No more than 10 per cent of surgical operations paid for by the National Treatment Purchase Fund (NTPF) on patients from hospital waiting lists should be carried out in the public hospital system, it has been decided.
Prompted by concerns that public hospital beds were being overused to treat patients under the scheme, Minister for Health Mary Harney has directed that the proportion of a hospital's clinical activity devoted to NTPF work be reduced from 20 per cent to 10 per cent.
For a hospital with 100 patients on its waiting list for surgical procedures, the policy means just 10 patients can now be treated internally using NTPF funds.
The remaining 90 patients must be offered treatment in the private sector in the Republic or sent to the North or Britain.
The Irish Times understands the NTPF has experienced difficulty getting some hospitals to remain within the 20 per cent limit. Contrary to best practice guidelines, a small number of patients were being treated privately by the same consultant on whose public waiting lists they were waiting for treatment.
When the NTPF began treating patients in July 2002, the internal treatment cap was set at 20 per cent. A year later, because of a slow rate of referrals, this was revised upwards to 30 per cent of an individual hospital's waiting list numbers, before being lowered again last year.
The NTPF has treated a total of 35,000 patients since its inception. Some 1,300 of these have had surgical procedures carried out in Northern Ireland; a further 700 people have been treated in Britain. The fund expects to treat 16,000 patients in 2005 at a rate of 1,300 per month.
There has been a trend towards undertaking more complex surgical cases this year.
Waiting list figures published earlier this month by the NTPF for six Dublin teaching hospitals found a quarter of patients have been waiting more than a year for their operations. However, the numbers waiting 12 months or more have been reduced by 70 per cent. An extrapolation of the figures suggest the number of patients "actively" waiting for surgical procedures in the State is now less than 10,000.