Hospital bosses spend millions to cut waiting lists
Health bosses are spending millions to buy private care for public patients after failing to deliver on promises of reform.
Despite Health Minister James Reilly's plans to cut treatment delays by making hospitals more efficient, internal figures obtained by the Irish Independent reveal the recent decline in numbers waiting for treatment was only made possible by outsourcing the care of public patients.
The overall number on surgical waiting lists went down from 60,030 in September last year to 58,628 in May.
And the numbers of public patients waiting over a year for surgery fell from 1,219 in February to 203 at the end of May.
However, since the start of the year, the Department of Health has spent €5.5m buying operations for 1,856 of these public patients.
And of the 1,856 public patients whose operations were paid for this year, 1,187 were waiting for over a year.
The strong reliance on outsourcing puts a question mark over the full extent to which the promised internal reform of public hospitals is responsible for cutting hospital delays.
It means the true picture of how successful efforts to reform the way hospitals are run is not yet clear.
Driving these efficiencies is now the responsibility of the Special Delivery Unit in the Department of Health.
It has claimed credit for working with hospitals to reduce blockages that are contributing to delays.
However, if the safety valve of being able to buy operations through the National Treatment Purchase Fund was removed, the waiting lists would rise.
The Special Delivery Unit has around €70m at its disposal through the National Treatment Purchase Fund to buy treatments, including operations.
Figures show that many of the patients whose operations were paid for, were treated in private hospitals such as the Mater Private and the Beacon Hospital.
This involves a fee paid to the hospital and also the consultant who carries out the operation.
However, hundreds of other patients were operated on in the same public hospital in which they were already on a waiting list.
For instance, Galway Regional Hospital operated on 362 of its own waiting-list patients for an extra fee and James Connolly Memorial Hospital provided state-funded private surgery for 116 of its patients.
This means that public hospitals, which get an annual allocation to provide services, are effectively paid on the double.
These public hospitals are doing the operations for a fee in the evenings and on Saturdays.
Dr Steve Thomas, a lecturer in Health Policy and Management in Trinity College, described the practice of buying operations for public patients as expensive and not the best value for money.
"You are probably making an inefficient purchase. It is reform that is needed to entrench any progress made in reducing waiting lists," he said.
The most recent figures show that there are 686 beds blocked in public hospitals by patients who no longer need acute care but cannot leave because they have nowhere suitable to go.