Treatment purchase fund - Obstruction of scheme intolerable

AT a time when efforts are being made to overhaul Ireland’s creaking health service, it is outrageous but perhaps not surprising that a number of consultants and hospitals are obstructing the treatment of patients under the National Treatment Purchase Fund (NTPF).

This regressive scenario, highlighted in the NTPF’s report on the progress of an increasingly successful scheme, is reprehensible and reflects badly on the motives of a vested interest group that includes some of the highest-paid people in the country.

In a healthcare system dogged by delays and difficulties, it is utterly unacceptable that individuals or institutions are not cooperating with measures aimed at accelerating the treatment of patients, many of whom have been waiting for years for surgical procedures which should be carried out as a matter of course.

Set up four years ago to reduce waiting times by referring patients for treatment in the private health sector in Ireland and abroad, the scheme is working. It operates on the basis that the fund could pay for alternative procedures on patients who were waiting for over three months at a hospital here.

In contrast with the dreadful scenario in 2002, when patients were waiting between two and five years, the average waiting time for general surgery has been reduced to between two and five months.

While around 95% of patients were treated in Ireland, the remainder were sent to Britain, the North and the US for treatment. Overall, 18,197 patients were treated last year under the fund which had a budget of €64 million. To date, more than 43,000 patients have been treated and the target is over 60,000 by the end of this year.

According to NTPF chief executive Pat O’Byrne, the finger of blame for not co-operating with the scheme is pointing chiefly at Cork University Hospital, Beaumont Hospital in Dublin and Sligo General Hospital.

The irony is, according to Tánaiste and Health Minister Mary Harney, that the very hospitals which are not referring patients to the NTPF are also the ones “with the biggest problem as far as A&E is concerned”. It is time that situation was rectified.

Interestingly, while the Irish Hospital Consultants Association claimed in a terse statement yesterday that its members are cooperating with the scheme, it goes on to concede that in a small number of cases, circumstances may arise which result in consultants not cooperating.

On the face of it, that would seem to imply tacit acceptance of a situation which ought not to be tolerated.

It goes without saying that the more cooperation that is forthcoming from consultants, then the greater progress can be made towards cutting waiting lists and bringing the treatment of patients up to standards regarded as the norm in other countries.

Regardless of the reasons consultants may offer for not cooperating with NTPF policy, the Government should not hesitate to go down the road indicated by Ms Harney by introducing whatever measures are necessary to empower GPs to refer their patients directly to the scheme.

Effectively that would help to bypass those who continue to obstruct its progress, perpetuating Ireland’s two-tier health system in the process.

In the final analysis, if certain hospital consultants persist with a policy of refusing to cooperate with this worthwhile scheme merely to protect personal fiefdoms, a tactic which is inevitably making life more difficult for long-suffering patients, they should be named and shamed.

If the Health Service Executive is to succeed in reforming the current system, the welfare of patients must be seen to transcend the narrow interests of selfish vested interest groups and individuals.