Minister Martin announces enhanced role for the National Treatment Purchase Fund in tackling hospital waiting lists
Comptroller and Auditor General´s Report on the WLI
The Comptroller and Auditor General (C&AG) has carried out a review of the Waiting List Initiative (WLI) which focused on the period 1998 to 2002. The C&AG’s Report acknowledges that the reported number of patients waiting longer than the target waiting times for elective treatment decreased by around 40% between the start of 1998 to the end of 2002. The C&AG also found that WLI funding resulted in more active management of waiting lists and waiting times and better hospital bed utilisation. The Report does, however, acknowledge that the waiting list problem is highly concentrated in hospitals in the Eastern region. The Report will now be laid before the Houses of the Oireachtas.
Waiting List Initiative (WLI)
The Waiting List Initiative was introduced in 1993 and has succeeded in having many thousands of patients treated through the dedicated funding of close to €250 million provided to hospitals between 1993 and 2002. In fact, two thirds of this funding (€172 million) has been provided between 1998 and 2002. Hospitals used the funding in various ways to increase elective activity and reduce waiting times in nine target surgical specialties.
- The WLI made a considerable contribution to the increase in acute hospital activity which increased by some 25% in the period 1997 to 2002. Day case work increased by 60% in the same period. Approximately half of all elective surgery is now carried out on a day basis.
- Through the combined efforts of the Waiting List Initiative and the National Treatment Purchase Fund there has been a reduction of over 40% since June 2002 in the number of adults waiting longest for in-patient treatment in the nine target surgical specialties.
- The number of children waiting more than 6 months for treatment in the nine target surgical specialties has decreased by 57% since June 2002.
Over the period of the WLI some health agencies employed additional consultant and support staff in order to provide additional capacity in public hospitals to increase the capacity for elective treatments. In recent years a number of long-term temporary consultant posts were converted to permanent status in line with the policy of Comhairle na nOspideal which is the statutory and regulatory body for the appointment of medical consultant staff. The Minister intends to continue to fund these posts which have now become part of the base or continuing costs of health agencies.
The C&AG report points to the scope for coordinating of waiting list funding more effectively. In this regard, and in light of the commitments given in the Health Strategy to reform the organisation and management of waiting lists, the Minister has decided that waiting list funding will, in future, be channelled through the National Treatment Purchase Fund.
“Having a single funding stream through the NTPF to reduce waiting times for patients will ensure an efficient use of resources and guarantee good value for money from the funding being provided.” The Minister said.
The Minister for Health and Children, Mr. Micheál Martin, T.D. today (26th November, 2003) announced that the National Treatment Purchase Fund will now be taking the significant lead role in targeting waiting times for patients. To date the NTPF has arranged treatments for approximately 9,000 patients. Satisfaction among those patients who have availed of the services being provided by the NTPF is very high. Currently, the NTPF has the capacity and funding to provide over 800 treatments per month in a wide variety of specialties.
The benefits of having a dedicated multi-disciplinary team working together under the National Treatment Purchase Fund (NTPF) has proved very effective in the validation of hospital waiting lists. The NTPF, in association with the acute public hospitals, identifies the individual patients who are on waiting lists and the specific procedure required. In the course of their work the NTPF has experienced a very high level of validation, in some cases up to 40%, during the course of its task in identifying individual patient needs. Building on the experience to date the Minister expects that the NTPF will succeed in identifying the true waiting lists at individual hospital level.