Elderly and more vulnerable being “taken advantage of” in drive to reduce waiting lists, GP says

A Co Galway GP has claimed the Health Service Executive is taking advantage of the elderly and more vulnerable patients in its bid to reduce waiting list numbers.

Dr Mary Rogan, who runs a large general practice in Annaghdown, north of Galway city, said she had had a number of instances where elderly people she referred to be seen by specialists at Galway University Hospital (GUH) were referred by the HSE for their appointments to hospitals as far away as Mullingar, Sligo or Limerick.

They were then removed from the waiting list when they were unable to attend these appointments at hospitals outside the region, she said, despite them having informed the HSE that it was too far to travel.

Many of her patients affected by this were over 70 years of age, and over 80 years of age in some cases, she said, and a number could no longer drive.

Other elderly patients who were referred to the Galway hospital group by her were offered appointments within its catchment, in Roscommon.

One of these patients, who spoke in confidence to The Irish Times, said he was over 80 years of age and could not travel to Roscommon for his varicose veins appointment as he had eye trouble. He said he was afraid he would be "put to the bottom of the list" if he refused.

HSE West disputed this and said that if a patient declined the opportunity to be treated in another hospital, he or she remained on the GUH waiting list unless he or she specifically requested to be removed.

“Our policy is to offer the patients the option of treatment in any of our hospitals and we are actively working to use the resources in Roscommon and Portiuncula for less common procedures,” HSE West said.

Phone calls

However, Dr Rogan said she had to make a number of phone calls to ensure patients were kept on waiting lists.

In a letter to GUH last month, Dr Rogan said the “predominant theme” she had picked up in telephone conversations with hospital administrative staff was a perception that patients were “recalcitrant, were difficult and were declining appointments or just not turning up, having accepted appointments”.

“If a large cohort of individuals are displaying this kind of behaviour, there is obviously a difficulty,” Dr Rogan wrote. “I do not think it is adequate to state that patient behaviour is primarily the cause of the problem. Rather I think that the effectiveness of the hospitals’ communication with the patient needs to be studied.”

Under the current public system, patients are offered a group time for clinic appointments which may apply to a large number of people. Consultants have little control over how the times and numbers are assigned by HSE administration.

Dr Rogan said that while she welcomed the tackling of long waiting lists, it would appear that waiting list figures were “sometimes being manipulated in order to look better”.

“We should put the patient first, not the figures,” she said.

Non-HSE hospitals

HSE West said that in line with national policy, patients were offered the option of attending non-HSE hospitals in situations where their waiting time exceeded the special delivery unit wait time target of 12 months.

“If patients agreed, their referral details were forwarded to the non-HSE hospital, and they were contacted to make an appointment,” it said. “These patients remained on a designated waiting list in the Galway/ Roscommon/ Portiuncula (GRUHG) hospitals group until confirmation that they had been seen was received and only then were they removed from the list,” it said.

In all, 7,268 patients opted for this last year, it said.

However, it acknowledged that 360 people “did not attend their hospital appointment and, therefore, in line with hospital and national policy, they were removed from the waiting list at the non-HSE hospital and in the GRUHG hospital”.