Call to halt non-crucial referrals for surgery

Surgery referrals for non life-threatening conditions such as cataracts, varicose veins, and tonsillitis could be significantly curtailed from next year because many of the patients involved do not need the treatment.

Independent watchdog the Health Information Quality Authority has made the recommendation as part of plans to ensure vital funds are spent on patients who need them most.

Under the HSE-requested proposal, which has been sent to Health Minister James Reilly and can be read in full at www.hiqa.ie, surgery referrals for some of Ireland’s most common conditions will be restricted, potentially as soon as next year.

In all, Hiqa is examining 20 separate ailments, including hip replacements.

The first conclusions released yesterday refer specifically to cataracts, tonsillectomies, varicose veins, grommet insertions for hearing difficulties and adenoidectomies to address breathing issues.

And, while the conditions have an impact on the quality of life for those affected, the Hiqa findings said restricting access to surgery may be in the wider population’s best interest.

According to Hiqa, just over one in three people who were referred for these surgeries between 2005 and 2011 were found in later tests to not need them.

As such, it has recommended that surgery referrals for the named conditions should be curtailed to free up hospital space and funds, and reduce waiting lists, to help benefit the worst affected patients.

If the new Hiqa proposals are taken on board, certain procedures will be restricted to patients who are in clear need of help.

The new guidelines also stress that patients with no clear signs of the disease, but who are at risk of developing it, should not be referred — even if they would receive “limited” aid from the treatment.

There are currently 388,000 patients waiting for a first outpatient appointment and the aim of the new guidelines is to ensure the right patients are referred for the correct treatment at the right time, Hiqa’s director of health technology assessment, Dr Mairin Ryan, said.

“The thresholds will potentially provide patients and their doctors with greater clarity about the clinical criteria used by surgeons to inform the decision to operate.”

* www.hiqa.ie