Reilly's NI waiting list model not working

[Posted: Wed 01/06/2011 by Niall Hunter, Editor www.irishhealth.com]

Health Minister James Reilly's proposed Northern Ireland model for reducing hospital waiting lists in the Republic is currently in trouble, with waiting lists continuing to grow over the border, according to latest statistics.

Dr Reilly is to launch his promised Special Delivery Unit (SDU) later today, in an initiative partly based on action taken in Northern Ireland in recent years, which, initially at least, led to a reduction in waiting lists.

However, latest figures show that proportionately per head of population, Northern Ireland now has more patients waiting more than three months for hospital treatment than the Republic does.

In December 2010, 17,156 patients in the North, with a population of 1.7 million, were waiting more than three months for treatment, while the figure for the South, which has a population of 4.1 million, was 26,028 in February of this year.

This means that around one in every 100 people in Northern Ireland is currently on a hospital treatment waiting list while one in around 140 is waiting in the Republic. If the North's figures were equivalent  to those down south, their waiting lists would only number around 10,500.

The numbers waiting over three months for hospital care in the North nearly trebled between December 2009 and December 2010.

Comparative figures also show that the numbers awaiting outpatient appointments in the North are proportionately greater than in the South.

There were 82,571 on outpatient waiting lists there in December 2009 and 124,589 in December 2010. In the South, the estimated number on outpatient lists is 200,000. This represents 7% of the population on outpatient lists in the North and 5% in the South.

The waiting list initiative implemented in the North initially had positive results, with reductions in lists recorded between 2005 and 2009. However, since then, lists have started to grow substantially.

Under the Northern Ireland initiative, a special delivery unit with the direct involvement of the local health Minister and greater administrative efficiencies, similar to Dr Reilly's planned SDU initiative, was believed to be crucial in the initial reduction in waiting lists.

Also crucial, however, was the facility to use private hospitals to treat people waiting long periods for care in the North. This policy was largely discontinued last year, and a decision made to build up capacity in the North's public system with additional funding.

However, the cutback in private care for those on waiting lists coincided with a major increase in list numbers.

A spokesperson for Health and Social Care Northern Ireland (its equivalent of the HSE) told irishhealth.com that the system in the North at present was in a transitional phase.

He said they were currently building capacity within the NHS in the North to deal with waiting lists, and much less work was being given to the private sector.

The spokesperson said they expected to see marked improvements in waiting lists numbers later this year.

In the South, where private hospitals also have been used to reduce long waiters, under the National Treatment Purchase Fund (NTPF), a major rise in hospital treatment lists has been recorded recently, with numbers rising by 6,000 between December and February this year.

A spokesman for Dr Reilly told irishhealth.com the Minister's waiting list initiative would not be solely based on the Northern Ireland model. Aspects of it would be used but there would be other components as well.

Observers believe the real challenge for Dr Reilly will be to effect reductions in waiting lists in the absence of additional funding to build capacity in the system.

Dr Reilly's reforms, will however, include greater efficiencies within hospitals and better cooperation between hospitals and consultants,  better use of information technology, and greater hospital accountability for reducing lists.

According to a report in today's Irish Independent, the NTPF will, under the initiative, be subsumed into the Special Delivery Unit.