This year is the third anniversary of the National Treatment Purchase Fund (NTPF). A Government initiative, its primary objective was to reduce the waiting times of patients for treatment on public hospital waiting lists. At the end of August (the latest figures available), more than 34,000 patients had been treated by the fund.
Its chief executive Pat O'Byrne said earlier this year that the target was to continue to reduce waiting times and to treat 16,000 patients.
For some people the NTPF has been imperative in their treatment and in often putting an end to a six-year wait for a procedure. The NTPF treats adults for a wide variety of procedures ranging from heart bypasses and hysterectomies to hip and knee replacements. Children are also treated and procedures include tonsillectomies.
In 2003 the NTPF was allocated €31 million in funding, this was increased to €44 million last year, and to €64 million this year.
NTPF patients also ensure business for consultants who work in hospitals that are part of the NTPF scheme. The summer months can often be a quiet time for consultants and a guaranteed stream of business from the NTPF is an attraction. One consultant in the Blackrock Clinic said the NTPF took slots on consultants' private lists that might not be full otherwise.
Private hospitals in Dublin to which NTPF patients are referred include the Blackrock Clinic, St Vincent's Private Hospital, The Mater Private Hospital and the Bons Secours Hospital. Patients are also referred to certain hospitals in Northern Ireland and Britain. In a small number of circumstances children have been referred to the John Hopkins Hospital in Baltimore in the US for cardiac surgery.
The process involved for treating an NTPF patient is as follows:
• Having been waiting for often a period of three to perhaps 12 months the patient is contacted by the hospital and asked whether they wish to be treated by the NTPF.
• The patient is usually given the choice of treatment in Ireland or Britain with expenses paid.
• Their notes are referred to a private hospital where the NTPF liaison officer in that hospital forwards their notes to the relevant consultant.
• The case notes are studied and the patient, if suitable, is given a date for a consultation followed by a date for the procedure.
• There is an approximate six- week wait from the time the consultant first receives the notes to the date of the procedure.
• Following referral, orthopaedic patients must be seen by a medical physician in the hospital for a pre-screening and only if they are deemed fit, are they referred to an orthopaedic surgeon.
• Patients are deemed unfit if they have a weight problem for example. The weight issue must be dealt with first before they are referred for a consultation with the surgeon.
The fund has been successful for patients who have spent a long time waiting in pain for treatment. However, there is also a negative side.
Although the NTPF tries to get patients treated in the relevant private hospitals, some consultants in the past have chosen to decline treating NTPF patients in order to treat their private patients, who are waiting for procedures and who pay annually for private health insurance. According to one physician, if you are busy it is not always viable to take on NTPF patients. Some consultants say they also have to deal with an increasing amount of NTPF patients who do not attend their consultation or in some cases their procedure date.
Some observers think the fund's future is somewhat uncertain. "If the waiting times come down to three months we could happily put ourselves out of business, if the goal has been achieved,"' says Maureen Lynott, NTPF chairwoman.