The National Treatment Purchase Fund has enabled 9,752 people toreceive their treatment. Are outpatients next on the NTPF's list? Éibhir Mulqueen reports
The director of the National Treatment Purchase Fund (NTPF) says the scheme would be compatible for tackling outpatient waiting lists after it fulfils its brief of clearing waiting lists for certain surgical procedures.
Maureen Lynott says the notion that the scheme, whereby public hospital care is purchased from the private sector, including in the North and Britain, could be extended to outpatient waiting lists has been discussed. "It has been mooted around the system that perhaps this is a methodology for dealing with that as well but I think that decision will have to wait.
"It is a method that could certainly work for the outpatient side. But I think the first job is to make sure that the people who are waiting for inpatient treatment who have already waited for their outpatient appointment are looked after.
"Just as the inpatient waiting list was a serious political problem for a long time, I think the outpatient list is a serious public concern and political concern as well.
"It may be that once the health strategy targets are generally achieved around the country, we will be asked to widen the brief."
Last year, with a budget of €31 million, the NTPF exceeded its target of enabling the treatment of the 8,305 patients who had been over two years on waiting lists. The number it reached was 9,752. People who had been waiting over 24 months are now off the lists for the one-off surgical procedures which the NTPF purchases. These include treatments for cataracts, varicose veins, hernias, gall bladder, prostate, tonsils, plastic surgery, cardiac surgery, and hip and knee operations
"We act as a kind of facilitator. We source the capacity, make sure the standards are good, negotiate the prices and then we work with each of the individual hospitals on referring their patients for, say, knee operations or hernia operations to specific hospitals, and they become partners in effect," Ms Lynott says.
With a budget this year of €44 million, it is now looking after all waiting list purchasing following the removal of that function from health boards and public hospitals. The NTPF is focusing on the three to 24-month wait section, amounting to about 10,000 people.
With an annual capacity to enable the treatment of 12,000 patients, she expects that by the year's end, some hospitals will have achieved the target of patients waiting no longer than three months for an operation.
The NTPF liaises with 23 health agencies, comprising public hospitals and health boards. "Of those 23, 13 are now referring people six to 12 months, meaning that they have virtually cleared their 12 to 24-month list. Their target time now is anyone over six months can be referred to the fund. And six are now referring people three to six months. What that means is that you have 19 agencies that are very close to the health strategy target of no-one waiting more than three months," she says.
As well as in the State's private healthcare sector, the NTPF sources treatments outside the jurisdiction. It now uses four hospitals in England - two near London and one in Manchester and Liverpool - and three in the North. But Ms Lynott says these largely represent unused capacity because of a lack of "acceptability" in the medical profession regarding referring patients abroad.
"The fact of the matter is we have sent a total of 700 since we started to the North and to England and we could send easily 200 a month. It is very, very slow. And that is largely not to do with patients, I would say that."
Over the past two years, the course for the NTPF has not been smooth. Last year, four hospitals were refusing to pass on patients' details to the fund, citing the Data Protection Act. "In the end of the day, we got a ruling from the Data Commissioner that details could be sent to us routinely because it is consistent with compatible disclosure, which they have already consented to for their healthcare."
Ms Lynott says there is still "pockets of resistance" within particular specialities, "where some consultants or some local hospital management may still have difficulties with the principle of the treatment purchase fund".
The NTPF has set up a 'lo-call' number for people who wish to contact the service directly. This has resulted in 8,000 calls being made, leading to 1,800 patients being treated.
- The NTPF lo-call number is 1890-720-820. Its website is
www.ntpf.ie