Hospitals face penalties over waiting list mismanagement

MINISTER FOR Health Mary Harney has urged the Health Service Executive (HSE) to put in place a system of financial rewards and…

MINISTER FOR Health Mary Harney has urged the Health Service Executive (HSE) to put in place a system of financial rewards and penalties to encourage hospitals to manage their waiting lists effectively.

In a letter sent to the chairman of the HSE, Liam Downey, in late October, the Minister said she wanted the organisation to develop and implement a plan to address long-term waiting lists, both in terms of on- going validation and to ensure that patients did not have to wait unnecessarily long for treatment.

“In the latter case, I would ask your board to develop proposals for a set of incentives/ disincentives that would encourage hospitals to manage waiting lists effectively, with particular reference to the issue of those waiting for longer than 12 months,” she said.

Ms Harney described the issue of patients who had been on public hospital waiting lists for hospital treatment, some for more than a year, as a continuing problem. However, she pointed out that the number of such patients had fallen from 4,637 in December 2007 to 1,178 in September 2009.

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She said information provided by the National Treatment Purchase Fund (NTPF) revealed that five hospitals accounted for more than 60 per cent of those on inpatient waiting lists for longer than 12 months. She said another five hospitals accounted for a further 20 per cent of such patients.

“The NTPF points out that a number of hospitals are not adhering to the agreed waiting list guidelines, which results in an overstatement of the numbers actually awaiting a service. The data indicates, for example, that the details of over half [53 per cent] of all those on a waiting list for more than a year are awaiting clerical/administrative follow-up by individual hospitals, and a further 8 per cent have already declined offers of treatment by the NTPF at least once.

“These situations underline the importance of all hospitals maintaining accurate, up-to-date waiting lists in accordance with the NTPF guidelines, so that the true number of patients who need treatment can be established and they can receive an appropriate service,” she said.

The Minister said that where it was considered clinically appropriate that patients should be treated in the hospital on whose waiting list they already were placed, arrangements should be made to provide them with the required service as soon as possible, given the small numbers involved.

Ms Harney’s letter followed a report earlier this year carried out by the State’s spending watchdog, the Comptroller and Auditor General, which found that fewer than 10 per cent of people listed as waiting longest for elective treatment in hospital were available for treatment under the NTPF.

It said the most common reason for unavailability for NTPF treatment (37-46 per cent of cases) arose from the failure of hospital administration to follow up patients who had not responded to a previous contact, for example, the offer of a hospital admission date.

In November 2008, three hospitals accounted for almost half of the numbers in this category – Letterkenny General (340), AMNCH Tallaght (228) and Sligo General (200).

Martin Wall

Martin Wall

Martin Wall is the Public Policy Correspondent of The Irish Times.