If a certain beer company did health services, they would most probably do them without making people wait. But they don’t – and so we are stuck with a health service where lengthy waiting lists appear to be a permanent feature.
Almost 400,000 people – one in 12 of us – are currently on the outpatient waiting list, while 50,000 are waiting for procedures.
It’s a sorry set of figures, but one which has resisted most efforts at improvement in recent years.
To outsiders, the situation is difficult to understand. After all, by common consensus, the care provided by staff once a patient gets into hospital is generally of a high standard, so why the mismatch in terms of access? Michael Dowling, an Irishman running a large healthcare group in the New York area, told a conference this week he "couldn't fathom" the problems we have with waiting lists.
People have tried to tackle the issue, especially politicians conscious of the proximity of elections. This generally involves throwing a few million at the problem, which is often spent farming out work to the private healthcare sector. It works to a point; patients get their hips replaced or their cataracts removed and they disappear off the list.
Yet in many cases, private consultants refer outpatients back to the public system for procedures, so they simply move from one list to another. They may first have to be seen again by a consultant in the public sector, so they end up being double-handled.
Sharp practice
Given the intractability of the problem, the temptation is to cut the lists in other ways. There is nothing wrong with “validating” a list – patients die, move away, or even get better on their own – but recent reports have fuelled a suspicion of sharp practice in removing patients from lists. GPs have claimed patients are being referred to distant hospitals, or given days to reply to letters threatening to remove their names from a list.
The most politically explosive waits are those endured by seriously ill patients accommodated on trolleys in hospital emergency departments across the country. On any given night, 300-400 patients will be on trolleys in wards and corridors, albeit an improvement on the figures recorded during the cold winters of 2010 and 2011.
Reducing trolley numbers was James Reilly’s main achievement as minister for health, but it may be a transient one. The numbers are starting to creep up again, as demand for hospital services rises and the system struggles to discharge elderly patients.
I asked Dowling how he would clear the waiting lists if he were in charge.
“Work late, work weekends, work harder, until they are gone,” came his answer. He pointed me to one hospital which has 350 beds and a modest waiting list of two patients. “What kind of hospital has that many beds and can’t fit in two more patients?”
