Waiting list stats 'massaged'

Official waiting list figures are being massaged by the Department of Health and the HSE, it was alleged today.

The Dail Public Accounts Committee was told that one of the reasons why inpatient waiting lists were reducing was that patients were not being processed through outpatients, with thousands now on outpatient waiting lists, and others waiting even to get on an outpatient list.

Chairman of the Dail Committee on Public Accounts , Fine Gael's Bernard Allen said that while the numbers of patients on waiting lists for hospital procedures had come down in recent years, waiting lists for outpatient procedures had "gone through the roof".

He told a meeting of the Committee today that the waiting list figures are being "massaged" by keeping people on outpatient lists, where they were waiting for long periods to get on to inpatient waiting lists.

Deputy Allen said there was also a "third" waiting list, whereby an additional cohort of patients who needed treatment were not being put on an outpatient waiting list.

Department of Health Secretary General Michael Scanlan admitted to the Committee that the official estimate of 175,000 on outpatient waiting lists, as revealed by the Comptroller and Auditor General late last year, probably underestimated the total numbers on outpatient lists.

The Committee was told, however, that verified audited figures for the exact numbers on outpatient listsand other data on outpatient waits do not exist at present.

Mr Scanlan said while he did not accept that the figures were being massaged, he accepted there was a need for far more focus on tackling outpatient waiting lists.

He said the data on outpatient waiting lists was not robust and there were people on lists who should not be on them.

Labour Deputy Roisin Shortall, pressing Mr Scanlan on this, queried why there was no accurate data on the extent of outpatient waiting lists. He replied that the data had never been collected.

"Our system is not up to the point where we can collect the sort of data we should be collecting," he said.

Deputy Shortall queried why despite the recent economic boom we did not have a system where such basic data can be collected.

"What has the Department of Health being doing in recent years if it has not got to grips with this?"

Deputy Shortall said we we do not know if inpatient waiting lists have improved because hospitals have been performing well or whether it is because fewer people are being referred into the hospital system.

Deputy Michael McGrath of Fianna Fail said the management of waiting lists in pubic hospitals was "an absolute mess." He said the waiting list figures do not present the full picture and people were still finding it difficult to get into the system.

He called for a national audit of waiting lists.

A delegation from the National Treatment Purchase Fund (NTPF), which arranges private treatment for people on public waiting lists and compiles inpatient lists, appeared before the Public Accounts Committee today.

NTPF Chief Executive Pat O'Byrne said at the end of 2009 there were 18,517 patients waiting over three months for inpatient and day case treatment. This was an increase of 1,000 from the figure in May 2009.

He said at the end of last year there were 719 surgical patients waiting over a a year for treatment, compared to 5,584 in December 2006.

"With approximately 675,000 discharges from the public hospital system annually, it is hard to believe that 700 people cannot be accommodated,' he said.

Mr O'Byrne said when the NTPF started in 2002, public patients often had to wait two to five years for treatment, but the average waiting time for surgery  was now 2.5 months.

He admitted, however, that the provision of access to consultants at outpatient level for first time appointments "remains one of the bottlenecks in the public hospital system."

Mr O'Byrne said in a small number of cases it is necessary for medical reasons where under the NTPF, patients on a public waiting list are treated by the same consultant in a private hospital. However, the consultants concerned did this outside their contracted public contract time.

This only happened with 1.7% of NTPF activity or 475 cases, last year. However, he admitted the figure was previously 3,800.

Bernard Allen said the work of the Committee was being hindered by the lack of data provided regarding consultants' public and priate work mix.

See also 'Crumlin rejects waiting list criticism'

[Posted: Thu 28/01/2010]