The Department of Health is to spend £12 million next year in an effort to reduce hospital waiting lists. An additional £4 million was announced in yesterday's Budget and the target is to reduce waiting times in certain specialities to less than 12 months for adults and six months for children.
However, despite the additional funding, the Minister for Health Mr Cowen was unable to say yesterday when this target would be reached. He said that they are to target areas such as ENT, orthopaedics, vascular surgery, gynaecology. "We do have a major problem here. This allocation is going out along with the health boards' general allocation and will be spent over an 11month period."
Mr Cowen said to maximise the impact of the funding there will be an increased focus on waiting times rather than waiting lists. "The rate at which the waiting list is cleared is more important that the size of the list," he said.
The causes underlying waiting lists in particular areas will be assessed, he said. The criteria for allocating waiting list money will include the extent of spare capacity in each hospital, the price quoted for targeted procedures, relative efficiency in the targeted specialities and the track record of individual hospitals.
Asked about cardiac waiting lists, where some people are waiting over six years for surgery, Mr Cowen said that a national cardiac strategy was being formulated. He will be presenting a plan to the Cabinet shortly, he said. "We are investigating what it takes, how long it will take and where, for cardiac procedures to be carried out within six months of diagnosis. It will be a five-year plan."
According to the Budget £36.8 million is provided for health service development. The total funding for the health services in 1998 is £2,964 million, excluding capital, an increase of 9 per cent on the 1997 out-turn.
Mr Cowen said it was a landmark year for the health services. Health boards were getting their allocation this weekend for the year ahead and there was no question of supplementary expenditure in the coming year. The introduction of new accountability legislation requires them to be vigilant in their monitoring of service plans, he said.
Mental handicap services were allocated £12 million in the Budget, £5 million towards capital funding. Mr Cowen said this would provide approximately 300 new day places and 250 new residential places.
The charges for hospital services are being increased from January 1st, 1998:
Charges for self-referral to Accident and Emergency (A&E) departments is being raised from £12 to £20.
In-patient charge is being raised to £25 from £20 and the ceiling is being raised from £200 to £250.
Charges for private and semiprivate rooms in public hospitals are being increased by 9 per cent and the day-care charge will increase from 60 to 80 per cent of the overnight charge.
Mr Cowen acknowledged this would probably mean a similar increase in VHI premiums next year. "VHI's financial performance this year compared to last year should be much stronger. But VHI will have a whole range of reasons to come to me next year, as they do every year, for an increase."
The charges were increased by 9 per cent last year as well. But Mr Cowen pointed out that the average cost for a hospital bed per night is £300 and even with the increase only 50 per cent of the charge is being passed on to the patient.
Extra respite and day-care places, and additional personal assistants and therapists, will be provided by the £3 million allocated to physical disability services. A further £3 million has been allocated in this area to support revenue developments and tackle waiting lists for prostheses in the health boards.
A&E services are to receive an additional £2.5 million to improve services to free beds for emergency admissions through the provision, where appropriate, of alternative step-down facilities for patients occupying beds in acute hospitals for lengthy periods.
It is expected that 75 per cent of those waiting for ophthalmic services, such as sight testing, will be dealt with through the provision of an additional £1 million this year. There are 45,000 people on the waiting list.
Funding of £5 million is being provided to open new units such as theatres and wards in acute general hospitals like Limerick Regional Hospital, Temple Street Hospital and Waterford Regional Hospital. Additional funding of £3.5 million is being provided to reduce waiting times under the dental treatment services scheme, and £2 million capital funding.