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Private versus public

HEART OF THE MATTER
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A trolley in a hospital corridor

Private versus public

Heart of the Matter
Joan Geraghty


At the November meeting of Health Forum West, Mr Pat O’Byrne, Chief Executive of the National Treatment Purchase Fund, revealed that part of its mandate is to send 90% of patients on waiting lists for treatment to private hospitals, with just ten per cent being directed to public hospitals.
The revelation generated an outcry among the 40 county council members sitting on the forum, with one Galway Independent Councillor claiming that Bertie Ahern’s Government was ‘actively promoting’ private hospitals over public facilities.
Mr O’Byrne had just disclosed that under the National Treatment Purchase Fund (NTPF), set up in 2002, average patient waiting times had been cut from two to five years to a maximum of five months. He concluded that the NTPF is ‘a good news story for public patients in Ireland’. 
His celebratory mood was not shared by Independent councillor, Catherine Connolly, however.
“This is clearly not about public waiting lists, but about the promotion of private hospitals,” she said. “I have figures here showing wards closed and no staff available in public hospitals. The Government has successfully run down public health services while actively promoting private hospitals.
“Now we are to have four private hospitals in Galway, including one for the elderly and one for children. We have the situation where neuro-surgery is not going to be in Galway, despite the need for it, but instead the Sandyford unit in Dublin will be a ‘centre of excellence’ for neuro-surgery.
“I cannot imagine how we can have this in a private hospital and yet not have one here in Galway where you have 72,000 people. I welcome that we have finally received clarification here about what is going on, although we still need to know what prices are involved.”
Galway councillor, Fidelma Healy Eames, said the Government had to come clean on whether it was giving up on public health services.
“A total of €4.5 million of our public money went to fund the Galway Clinic, a hospital going down the tubes without such money, which receives tax breaks on top of that. That money is there for the public patient but that is not really an investment in public health services. It’s just an excuse for them to go down the swanny. It’s just covering up all the errors in our public health service.  I think there is a cover-up job to keep private hospitals going.
”We need a public debate in this country to see if we want to support private health care. We need a complete reform to see how that money would better go in to funding our public services. One million of the population has private health cover, while three million are without it. Health is the most essential resource for us all to live and we must have health for all.”
Contending that the NTPF is an advocate for public patients, Mr O’Byrne added that up to 95 per cent of patients who qualified for the fund were treated within the State, ‘despite rumours that everybody is being sent abroad and might never see their family again’.
“We do refer patients for specific paediatric and cardiac surgery to the North and, yes, we do have to send some abroad because of capacity deficiency.”
He added that the budget for the NTPF for 2006 of €78 million equated to just half of one per cent of the total health spend. During the year, 53,000 people on waiting lists had received treatment under the initiative.
“Everybody is entitled to a bed in a public hospital at the moment. We’re there for those on social welfare and those on medical cards etc. Our mission is to reduce the length of time people wait for their operations and get them back to their lives and all that goes with it.”
He said that in 2005 a number of pilots were conducted, which involved 4,500 patients being referred to private hospitals.
“That experiment had positive feedback from patients and hospitals, which shows this works. People can be treated quicker going the private route. Of the 4,500 referred, 25% were seen and discharged back to their GP, 13% were sent for further investigation, 41% required surgery and 18% just didn’t turn up. So all that some need is to be seen by a consultant, reassured and they’re fine again. We have expanded this initiative in 2006 to offer up to 7,000 patients first time appointments.”
As the debate raged on, it came to light that plans to develop another private hospital in Galway, on the grounds of UCHG, are now well advanced. Demand for specialist services within the public health sector, meanwhile, continues to grow.
“Statistics for patient operations show that neuro-surgery has increased by 60%, open heart and cardiac procedures have doubled, while orthopaedic work on knees and hips has ballooned.
“Joint replacement surgery is a victim of its own success because people go for it and more people are demanding it. At some stage we all have joints that need replacing,” said Mr O’Byrne.
“While a certain amount of the steam has gone out of the inpatient waiting list, they haven’t all gone away, but a lot of the bottlenecks are at the outpatient stage and people can’t get to see consultants.”
The lo call number for the NTPF is 1890 720 820 or log on to www.ntpf.ie.