In the report of the Comptroller and Auditor General on the waiting list initiative, the Comptroller and Auditor General notes that the existence of a waiting list does not, in itself, indicate that a problem exists within the system. The Comptroller and Auditor General goes on to say that achieving optimum efficiency in the provision of public services may inevitably result in the creation of waiting lists.
As the Deputy will be aware, there are two streams to hospital activity — emergency and elective activity. Pressures on the hospital system due to identified capacity constraints hinder its ability to provide elective activity in a planned way because of the urgent and unpredictable needs of emergency patients. This is a complex area and compounded by difficulties relating to the availability of long stay beds and other supports in the community. Patients who require elective treatment may have to wait because beds, staff and operating theatres are being used to treat emergency cases. The balance to be achieved is to ensure that the available resources are used efficiently and that treatment can be delivered to patients in a reasonable time.
The waiting list data for the period ended 30 September 2003 showed that there were significant reductions in the number of adults and children waiting longest for in-patient treatment. The total number of adults waiting more than 12 months for in-patient treatment in the nine target specialties has fallen by approximately 42% in the period September 2002 to September 2003. The total number of children waiting more than six months for in-patient treatment in the same specialties and for the same period has decreased by approximately 39%.
Significant progress has been made in many health board areas to achieve the target of no adult waiting longer than 12 months and no child waiting longer than six months. This has been achieved through active management of long waiting lists at a local level and the involvement of the national treatment purchase fund, NTPF. Up to the end of December 2003, more than 9,700 patients had already received treatments through the NTPF, predominantly in private hospitals in Ireland. All health boards outside of the eastern region are reporting that, in general, those adults reported to be waiting more than 12 months and those children reported to be waiting more than six months have either been offered treatment under the NTPF or have conditions that are complicated and need to be treated locally.
While the rate of progress in achieving the targets set out in the health strategy has been slower than anticipated, the targets still remain a goal to be achieved and I will continue to keep the focus on reducing waiting lists and waiting times.