Monday 22 July 2019

Eilish O'Regan: This quick-fix remedy will do nothing to solve underlying issues in system

Stock image: PA Wire
Stock image: PA Wire
Eilish O'Regan

Eilish O'Regan

The desperation felt by thousands of public patients on waiting lists who are in failing health and in pain is harrowing.

It makes the debate about the merits of some public hospital staff, including staff such as consultants, being paid on the double to treat a portion of these waiting list patients somewhat dispensable.

If it takes even a modest quota of these patients off the list, where is the harm?

But we shouldn't have to be paying out top-up funding of more than €50m to buy extra treatments for public patients in 2018.

You don't have to be an economics guru to know that paying on the double for any service is not financially efficient.

The money does nothing to tackle the underlying causes of waiting lists, such as the lack of beds and staff.

It is falling back again on the old quick-fix safety net of purchasing treatments we were promised would be left behind as public hospitals became more self-sufficient in clearing lists.

But the most recent waiting list figures, with 80,058 in need of surgery and 504,111 in the queue to see a specialist, show just how far hospitals are from being self-reliant.

The aim is to buy treatments for around 20,000 waiting list patients this year in private and public hospitals. Health Minister Simon Harris admitted in the Dáil last week that no cost-benefit analysis has been carried out on this kind of activity, which is funded through the National Treatment Purchase Fund (NTPF).

The task of the NTPF is to be the agent of the Government, tendering for the extra work to be carried out in private and public hospitals.

The taxpayer might wonder how can a public hospital that has a waiting list of its own tender for more work, paid for from the top-up funding.

Why can't it treat the patients from its existing budget?

Some of these hospitals have spare theatres and beds but need the extra funding to pay staff for doing what is essentially overtime. The NTPF pays the hospital a fixed price for each procedure and it is a matter for the hospital how it passes it on between staff and other costs such as use of equipment.

The €50m will reduce waiting lists but around 70,000 will still be in the queue for surgery at the end of the year.

Based on past performance, the waiting list figures will surge upwards again once the money runs out.

The latest beacon on the horizon is to build a hospital which deals exclusively with waiting list patients.

It would not have an A&E department and would concentrate on treatment of patients in areas of the highest demand, such as ophthalmology and orthopaedics.

It has worked in Scotland and brought down waiting lists. But as of yet it just remains a proposal here with no work done on timescale, costing or location.

In the meantime, patients and taxpayers are being ill-served.

Irish Independent

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