ALL PUBLIC hospitals were being instructed to ensure they had no patients waiting more than 12 months by the end of this year, Minister for Health Dr James Reilly said at the MacGill Summer School last night.
Should they fail to do so, the National Treatment Purchase Fund (NTPF) would ensure the necessary treatments and the hospitals’ budgets would then be reduced by a corresponding amount in 2012.
The Minister’s instruction takes effect immediately and is being presented as another stage in the implementation of the Government’s health reform agenda, following on from last month’s establishment of the Special Delivery Unit (SDU) to cut waiting lists .
“When I announced the setting up of the SDU, I said that the role of the NTPF would be changed to support the mission of the new unit. The SDU led by Dr Martin Connor is already putting systems in place to track, monitor and manage patient flows through the hospital system.
“I intend that the resources of the NTPF, and by that I mean not just financial resources but also its data systems and highly trained and experienced staff, will now be fully aligned with the SDU,” the Minister said.
There are three main changes involved: firstly, all public hospitals are being instructed to ensure they have no patients waiting more than 12 months by the end of the year. Secondly, the NTPF will target particular backlogs rather than routinely accept referrals of patients waiting over three months; and thirdly, the requirement that the NTPF purchase 90 per cent of treatments in the private sector is being ended.
“It is unacceptable that hospitals leave some patients on waiting lists for very long periods of time, safe in the knowledge that the NTPF will eventually pick up the tab.
“I will no longer tolerate this attitude to patients – hospitals need to become accountable for the listing decisions of their surgeons,” Dr Reilly said. “I want a system where the patient and taxpayer get the greatest return on scarce resources consistent with quality and safety.
“I am ending the requirement that the NTPF purchase 90 per cent of treatments in the private sector. The NTPF will purchase treatments wherever it gets the best value in either the public or the private sector,” he said.
“I want the NTPF to drive a hard bargain on behalf of patients without regard to the location of the treatment.”
Dr Reilly told reporters it was unfair to patients “to leave them on waiting lists for 12 months, 18 months and two years”.
Health policy analyst Dr Ruth Barrington told the summer school it was an exciting time in health policy.
“The health system is to be reformed to provide access for all to medical care on the basis of need, not ability to pay.
“The funding model will change to a model of payment based on social solidarity – the healthy and the wealthy supporting the costs of caring for the unhealthy and the unwealthy, both within and across generations. This is a momentous change.”
However she urged the Government also to address the “much bigger issue” of the unequal distribution of health in our society.
“It is now widely accepted that governments and health systems have a responsibility, not simply to guarantee fair access to health care but also to address the underlying social and economic inequalities that shorten the lives of poor people and burden their lives with more illness and disability,” Dr Barrington said.
Health policy journalist Aileen O’Meara said there were vested interests opposed to change in the health services – “but there are also lots of staff who want to change”.
There was “a real mood for change” now and this was the time when people would engage, including the unions, Ms O’Meara added.
