Examination of Witnesses (Questions 140-159)
NORTHERN IRELAND
DEPARTMENT OF
HEALTH, SOCIAL
SERVICES AND
PUBLIC SAFETY
2 NOVEMBER 2004
Q140 Mr Bacon: On top of those who
are waiting more than 12 months.
Mr Gowdy: We will give you the
accurate information on this.
Q141 Mr Bacon: If you could send
us a note that would be helpful.
Mr Gowdy: It is important to give
you the accurate information.
Q142 Mr Bacon: I would love a note
with accurate information, that would be great. In the ballpark,
3,000 plus 2,000, so 5,000, 5,500?
Mr Gowdy: More than 12 months?
Q143 Mr Bacon: Yes.
Mr Gowdy: That is my expectation
but I would like to give you the accurate figures because we do
not record—[4]
Q144 Mr Bacon: The point is that in the
context of the table on page 66 where you have got available sessions
of 48,000 and sessions held of 30,000, it is a soluble number
of people, is it not? If you increased your efficiency radically
then you could do a very, very great deal to reduce those waiting
lists.
Mr Gowdy: It is not simply—
Q145 Mr Bacon: I know it is not and
you have given all the reasons why.
Mr Gowdy: It is getting patients
right through the system from when they first present to their
GP until we are able to get them back into the community again.
We have to make an investment in every stage of this.
Q146 Mr Bacon: Yes, of course. This
goes back to my second question about the table. It is correct,
is it not, that Northern Ireland has amongst the highest funding
per head of population for health in the UK?
Mr Gowdy: Less than Scotland.
Q147 Mr Bacon: Less than Scotland.
Scotland has 20 times better results than you do.
Mr Gowdy: On a par with Wales.
Q148 Mr Bacon: Yes, but more than
England.
Mr Gowdy: More than England. Our
levels of needs, as I was saying earlier, are greater so there
are reasons why that funding has to be greater.
Q149 Mr Bacon: Nevertheless, the
table on page 66 shows this spare capacity of 37% on average.
Of the hospitals in that table, 15 out of the 23 hospitals and
58 out of the 106 theatres are worse than average, which perhaps
conceals more than it reveals. There are quite a few down at 50%.
Is that because they are all emergency units? If you take Belfast
City downwards, Belfast City is 52%, Ards, Whiteabbey, Royal Maternity,
Erne, Causeway, Belvoir Park, Coleraine and Route, are they all
emergency units? Why do they have such low utilisations, roughly
half the time they are not used?
Mr Gowdy: Belvoir Park, for example,
is a cancer centre and does specialist cancer procedures.
Q150 Mr Bacon: What about Causeway?
Mr Gowdy: The Causeway was a new
hospital which was opened during the period under this Report,
so they were not operating at full capacity at that stage.
Q151 Mr Bacon: What about Erne?
Mr Gowdy: Causeway replaced Coleraine
and Route.
Q152 Mr Bacon: What about Erne?
Mr Gowdy: Erne is a rural hospital
in the south-west of the Province.
Q153 Mr Bacon: Belfast City, 52%.
48% spare capacity at Belfast City. That cannot be because they
are all emergency units, can it?
Mr Gowdy: No. They have substantially
increased their utilisation and it is now up at 78%.
Q154 Mr Bacon: Can I ask you to turn
to page 55, paragraph 3.1.1. It states that there is a need for
advance notice of planned leave by surgeons, but "Persistent
non-compliance by some consultant surgeons has resulted in anaesthetic
cover being scheduled for sessions that subsequently could not
be held because of surgeons taking leave, leaving the Clinical
Director with the problem of trying to redeploy the available
anaesthetic cover elsewhere at little notice. This redeployment
has not always been possible, resulting in a waste of resources
and a potentially viable session not being held." What action
is taken against persistent non-compliance by some consultants?
Mr Gowdy: If I may, I will ask
Dr Carson, who is very familiar with all of these issues.
Dr Carson: I think there are several
levels at which you can exercise management action.
Q155 Mr Bacon: Mr Curry just said
sotto voce there is can and there is do. What action is
taken against persistent non-compliance?
Dr Carson: Persistent non-compliance
would be failure to fulfil their contractual commitments which
is a disciplinary procedure within the trust.
Q156 Mr Bacon: How many doctors have
been disciplined?
Dr Carson: I do not have that
information.
Q157 Mr Bacon: Could you send us
a note?
Dr Carson: We could look at that,
yes, certainly.[5]
Chairman: Thank you very much. Under
our procedure, gentlemen, we allow Members to ask short supplementaries
as long as they do not take more than 15 minutes in total, or
I reserve the right, if they are long, time wasting answers, to
allow them more time. We start with Mr Curry and then go on to
Mr Allan, Mr Steinberg and then Mr Jenkins.
Q158 Mr Curry: Could I bring you
back to Mr Jenkins's questions on the table on page 104, the reason
given for last minute case cancellations. You said in response
to an earlier question that you book surgery sessions a week in
advance, is that right?
Dr Carson: In the cardiac surgery
unit.
Q159 Mr Curry: And elsewhere?
Dr Carson: I would suspect that
prior booking for elective general surgery is well in advance
of that. Patients would be given dates for surgery well in advance
of a week.
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