HSE rejects claims waiting lists falsified

Memo suggests HSE advised manipulation of ‘long waiter’ figures to meet targets

The Department of Health has said it will be pursuing with the Health Service Executive what it described as "serious allegations" that waiting lists have been manipulated by health officials to meet targets.

The HSE said yesterday it had "no knowledge" of a confidential internal HSE memo outlining the practice, which was cited by the Sunday Business Post. The HSE said it did not condone any such practices. It also said it would take "appropriate disciplinary action" against managers if the allegations could be proven.

The department said it would be pursuing the matter further with the HSE during the week in the context of ongoing discussions regarding waiting lists.

The memo from one region of the HSE cited yesterday advised staff to give priority to those patients just about to be classified as “long waiters”.

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It said the motivation was to ensure the number of patients in this category did not increase.

The report said the memo maintained “this would mean that those longest on the waiting list would continue to wait”. It said the memo stated this practice was happening “throughout the health service in all clinical areas”.

Fianna Fáil health spokesman Billy Kelleher called on Minister for Health Leo Varadkar to clarify whether pressure was being placed on health staff to manipulate waiting lists: "If this is the case it is a shocking indictment of the management of the HSE and the unrealistic targets it was set by Government."

The row over the alleged manipulation of figures came as the HSE’s head of hospital services warned waiting lists could increase. Dr Tony O’Connell said there was no money this year to outsource waiting lists to the private sector.

He also said while outsourcing of outpatient waiting lists, as happened last year, might look cheaper, it was not without its problems: “An outpatient appointment may look like it costs less in the private than in the public system. But a lot of the underlying costs of having the clinic in the public hospital, even though it has no patients, still exist.

“We are also seeing that patients we purchased an outpatient appointment for, in need of a cataract operations for instance, at the end of last year have seen a surgeon and the doctor has said they need an operation. But they have now gone back to the queue in the public hospital to have the procedure.

“If you don’t buy the whole package you are sending them back to the public system where doctors are not always comfortable with what their colleagues in the private hospital are doing. The public doctor wants to have another look at the patient.

“You then double the cost because you have now had in effect two outpatient clinics.”

Costly side-effects

Dr O’Connell also said many problems affecting the hospital system stemmed from unintended side-effects of the Government’s austerity programme.

He said the 30 per cent cut in pay for new entrant hospital consultants introduced in 2012 had undoubtedly led to the falling attractiveness of senior medical posts.

He said all 19 doctors who had graduated from the training programme in anaesthesia had indicated they planned to leave the country.

Dr O’Connell said the ceiling on the number of permanent staff employed in the health service was “a fairly blunt instrument” to reduce the cost of labour: most of the savings generated had been eroded by the cost of taking on agency staff.

Meanwhile, at the Irish Hospital Consultants’ Association conference this weekend, its president, Dr Gerard Crotty, said patients were almost certainly dying unnecessarily while waiting on trolleys for a hospital bed.

Martin Wall

Martin Wall

Martin Wall is the former Washington Correspondent of The Irish Times. He was previously industry correspondent