NTPF rip off

Letter in yesterday’s Irish Times.

Madam,

The National Treatment Purchase Fund (NTPF) has a budget of of €100 million in taxpayers’ money for 2008.

According to the NTPF’s latest report, some 20,000 “in-patients” were treated in 2007 at a cost of €92 million. The report does not provide precise details of the procedures performed or of their individual cost, but at least two-thirds of the procedures listed, such as endoscopy, tonsillectomy and dental extraction, would normally be carried out as day-case procedures, which are relatively inexpensive.

Some 10,000 out-patient consultations and some 2,000 MRI scans were also provided. Excluding the out-patients, the cost per in-patient treated was therefore €4,600. Four private hospitals shared €49 million of the fund.

The Mid-Western Regional Hospital complex in Limerick, which includes three hospitals – the Regional Hospital, the Regional Maternity Hospital and Croom Orthopaedic Hospital – has a budget of €195 million. In 2007, it treated 33,000 genuine in-patients, about 75 per cent of which were emergency cases, of all levels of complexity, and 19,000 day-case “in-patients”; 29,000 new out-patients were seen along with 109,000 review out-patients. Again excluding this massive out-patient activity, the cost per-inpatient treated was €3,750.

There is something radically wrong here. On the basis of these numbers and the case mix, the NTPF figures suggest a waste of, at the very minimum, €20 million.

Those who are committed to eroding our public hospital system in favour of creeping privatisation might take note.

Yours, etc,

Dr GERRY BURKE, Riverside Clinic, Steamboat Quay, Limerick.

The figures quoted in this letter are astonishing and outrageous. The NTPF was originally set up to treat seriously ill patients languishing on long waiting lists. The idea was to treat these patients outside the jurisdiction in order to relieve pressure on a creaking and inefficient health service.

But as always in Ireland the scheme has been corrupted. Here’s how it now works.

A consultant in a public hospital treating a public patient will be paid X amount for his work. If that patient is put on the NTPF list the consultant’s fee is considerably increased.

So, we can have a situation where a consultant, working in a public hospital paid for by the taxpayer, treats a patient in the morning and decides to put him on the NTPF list. The same consultant returns in the afternoon and because the patient is now on the NTPF list and therefore judged to be a private patient the consultant’s fee is multiplied.

As the above letter reveals many of the treatments are not of a serious nature and therefore should not qualify for NTPF. I suspect that the €20 million wastage mentioned is a fraction of the total cost to the long suffering taxpayer.

See here for more on this scandal.