Public patients pay for private consultations to skip queue

A growing number of desperate patients on public hospital waiting lists are paying for appointments in a bid to skip the queue, it has emerged.

Faced with delays of up to two years to see a specialist at a public outpatient clinic, patients and their families are finding the money to secure a private consultation in the hope of being fast-tracked onto a surgery list and cutting their wait for treatment.

It comes as 515,000 patients are waiting for an outpatient appointment and nearly 71,000 still languish in the queue for surgery.

A consultation in a hospital consultant’s private rooms costs between €150 and €200.

If, after examining the public patient for the private fee, the specialist recommends surgery they may put the patient on their public surgical waiting list.

It means they can jump the public outpatient list and slash the time they must endure before getting their operation.

Dr Michael O’Keeffe, the retired Mater Hospital ophthalmologist who is now in private practice, said some patients are using this route to speed up their wait for surgery.

“They can be taken off the public outpatient list and put on the public surgery list. They are still waiting but it’s for a shorter time.

“I can appreciate how desperate patients feel but they should not have to resort to this. Other patients are left waiting.”

ScolioNetwork, which represents children with scoliosis, the severe spinal condition, said some worried parents are having to resort to this method of getting a private outpatient appointment to get quicker treatment.

The public outpatient lists are so long parents who are knowledgeable and have the ability to pay are going to a private clinic. If surgery is necessary they are placed on the public surgery list.

Many children who have scoliosis are waiting more than a year for their first outpatient assessment and concerned patients are distressed at seeing their child deteriorate.

Professor Paul Burke, a vascular surgeon who is chief clinical director of the University of Limerick Hospital Group, said: “Equity of access to the public hospital would be improved if private practice is removed from the public hospital.”

There would be “less incentive to ensure preferential access of the patient who joined the hospital queue from the private consultation”.

He makes his comments in a submission to the expert group looking at whether private practice should be removed from public hospitals.

In response the HSE said: “If a consultant sees a patient privately in rooms or a private clinic and then determines that the patient requires surgery, the patient can choose to be seen privately or publicly in that public hospital.”

A spokeswoman said a common waiting list is the current policy.

The HSE service plan for 2019 has signalled the number of in-house surgeries for public waiting list patients will reduce and more reliance will be placed on the National Treatment Purchase Fund (NTPF), which has €75m to buy treatments, many in private hospitals.

However, at the end of 2019 some 59,000 people will still be on a waiting list for surgery.

Meanwhile, a breakdown of who benefits from the NTPF and how it spends its money shows that the treatments it buys for public patients are heavily concentrated in a number of specialties such as cataracts and varicose veins.

A spokesman for the NTPF said it identified seven procedures for which a large proportion of public patients are waiting – specifically cataracts, joint replacements, tonsils, cystoscopies, skin lesions, angiograms and varicose veins.

The NTPF has targeted these procedures so that by the end of 2018 all patients who are clinically suitable for outsourcing and who are waiting for more than nine months for one of these procedures will have received an offer of treatment.

In addition, the NTPF is arranging treatment for patients waiting for more than 50 other procedures. Within each procedure arranged, longest-waiting patients are authorised for treatment first.

“Working with the HSE and the Department of Health, the NTPF has contributed to a 16pc reduction in the number of public patients waiting for an appointment for elective surgery since July 2017, the month NTPF commissioned treatment began to impact. There were 13,393 fewer patients on the active inpatient daycase waiting list at the end of September 2018 compared to July 2017. The number waiting more than nine months has reduced by 32pc over the same period.

“In 2019, the NTPF will arrange treatment for 25,000 patients on the active inpatients and daycase waiting list, 5,000 gastrointestinal endoscopies and 40,000 first-time outpatient consultant appointments.”

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