No clear evidence exists to show an overall reduction in hospital waiting lists despite the allocation of £70 million in the past five years, according to a report of the group appointed by the Minister for Health. Figures issued last week show there are 34,331 people waiting for treatment.
A total of £58 million was spent on the Waiting List Initiative (WLI) between 1993 and 1997, and a further £12 million has been set aside for this year. However, the report said that it was "difficult to point with absolute certainty to a direct link" between funding given and a reduction in waiting lists.
The report, presented to the Minister, Mr Cowen, more than three months ago, called for an urgent review of hospital capacity, saying it believed that some hospitals have reached full capacity. The latest data available revealed, it said, that bed occupancy rates in Irish hospitals were the highest in the EU.
The group was set up by Mr Cowen in April to examine the effectiveness of the WLI and how best to reduce the numbers awaiting hospital treatment. It is due to be presented to the Cabinet within the next few weeks.
The report concluded that a series of initiatives must be taken if waiting lists and waiting times were to be reduced substantially. "There are no simple, short-term solutions which on their own will have a significant impact."
Meanwhile Fine Gael announced a plan yesterday to tackle the "endemic and persistent" problem of waiting lists. The party's health spokesman, Mr Alan Shatter, said the Government should admit the true extent of the crisis.
He said there were, in fact, two waiting lists. "The visible list is made up of 34,331 public patients throughout the country who are waiting to be admitted to a hospital for surgery or treatment. The second, hidden list is made up of those tens of thousands of people who have been referred by their GP to a consultant and cannot be easily estimated since the Department of Health does not keep records of it," said Mr Shatter.
The report also said the system may be acting as a disincentive to improving waiting lists. The group considered whether the basis on which this funding was currently allocated "might send inappropriate signals in this regard to hospitals, who might fear that an improvement in their waiting-list performance would lead to a reduction in WLI funding".
However, the report said, the available evidence suggested there was a strong correlation between funding and the reduction in the number of people waiting for treatment by the end of each year.
Total lists fell by the end of years in which substantial WLI funding was provided. In contrast, total lists rose by the end of 1995 and 1997, when the funding was reduced considerably from the previous year.
The group said the WLI had been an important element of hospital activity since its inception in 1993. "Inevitably, questions can be raised about validation (and hence the true extent) of waiting lists, the net effect of WLI on waiting lists and waiting times, and the management of waiting lists at hospital level."
Nonetheless, said the report, it was clear the WLI had funded a large number of elective procedures and had enabled thousands of patients to receive treatment more quickly than would have been possible under normal hospital services.
It said the aim of the WLI was to reduce waiting times for in-patient procedures in public hospitals to no longer than 12 months for adults and six months for children.