The real cost of patient treatment

Madam, – I see where the National Treatment Purchase Fund (NTPF) is up to its usual tricks in the annual triumph of obfuscation…

Madam, – I see where the National Treatment Purchase Fund (NTPF) is up to its usual tricks in the annual triumph of obfuscation and self-congratulation that passes for its Annual Report.

As usual, no details of the procedures performed or what they cost are provided. And certainly we get no details of the number of patients with surgical complications who were transferred back to the public system for treatment of those complications (are these data even collected?).

In 2008, the NTPF treated just under 21,000 “in-patients”, an increase of just over 1,000 (5.4 per cent) on the number treated in 2007. The report states that its revenue was €104 million in 2008, compared with €92 million in 2007, an increase of 13 per cent. Elsewhere in the report, it is stated that it spent €110 million in 2008.

Does the NTPF actually know what it spent, let alone what the money was spent on?

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The authors of the report include MRIs and out- patient consultations in its tally of 36,000 “patients treated”. As far as I am aware, no one was ever treated, let alone cured, by an MRI scan, which is a purely diagnostic procedure.

But what is really interesting in the report is the amount spent on “administrative” costs, 4.5 per cent. Administrative costs amount to €152 per patient, more than the price of an out-patient consultation in many medical specialities. Surely, the NTPF’s administrative functions are confined largely to making phone calls and sending out appointment letters?

Canadian Medicare has administrative costs of 1 per cent; in the US, Medicare has administrative costs of 3 per cent.

Launching the report, Minister for Health Mary Harney (HealthPlus, May 19th) is reported to have said, “I don’t believe there is any hospital in the country that would have treated 36,000 patients last year for the budget that we give to the NTPF.”

She is right not to believe it – there is not a single public hospital in the country that would have spent €104 million carrying out 21,000 mainly day-case procedures, along with a relatively small number of out-patient consultations and a bunch of MRI scans: if they did, they would be closed down. – Yours, etc,

Dr GERRY BURKE,

FRCOG Consultant

Obstetrician Gynaecologist,

Riverside Clinic,

Steamboat Quay,

Limerick.