Thousands of individual stories of people’s anxiety, suffering and distress are contained in the hospital waiting list figures. That’s why the Irish Hospital Consultants Association (IHCA) statement last week that waiting lists have increased by 16 per cent over the past year gives rise to serious concern. It means 46,000 people – adults and children – are currently waiting for treatment. The IHCA blames the increase on operating theatres closing and beds being taken out of service for budgetary reasons.
The bad news is that the true figure is almost certainly worse. The figure of 46,000 is based on 15,000 people waiting for inpatient treatment and 31,000 who have been promised day-case treatments at some point in the future. These patients may actually be the lucky ones; many more people who have been referred by their family doctors for treatment do not feature in the figures at all. The Health Service Executive has no system to measure the number of patients, and the waiting times, from the day someone is referred from primary care to a hospital. This is the purest measure of patient waiting in a health system and one the Department of Health has yet to insist is measured in this country.
While the National Treatment Purchase Fund said last week that waiting times, rather than numbers, was a better indicator of health system performance, its figures relate to those waiting in excess of three months for surgery or a medical procedure. Although the fund has succeeded in significantly reducing waiting times to a point where the average wait is now 2½ months, it too fails to record true waiting times from the moment of referral by a family doctor.
It is this waiting time that matters to patients. Being told by a GP that he would like a second opinion, or a specific procedure to be carried out, marks the beginning of a period of uncertainty and worry for patients; it means there is a question mark over their health which will persist until they are plucked from waiting time limbo.
The latest figures are a worrying straw in the wind in the run-up to budgetary cuts of €3-€4 billion in December. The Minister for Health has already conceded cuts of €700,000 in the health budget which are bound to impact negatively on hospital waiting times.
So are we facing a return to the days when people waited in pain for five years to obtain a hip replacement and must we endure the appalling vista of patients dying while waiting coronary bypass procedures? Without remedial action to improve health service efficiency, the future looks bleak.
This makes the HSE’s latest initiative to tackle waiting times in emergency departments very timely. The proposed acute medicine programme is the latest attempt to deal with the issue of patients spending lengthy periods on trolleys. A determined effort to implement it will not only tackle delays in emergency departments, but hopefully will also lead to improvements in overall hospital waiting times. Such changes can help to soften the impact of reductions in the health budget.