Dublin bears brunt of waiting list problem - C&AG

Four Dublin hospitals accounted for more than half of patients on long waiting lists at the end of last year, the Comptroller and Auditor General, Mr John Purcell, said in a report today.

The report on Mr Purcell's examination of the operation of the Department of Health's Waiting List Initiative (WLI), says Beaumont, the Mater, St Vincent's and Tallagh hospitals accounted for the majority of long waiting patients.

The Waiting List Initiative (WLI) was introduced in 1993 to deal with the problem large numbers of patients waiting long periods for elective treatment.

At the end of last year, the report says, the estimated average waiting time for public elective treatment in all hospitals in the Eastern region was almost 13 months for adults and nine months for children. These estimated averages were higher than the target maximum waiting times, the report says.

However, the reported number of long waiting patients has fallen by approximately 40 per cent from 1998 to 2002 — from 14,100 to 8,700. The C&AG report says this improvement is attributable to the impact of the WLI, increased funding generally of acute hospitals and, from the second half of 2002, the operation of the National Treatment Purchase Fund.

A total of €246 million was allocated under the WLI between 1993 and 2002. More than two-thirds of the funding (€172 million) was spent between 1998 and 2002. The report says that up to half of WLI money is now being spent on funding of temporary medical posts and associated support staffing, which increases treatment capacity.

"This has reduced the discretion available to the Department and health boards to move WLI funding to where the problem of long waiting remains greatest," the report says.

"It also results in significant amounts of WLI funding being directed, on a more or less permanent basis, to some hospitals and health boards that have succeeded in reducing the reported number of long waiting patients."

Improvements are needed, the report says, in the measurement, management and reporting of waiting lists and waiting time to ensure that data collected and reported is more accurate, consistent and useful.

The C&AG is an independent constitutional officer with responsibility for the audit of public funds. He reports to Dáil Éireann.

Fine Gael said the Waiting List Initiative (WLI) scheme was being "badly managed, badly targeted and does not provide value for money",

The party's spokeswoman on health, Ms Olivia Mitchell, said: "The C&AG's report on the operation of WLI mirrors almost every other report on the health service and highlights again the urgency of introducing new forms of governance.

"The poor management and poor information, which characteristics the health service, also bedevils the WLI initiative and makes real evaluation impossible."

Labour said the report showed the Government's efforts to reduce waiting lists were a "shambles". The party's spokeswoman on health issues, Ms Liz McManus, said: "There are 3,280 more people on waiting lists today than there were in June 2002 when the Government was returned to office.

"Micháel Martin has had the audacity to admit that the promise to end waiting lists in two years was a 'mistake', and all the targets on waiting times under the National Health Strategy have so far been missed."