Plans to cut waiting lists by the end of the year are seriously underfunded, internal Health Service Executive documents show.
Minister for Health Leo Varadkar has provided only a quarter of the money the HSE originally said it needed to eliminate long waiting times, according to a report seen by The Irish Times.
Ensuring no patients wait longer than 15 months for hospital appointments or treatment by December will cost the health service an additional €102.5 million, the HSE report says.
The document appears to cast doubt on the viability of Mr Varadkar’s target, for which he has secured funding of €26.4 million. Some €23.2 million of this will be spent on reducing outpatient waiting lists and €3.2 million on taking patients off inpatient and daycase lists.
However, the Minister said last night the report was a “draft, indicative early analysis” and the HSE subsequently revised the funding requirement downwards. “The final, revised figures agreed with the HSE formed the basis of the funding allocated at the end of July.”
HSE sources said the ultimate cost of meeting the target would depend on the amount of outsourcing involved and this was being assessed currently.
Outsourcing
Earlier this year, the Minister provided an additional €25 million to help the HSE meet an 18-month maximum waiting time target by the end of June. The target was substantially met, largely by outsourcing thousands of patients to the private sector, but the numbers waiting over 18 months have bounced back up since then.
The HSE report says to achieve the 15-month target by December, almost 18,000 extra people needing daycase and inpatient treatment will have to be seen. This will require an additional 20 per cent in capacity and cost €15 million.
To meet the outpatient target, 117,000 patients will have to be treated, of which 40,000 will be dealt with through the normal workload. Providing an additional 70,000 appointments will cost €87.5 million, based on an average cost of €1,250.
But Mr Varadkar told The Irish Times the target would be met within the funding provided by redeploying existing resources and drawing on additional resources provided. The HSE has been told to save money by sending no more than 20 per cent of patients for private treatment.
Breach of policy
“There is clear evidence that many hospitals have not been treating routine cases in chronological order. This is a breach of policy. Also, on validation, when patients are actually contacted, as many as one quarter to a third have actually already been seen in another public or private hospital,” said the Minister.
The HSE report focuses on the performance of the health service in meeting the earlier target by the end of June. By that time there were just 19 patients waiting longer than 18 months for inpatient or daycase treatment, all of them orthopaedic patients in Tallaght hospital. Six were offered private appointments and refused, and the rest were deemed clinically unsuitable for private treatment.
On the outpatient lists, 4,201 patients were still waiting more than 18 months for appointments, including 1,000 gynaecology patients in Cork University Hospital and 1,200 in a range of specialties in hospitals in the west, the report says.
However, up to 20,000 patients whose names were taken off the list had appointment dates beyond the end of June.By the end of August, the number of outpatients waiting more than 18 months was back up to more than 11,000.
