Our system of hospital waiting lists for public patients continues to creak and groan

The announcement by the Department of Health that the number of patients on hospital waiting lists has dropped by 5,000 during…

The announcement by the Department of Health that the number of patients on hospital waiting lists has dropped by 5,000 during the first half of this year is a welcome reversal of an upward spiral.

However, the overall figures mask separate trends within different medical specialities.

While cardiac surgery shows an encouraging drop of 28 per cent, the actual waiting time for some heart operations remains at four to five years. To avoid people dying on cardiac surgery waiting lists would require a maximum waiting time of six months.

Neurosurgery waiting lists have increased from 444 to 546 in the last year. Urology and vascular surgery waiting numbers are also up, as is the gastroenterology list.

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The reality for the individual patient who is waiting anxiously for a consultant medical opinion is that there are two waiting lists.

The first is the waiting time to see the specialist as an outpatient. Following this assessment, the majority of patients will require further investigation or a surgical procedure.

They are then placed on the next waiting list, which may be a wait for a sophisticated MRI scan or CAT scan or a much longer wait for a hospital bed and a place on a routine operating theatre list.

As the nursing staff crisis grows, these coveted operating slots may be cancelled in the week prior to admission, with the patient left anxiously waiting another call from the hospital.

The fear of cancer is a worry for some patients on waiting lists. In the case of urology, many will be waiting for a procedure called a cystoscopy, which is used to definitively diagnose a tumour in the bladder or prostate.

Similarly, in gastroenterology some patients are waiting for an endoscopy in which a flexible tube is passed into the stomach and a biopsy taken to rule out the presence of malignancy.

Although the ear, nose and throat (ENT) numbers are down by 0.5 per cent, there are still 7,061 patients, many of them children, waiting to be seen. For parents and children alike, it can be a difficult time. Many are waiting to have tonsils removed. The enlarged glands are a source of chronic infection, against which repeated antibiotics become less and less effective.

The child is debilitated, often losing weight as swallowing becomes more difficult. School performance can suffer. Seeing a child weeks after a successful tonsillectomy makes you realise how important it is that ENT waiting lists need to be targeted in an urgent and more effective way.

Chronic pain is the lot of almost 5,000 people on orthopaedic waiting lists. Those waiting for hip or knee replacements are unable to stay mobile. A full night's sleep is beyond their hopes as the constant nagging pain of arthritis gnaws at their joints.

Despite their family doctors' best efforts to ameliorate the symptoms, the real solution lies in the hands of an orthopaedic surgeon. It is not uncommon to have to wait years for an operation.

The reality behind hospital waiting lists is a grim one. It means there is often a parallel, fire-fighting health service in which the general practitioner contacts a consultant for an urgent appointment.

The already overstretched hospital team agrees to "squeeze in" the extra patient. It is then faced with attempting to fit the needy individual into an already backlogged procedure or operation list. This slot is now no longer available for a patient who had risen to the top of the "routine" waiting list and the procedure must now be cancelled. And so the system creaks and groans on its sorrowful way.

While the Minister, Mr Martin, must be given some credit for his achievements there is clearly a need for fundamental health-service changes to address the difficulties facing public patients.