataract removals (2,256), procedure scopes (1,378), tonsillectomies (1,351), varicose vein removal (916) and joint replacements (976), as well as cardiac surgery (1,105) and the removal of skin lesions (383).
By the end of the year, the fund hopes to have treated around 60,000 patients since its establishment.
Around 3 per cent are treated in Northern Ireland and around 2 per cent in Britain.
Last year the NTPF cost €64 million to administer. Of this, about €60 million was spent on surgical procedures. This year the fund has a budget of €78 million.
The fund hopes to treat 22,500 patients this year, compared with 18,200 last year and to continue to reduce waiting times.
Asked if treating extra patients took extra money, O'Byrne replied that the numbers treated were subject to available funding, but this had not been a problem to date.
Last year, the NTPF also began its first outpatient pilot programme. This was designed to help people who were waiting for appointments with consultants to get them.
It said the scheme had been very successful and would be extended to include more hospitals this year.
O'Byrne was reluctant yesterday to give overall figures for how many people might be on hospital waiting lists across the State. Data released as recently as April showed around 29,000 people could be on hospital waiting lists here.
Clearly, it will be a long time before the fund becomes a victim of its own success.