Doubt has been expressed by a member of the Eastern Regional Health Authority that it will be able to implement its plans to curb the influx of patients coming to its hospitals from other regions, writes Eithne Donnellan, Health Correspondent.
The authority has devised new protocols to stem referrals for treatment which can be carried out in the patient's own health board area.
These referrals, it says, are putting increased pressure on overstretched hospitals in the eastern region and pushing people in the east further down waiting lists.
In future, it wants GPs to refer patients to their local hospital or local specialist.
Patients should then only be referred to ERHA hospitals if they require treatment not available in their own health board area.
Members of the authority adopted the plan at their monthly meeting on Thursday night and gave the go-ahead for negotiations with other health boards and hospitals on implementing the new framework.
However, yesterday a member of the ERHA who was not at Thursday night's meeting, Dr Maurice Guéret, said he had "serious doubts" about the plan working.
He said he could not understand why the ERHA had not just decided to bill health boards across the country for treating their patients.
It appeared, he said, there was no provision at present for health boards to reimburse each other. "It would be a lot simpler to bring that in," he said.
Some 270,000 bed days were used in hospitals in the east in 2001 by patients from outside the region. Treating them cost €174 million.
Dr Guéret predicted that people in the regions would find their way around the new protocols. "One very easy way around it is to give a relative's address in Dublin," he said.
There was also a danger of the plan impacting on the clinical independence of family doctors who had always been able to refer patients to where they felt they would get the best care.
He accepted, however, that the influx of patients was causing problems.
The size of the ERHA's annual budget was based on the size of its population, but it was also catering for large numbers of people from other regions without getting the necessary funding.
"We do have a problem. We are just going about solving it the wrong way," he said.
Meanwhile Labour's health spokeswoman, Ms Liz McManus, said the ERHA's plan of action was akin to "moving deckchairs on the Titanic".
"While it is understandable that the ERHA is proposing changes to relieve pressure on its own resources, I am concerned that it is limiting access to treatment for patients in other parts of the country and increasing pressure on local hospitals.
"It is simply relocating the problem of patients being forced to wait to access care," she said.