Public patients have to wait at least six times longer than people with private health insurance for essential heart tests, a new report reveals.
Eighty per cent of public hospitals do not allow GPs refer patients directly for echocardiograms, an essential diagnostic test for heart patients, according to the research by heart and stroke charity Croí.
Public patients generally have to see a cardiologist at a hospital outpatient clinic before they can be referred for an “echo”, thereby increasing the time they have to wait before being tested.
While private patients wait on average up to one month for their test, waiting times in the public system are at least six months and in many cases over one year.
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In the UK, patients have a legal right to treatment within 18 weeks of referral and the national health service pledges that patients should not be required to wait longer than six weeks for a diagnostic test.
In Ireland, Croí says only private hospitals meet this benchmark. Delays in the public system are linked to a lack of trained personnel and streamlined referral pathways.
Greater inequalities
Just five public hospitals allowed GPs to refer patients directly for the test — three in the Saolta hospital group covering the west and northwest, and one apiece in the RCSI and Ireland East hospital groups.
There is a danger of even greater inequalities and wait times for tests in the future due to an undersupply of cardiac physiologist graduates, the healthcare professionals who provide ‘echoes’, entering the workforce, according to Paul Nolan, who contributed to the report. The profile of cardiac physiologists is ageing, with up to 20 per cent set to retire within five years in some hospitals.
Physiologists are readily employable in many countries. Some 28 physiologist posts in the HSE are unfilled, he pointed out, and 92 in England and Wales.
Echocardiography uses sound waves — ultrasound — to take a moving picture of the heart. It is routinely used in the diagnosis and management of a range of heart conditions, including heart valve disease and heart failure.
“This research demonstrates glaring inequalities in what is available to Irish patients,” according to Croí chief executive Neil Johnson. “A delayed diagnosis can result in deterioration which limits treatment options or can even prove fatal.”
Echoes can now be performed on increasingly portable and affordable equipment, he pointed out.
Up to 13 per cent of people over the age of 75 are thought to be living with heart valve disease, with the number of people affected expected to double by 2040, though the condition is treatable. Mortality for the most common type of untreated heart valve disease is between 25 per cent and 50 per cent per year.
