Waiting lists - the numbers game

  • Niall Hunter, Editor

Waiting lists and waiting times for treatment have always been an emotive issue (among many) in the ever- beleaguered Irish health system.

While some inroads have been made into waiting lists for inpatient procedures in recent years, there remain huge waiting lists and waiting times for public patients just to get to see a consultant in an outpatient clinic.

Outpatient waiting times and the inequity between public and private access to outpatient services have been in the news frequently. Indeed, Health Minister Mary Harney has made equality of access, regardless of insurance status, to outpatient care as a key component of the proposed new consultant contract.

The NTPF, which, in addition to providing treatments for those on waiting lists, also collates public waiting list figures, says there have been major improvements in waiting times since it was set up in 2002, when in-patient lists stretched to around 30,000.

But how significant have the improvements been, and do the figures frequently quoted provide a true representation of how many people really in need of treatment are on long waiting lists? 

The average waiting time for a patient to get a surgical procedure carried out in a public hospital in Ireland now stands at 3.4 months, according to the NTPF.

However, while inroads have been made into inpatient waiting lists, outpatient lists remain a problem. How big a problem it is not really known, as there are no official figures produced by the HSE.

However, over 140,000 are still believed to be on outpatient lists, with some people waiting up to eight years to see a consultant in an outpatient clinic.

The NTPF has, since, 2002 provided treatments, in public or private hospitals, to people who have been on in-patient or day case waiting lists for over three months. It sources treatments in public and private hospitals in the Republic of Ireland, Northern Ireland and England.

Critics of the NTPF system claim that it merely reflects the chronic under-resourcing of the Irish public hospital system, and is essentially a 'sticking plaster' solution. There is no doubt , however, that the NTPF has helped to reduce inpatient waiting lists in many specialties. 

However, even with the recent reduction in inpatient waiting lists and waiting times, there are still signifcant numbers of patient on these lists; around 20,000, according to NTPF figures.

An NTPF spokesman told irishhealth.com that prior to the establishment of the NTPF in 2002, the average waiting time for the most common inpatient surgical procedures was between two and five years; whereas now it  between two and five months for the most common procedures.

He said that for all surgical procedures, the average waiting time is now 3.4 months.

Referring to a HSE figure reported this week of 42,774 patients currently on inpatient waiting lists, the spokesman said this figure was based on NTPF statistics, but included patients who had been waiting between zero and three months for procedures.

The NTPF claims including the zero to three months waiting time does not give a totally accurate picture of the real numbers on waiting lists,and the HSE has also pointed this out in the context of the 42,774 figure.

However, a report in the Irish Times earlier this week noted that  the HSE has seen an increase recently in the total number of patients on lists for inpatient treatment.

"The zero to three months period is incredibly fluid, with people coming onto and going off the lists all the time. It can include patients who have just been informed of a time for their procedure or those who may who may have only recently received their treatment," the NTPF spokesman said.

According to the NTPF, a more accurate figure for the total numbers on waiting lists at present would be around 17,000 on surgical waiting lists and just over 5,000 on medical waiting lists for inpatient care.

These figures, the spokesman said, would exclude those waiting for treatment for periods of between zero and three months.

He added that there are currently no official figures produced for outpatient waiting lists.

Under a pilot project being carried out by the NTPF, 20,000 people on outpatient waiting lists were offered appointments last year, but only 10,500 took up the offer.

The NTPF says reasons for patients not taking up the offer could include that they had since sought a private consultation or that their condition had resolved, or was no longer considered a problem.

The NTPF also claims that some people may be on placed on outpatient lists  for 'peace of mind' and may not , on review, actually need treatment.  Some patients too, would be deceased.

While it is known that many patients are on outpatient waiting lists for a number of years, often with serious conditions, no official figures for these lists have been produced by the HSE since its establishment in January 2005.

The HSE has said it is still undertaking a verification process in order to get accurate numbers for outpatient lists.

It was reported earlier this year that there are at least 139,000 on outpatient lists at present, with some patients waiting up to eight years for an appointment.

Outpatient waiting times are known to be particularly long in some specialties, stretching to a number of years in specialties like rheumatology, dermatology and urology.

In many cases this reflects a shortage of consultant manpower in these specialties in some parts of the country. 


aine - 27/03/2008 16:55

Since last September, I have been waitging to be called for a hip replacement in a private hospital in Waterford. I have now contacted a hospital in Cork, and I have an appointment for May and my hip surgery done in Aug/Sept. I should add, I was told in Waterford I would be called before Xmas, and after several letters, calls, etc. I have had no response from them.

aine - 27/03/2008 20:19

I would love to hear from people as to how long they were waiting for a hip replacement as a private patient in the South East. Thanks.

Anonymous - 27/03/2008 21:10

My GP advised my a hip replacement. To see a consultant, will take 24 months and if I go private than it will still take 6 months to see him. A bit to long I think, 10% of that timespan is alot better. 1 to 4 weeks is better.

Mari - 28/03/2008 10:00

I'm glad this has been highlighted, reducing treatment times to 3.4 months via the NTPF is great but it's not the full picture when someon might have been waiting, literally, years to see a cons in order to be referred for the surgery. An 8 year waiting list in any speciality is a farce. I know very little about dermatology but many things rheumatology related can be agonising and disabling and a wait with regard to urology, especially in men, can literally be fatal if its related prostate.

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