With €30 Million due to be removed from the National Treatment Purchase Fund’s (NTPF) €85 Million budget, how will this affect the 25,000 adults and children waiting for elective procedures and the 200,000 people waiting to be seen at outpatient clinics across the state?

Last Tuesday the Minister for Health Dr Reilly said that the waiting list problem would be solved within three years and the newly established Special Delivery Unit (SDU) will be part of the solution. The problem is that promise has been made before.

In 1993 the Government introduced the Waiting List Initiative whose primary purpose was to deal with the significant numbers of public patients waiting long periods for elective surgery. It set targets for the maximum length of time patients should have to wait for treatment in specialties with the longest waiting lists. The targets were that adults would not have to wait longer than 12 months and children would not have to wait longer than 6 months. However later reviews of the initiative showed that much of the money meant for the treatment of patients was spent employing staff.

After that we had the (NTPF) who managed the role to a better extent through the provision of private treatment, either at home and abroad, for those waiting for elective treatment for longer than 3 months. End of year figures for 2010 suggest that 200,000 people have been removed from the waiting lists as a result at a cost of just under €600 Million. However waiting lists persist to be a thorn in the side of the Irish Health System and successive department ministers. So what’s different this time?

As yet we don’t know. No information has been given as to how the (SDU) will be funded aside from the diverted funds from the (NTPF), no information has been given as to how long it will take to set it up and no information has been given as to how it intends to achieve it’s stated aims. It has however been indicated that its first priority will be to deal with waiting times in emergency departments, then inpatient waiting lists, followed by outpatients waiting lists.

This has given rise to speculation that perhaps the minister’s real agenda is to avoid a reoccurrence of last January’s emergency department waiting list which saw over 500 people on trolleys by throwing money at the problem.

The real concern is that if this is a short term fix for emergency departments, the redirecting of funds to finance it, could do long term damage to the (NTPF’s) good work and see an increase in treatment waiting lists. Indeed Minister Reilly has flagged this as a real possibility albeit on a temporary basis. The other concern is that perhaps this new initiative spells the end for the (NTPF). Indeed Minister Reilly has in the past criticized the efficacy of the (NTPF).

One of the arguments often used for the dismissal of the need for Private Health Insurance is the existence of the (NTPF). Without it and with more people cancelling their Private Health Insurance further pressure is bound to be placed on an already struggling public system. Add to that the HSE deficit of €117 Million in the first quarter of this year and further cuts due in the years to come and you have as Brian Cowen once put it “the Angola of government departments”.

Once again we wait with baited breath to see how the latest initiative holds up to the expectations of a long list of weary patients. At this point we can only wish the minister luck.

Patrick Brennan
Director of Corporate Business
Irish Health Insurance

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