Inpatient waiting lists here could disappear in two years if hospital stays were cut to match those in England, a new report claims.
he Northern Ireland Fiscal Council study of health spending has uncovered alarming inefficiencies in our health service weeks after it emerged that the system is facing a £450m black hole.
It also revealed a number of shocking disparities between the NHS here and in England. Among the findings were:
• People here are four times more likely to be waiting for planned care than in England.
• We have the longest waiting times in the UK for emergency care.
• Bed blocking cost £63.5m in just three years, with 139,000 bed days lost between 2016-17 and 2018-19.
• The average cost of day case treatment here is almost £100 more than in England.
• The average cost of an outpatient appointment in Northern Ireland is £211, compared to £133 in England.
• In December last year, 53% of those waiting for a first hospital appointment had waited more than a year, compared to just 5% in England.
The Northern Ireland Fiscal Council was established last year to bring greater transparency and independent scrutiny to the region’s public finances, with a focus on the Stormont Executive.
Its most recent report has focused on health service spending and revealed that the average hospital stay is 1.5 days longer than in England.
He said that if the average length of stay were reduced to match that of England, local hospitals could accept another 200,000 admissions a year.
He added: “If a quarter of these were used for planned care, Northern Ireland’s 120,000 inpatient waiting lists could, in theory, be eliminated within two years.”
It comes amid growing concern that waiting lists could balloon further if health trusts are forced to scale back elective activity to help ease pressures on emergency departments.
Referring to a Nuffield Trust study commissioned by the council, the report said “a major source of excess cost” is bed days, where a patient’s stay in hospital is longer than expected.
It said: “Over the last year, where comparable data is available, excess bed days accounted for 10% of all inpatient costs admitted in Northern Ireland, compared to just 5% in England.”
Another stark conclusion was that health spending here would have been £340m lower in 2019-20 if per capita spending had been in line with England.
Meanwhile, the average cost of patients admitted to hospital increased by 28% between 2015-16 and 2019-22, compared to 8% in England over the same period.
Professor Deirdre Heenan, who was part of an expert panel that carried out a major review of the NHS in 2011, described the report as a “damning indictment” of the way the health service works in Northern Ireland.
“This report says there are very serious problems with productivity and inefficiencies,” he said.
“It tells us that, over the last decade, we have had more money per capita than England, but our results are much worse.
“Despite this, there doesn’t seem to be any accountability.
“There are doubts about transparency, about financial scrutiny.
“This report raises serious questions about oversight, accountability, governance and how we spend public money.
“Which is the Health Department going to do with this report?
“Nobody seems to be responsible, and you have to ask: who is in charge?”
Mark Taylor, the Northern Ireland director of the Royal College of Surgeons, said the report “draws uncomfortable comparisons with our counterparts in England”.
He added: “We have over 360,000 people waiting to see a consultant for the first time and over 124,000 patients waiting for surgery or treatment.
“Unbelievably, more than 40% have been waiting for more than two years.
“We know that disadvantaged communities are most affected by excessive or increasing wait times, and this report once again shows the scale of unacceptable wait times experienced by patients.
“We are worst in the UK for elective waiting times and demand shows no signs of slowing down.
“We urgently need a functioning Executive and a recurring budget so that we can really begin the work of turning the tide of this difficult situation that affects our population.”
Sinn Fein MLA Colm Gildernewformer chairman of the Stormont health committee, echoed Mr. Taylor’s calls for a functioning Assembly.
It is in limbo due to the DUP boycott over opposition to the Brexit protocol.
“Behind the statistics and figures are human beings, people struggling with a cost-of-living crisis and having to wait an unacceptable amount of time for often urgent medical care,” he said.
The Department of Health said reconfiguring services offered the best prospect for greater financial stability while improving quality of care.
He added that the design plan commissioned by the Ministry of Health on the future shape of services will map out how the reconfiguration could be delivered.
“There is no doubt about the substantial difficulties facing the system; however, we are committed to improving our services for all and this important work will greatly assist in this vital work.” she said.