Belfast Telegraph

Longer surgery waits loom as NHS cuts back on private ops

By Lisa Smyth

Some of Northern Ireland’s top doctors have warned that the bad old days of patients enduring years of misery waiting for hospital treatments are on their way back.

Their comments come as the Belfast Telegraph reveals that four of Northern Ireland’s health trusts shelled out almost £50m for NHS patients to be treated privately in just one year.

Figures released by health chiefs under a Freedom of Information request have uncovered the extent of our reliance on the private sector — a way of ensuring government waiting list targets are met.

However, the Health Minister has been forced to order trust bosses to cut back on the use of the independent sector in an effort to save money as massive budget cuts are imposed on the NHS — leading to growing concerns over the impact on patient care.

A leading doctors’ union yesterday called for urgent action to address the issue as members revealed a growing number of their patients were facing lengthy waits for hospital treatment.

The British Medical Association (BMA) in Northern Ireland has issued a stark warning that the region is on course to return to the position of having some of the worst waiting lists in Europe.

Dr Donal Duffin, a member of the BMA (NI) Consultant’s Committee, said he was aware of patients waiting over 12 months to be seen by a consultant.

“It’s actually going to be worse than it was. Waiting lists are already getting significantly longer,” he said.

“The Government spent a huge amount of money to get the waiting lists down and there is no doubt this did shorten waiting lists but it wasn’t a good use of money. Now the money is gone and waiting lists have gone back up again.

“There was no long-term plan in this at all. They created political short-term targets. The money spent on the private sector made a profit for them and their shareholders but it didn’t do the health service any good.”

Dr Paul Darragh, chairman of the BMA's Northern Ireland Council, welcomed the reduction in waiting times for first appointments in recent years but said it would have been better if the money used to achieve this had been invested in building up the NHS to meet demand.

“Better workforce planning and investment in the health service and its staff instead of squandering money on expensive private providers would provide better care for patients,” he said.

“The problem now is that the waiting lists are lengthening and that is with the present financial constraints. Our concern is that worse is to come.”

Dr Allen McCullough, a member of the BMA (NI) General Practitioner’s Committee, said: “Obviously if you stop funding the private sector, patients are not going to be treated.

“Instead of throwing money at the private sector they should have invested that money in the health service.

“There is also a growing problem with review appointments. Targets were introduced to reduce the length of time people wait to get a first appointment.

“We now have a situation where patients who have seen a doctor who has decided they are unwell and require treatment cannot get an appointment.”

Lessons to be learnt from days gone by

In June 2005 the then Health Minister, Shaun Woodward, announced a reduction in hospital waiting times.

They were at their lowest level in five years but, unlike now, Government targets stated patients should not have to wait longer than 18 months for treatment.

The figures revealed 95% of inpatients and day cases seen in the quarter ending in March 2005 had been on a waiting list for less than 12 months.

The total number of inpatients and day cases for 18 months or more had fallen by 2,834 — a 78% drop — over the year with 782 remaining on the list after 18 months.

The majority of those waiting longer than 18 months were within seven specialties — general surgery, ophthalmology, trauma and orthopaedic surgery, gynaecology, ear nose and throat, urology and general medicine.

According to the figures, almost 4,000 people were waiting longer than two years for trauma and orthopaedic outpatient treatment.

Over 600 people waited more than two years for their first oral surgery appointment, more than 300 for their first pain management appointment and 726 ear, nose and throat patients waited more than two years to see a consultant for the first time.

Trusts spend millions on private care

Four of Northern Ireland’s health trusts spent almost £50m for patients to be treated privately last year — revealing their heavy reliance on the independent sector.

Three trusts referred 32,177 people outside of the NHS for treatment due to limited capacity and to meet waiting targets, while the Southern and South Eastern Trust paid for a total of 20,500 episodes of private treatment.

The figures act as a solemn warning for people across Northern Ireland after the Health Minister ordered health bosses to cut back on independent sector work as his budget is slashed.

Mr McGimpsey has admitted the move will lead to patients waiting slightly longer for hospital appointments — but figures released to the Belfast Telegraph under a Freedom of Information (FoI) request suggest the NHS could crumble as cash used to pay for patients to be seen privately dries up.

In just one year, Belfast Trust referred 23,658 patients to be seen privately at a cost of about £25m. Health bosses spent £12m on private referrals outside Northern Ireland between April 2009 and March 2010 to meet waiting time targets.

The Western Trust referred 16,109 patients to be seen privately during the same period..

In 2009/10, the Northern Trust spent £6,205,229 on private referrals with a total of 11,545 people treated in this way. High numbers of gynaecology, dermatology and ENT patients were referred privately.

The Southern Trust paid for 8,955 episodes of private referral treatments in 2009/10 which includes first outpatient consultations, review appointments and daycase procedures.

The South Eastern Trust provided information according to number of episodes. There were 23,222 episodes in 2009/10 at a cost of £9,866,026.



Analysis: Cracks beginning to show as the future looks bleak

Less than a decade ago it was not unusual for people in Northern Ireland to wait years for hospital treatment.

The Department of Health, Social Services and Public Safety (DHSSPS) has addressed this with a number of waiting list initiatives.

The figures uncovered by the Belfast Telegraph reveal how much money has been spent cutting the waiting time for patients — in just one year alone four of the Trusts ran up a massive £50m bill.

And while there is no doubt the cash injection has helped, the cracks are beginning to show.

DHSSPS targets state that no patient should wait longer than nine weeks for a first outpatient appointment or 13 weeks for inpatient treatment and latest government figures show the number of breaches have risen in both cases compared to last year.

But what is most interesting is the fact that the number of waiting time breaches spiked considerably the previous quarter — at the same time Trusts were ordered to suspend private referral work due to financial constraints as the Health Minister waited for funding for the fight against swine flu.

It is clear the Trusts rely heavily on being able to send their NHS patients for treatment in the private sector in order to meet the waiting list targets.

So, what happens now that Michael McGimpsey has told the Trusts to stop private referrals once again in order to make savings?

Doctors are warning the future looks bleak for waiting times.

They are already reporting their patients are facing increasing waits for hospital treatment — with some cancer patients waiting up to nine months for review appointments.

Patients are now counting the cost of the government throwing money at waiting lists initiatives which relied upon the private sector for their success.

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