NCPA - National Center for Policy Analysis

"Unofficially" Waiting for Care in Ireland

September 18, 2001

Ireland's hospital waiting list system is "flawed, inequitable and in need of reengineering," according to a report from a group of management specialists, says the British Medical Journal.

Waiting lists are used by countries with national health systems to ration health care. In addition to waiting lists, there are often "unofficial" waiting lists -- obstacles patients must navigate on the way to getting on the official waiting list.

That is apparently the case with hospital waiting lists in the Republic of Ireland, according to the leaked report from the Harvard Association, a Dublin-based group of Harvard University graduates.

Their report is based on interviews with "key stakeholders" in the acute hospital process: hospital consultants, hospital managers, general practitioners and patients.

  • The report warned outpatients were not going on the official list for up to three months because they had to make return trips, due to a lack of resources and consultants in outpatient departments.
  • It found surgical patients categorized by a consultant as "routine" might be "left waiting indefinitely for years without a realistic expectation of treatment."
  • The waiting lists were "totally skewed," with people from outside Dublin seeking treatment at the capital's specialist units, resulting in blocked access for local residents.
  • The group argued that waiting list "targets" of three, six or 12 months were "arbitrary and lack any substantive clinical meaning."

It recommended that the Irish government "depoliticize" the waiting list, and that private hospitals be given more incentives to conduct more public work.

"There should be a mandatory requirement to inform patients as to the length of waiting lists with the option to go elsewhere," it concluded.

Source: Doug Payne, "Ireland's waiting lists are inaccurate," British Medical Journal, September 15, 2001.


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