Public hospital won't accept me onto their list - options?

Dubwat · 13-11-2018 7:53pm #1

Apologies if this is the wrong forum but 'health sciences' keeps popping up when I use the search function.

My optician recently diagnosed me with a cataract and referred me to my GP. I have no medical card or health insurance.

My GP wrote to the local major teaching hospital in Dublin to put me on their waiting list. They wrote back (via email) to basically say no, they're full and suggested I go private via a named company.

My GP gives the impression that he's upset about this development and so am I am. As of today, he can't give me any alternatives. He said the Eye & Ear doesn't cover the Northside? Is it legal for a public hospital to refuse to even put me on the list for an appointment? Can I appeal? What are my 'public' options (forgetting about private for the moment).

Since the diagnosis, I always knew I'd have to go private but the flat-out 'no' has annoyed me and I want to push back against it a little bit. Also, without a consultant's referral, I don't think I can go 'North' for the operation...

It's kinda ironic because cataract waiting lists were supposed to be eliminated in 6 weeks time... 'by 2019'

(Irish Times article, 2017)

Cataract waiting lists to be eliminated by 2019 as new unit opens

Waiting lists for cataract operations for most patients in the greater Dublin area are to be eliminated by 2019 following the opening of a new unit in the Royal Victoria Eye and Ear Hospital.
The unit, which was opened by Minister for Health Simon Harris on Monday, will more than double the capacity of the hospital to carry out cataract operations.

There are photos of the Minister opening the unit so it did actually happen!

Wesser · 15-11-2018 12:54am

That's actually shocking.

You could try the cross border treatment schemer.
Get your treatment do me in Belfast before brexit!

Dubwat · 15-11-2018 6:06pm

Thanks. Can't do the Cross Border scheme without being on a public waiting list... Hadn't thought about Brexit

I rang the HSE (1850 24 180 / 041 6850300) and the lady on the phone said the hospital couldn't refuse me. My GP should insist in writing that I be put on the list. Also, the Eye & Ear is a national resource so I could apply to them as well.

So, back to my GP next week and hopefully the situation will have changed.

Peter Denham · 15-11-2018 6:09pm

Dubwat wrote: »

Thanks. Can't do the Cross Border scheme without being on a public waiting list... Hadn't thought about Brexit

I rang the HSE (1850 24 180 / 041 6850300) and the lady on the phone said the hospital couldn't refuse me. My GP should insist in writing that I be put on the list. Also, the Eye & Ear is a national resource so I could apply to them as well.

So, back to my GP next week and hopefully the situation will have changed.

Get on to a local TD.

Corruptedmorals · 15-11-2018 9:58pm

The Eye and Ear hospital is the national referral centre for ENT but for eyes it's not supposed to cover the northside, the Mater is.

It is not a new thing for a hospital to close a waiting list unfortunately. ENT non-urgent has been closed in Crumlin for years and if it is open now it is quite limited. The knock-on effect of this for other hospitals is brutal. Dermatology paeds has also closed for children in the past.

If the Mater are closing ophthalmology lists that is horrific news. Eye and Ear routine waiting lists for ophthalmology are all over 3 years.

You are fully entitled to walk into either the Mater or the Eye and Ear A&E department with a referral and be seen. A&E's have no catchment areas and both have eye A&E's. You and your GP would be much further advanced in knowing then about the urgency in getting an appointment privately etc. or you might even be referred into the public system via A&E.

Dubwat · 16-11-2018 7:01pm

Looks like I'll be going private... I kinda knew that from the beginning but it would have been nice to have a choice

Just a bit annoyed if it is true they refused me off the list. I wonder if 'they' are manipulating the data so the lists don't look so bad. But I guess they couldn't get any worse! So much for the cataract list getting cleaned up 'by 2019.'

Thanks for all the replies. I'll see if my GP has any updates next week.

Corruptedmorals · 17-11-2018 12:25pm

Hospitals close waiting lists if the consultants in that speciality feel that it is too long and they cannot in good conscience continue accepting referrals onto it. But of course it has a brutal effect on other hospitals. I wouldn't say that it is common but it IS happening. Individual referrals can be refused onto public lists sometimes on the basis of something being cosmetic and not medical but that is obviously not relevant here.

I can't really say but in my experience, waiting lists do not need to be manipulated they really are that bad. There are so many referrals received every day even into small hospitals. Waiting list validation (periodically sending letters every 6 months/year to ask if people still need an appointment and discharging with notification to GP and patient if no response) has been heavily criticised but I have seen it in action and it is taking people off the lists who have gone privately, whose problem has resolved or who have passed away and that can only be a good thing. A lot of hospitals are invested in long waiter clinics once validation has been done where patients waiting the longest are seen in separate extra clinics held out of hours or held for free in private hospitals on weekends. In one year in my hospital these extra clinics have saved us from the waiting list worsening by another year.

Dubwat · 17-11-2018 7:02pm

@ corruptedmorals; thanks for your very informative insights. I haven't been near a hospital for probably 20years so this is all new to me.

I didn't mention the hospital I was referred to but the waiting list must be huge. According to their website, it has 16 ophthalmology consultants!

byhookorbycrook · 22-11-2018 7:25pm

Hence the "good news headlines" last week that waiting lists were getting shorter .

RoamingDoc · 25-11-2018 10:56pm

Corruptedmorals wrote: »

You are fully entitled to walk into either the Mater or the Eye and Ear A&E department with a referral and be seen. A&E's have no catchment areas and both have eye A&E's. You and your GP would be much further advanced in knowing then about the urgency in getting an appointment privately etc. or you might even be referred into the public system via A&E.

This is very unfair on A&E staff. Most hospitals also have systems in place to try to prevent this circumvention of the waiting list system.

OP, there are multiple services you should request a referral to. Any public hospital will do. Travelling to Sligo would be preferable to not getting this done right?

Corruptedmorals · 26-11-2018 7:16am

RoamingDoc wrote: »

This is very unfair on A&E staff. Most hospitals also have systems in place to try to prevent this circumvention of the waiting list system.

OP, there are multiple services you should request a referral to. Any public hospital will do. Travelling to Sligo would be preferable to not getting this done right?

It is the reality of having the eye waiting lists as bad as they are. Some people cannot go private and while waiting on a long waiting list or not even being accepted onto one, it is hard for the GP/opticians to assess how bad an issue is and if vision is being affected. Eye A&E's will always deal with more than just critical loss of vision/injury. Getting referred to a clinic via A&E is only for urgent patients.

Dubwat · 03-12-2018 7:18pm

A quick update...
My return visit to my GP was delayed while I waited on some other (non-eye) tests to come back. Long story short, there's been no developments (or communications!) with the northside teaching hospital. Apparently, Blanchardstown might be taking people onto their cataract waiting list.

But I think my mind is made up that I'll go 'North' and take advantage of the 'Cross-border directive';
1. If I persist in going public, it'll take years and there's every chance I'll go blind. I need my eyes for my job

2. If I go private (to the Doctors who won't see me publicly), it'll cost c. €2.5k-3k and I'll get 20% back via tax rebate. The wait would probably be months, rather than years.
3. If I go North and pay upfront myself, there's a good chance I'll be treated (not just seen) within 2 months. And I get most, if not all, of the money back via the HSE cross-border directive scheme.

Cross-border directive info = https://www2.hse.ie/services/cross-border-directive/about-the-cross-border-directive.html

In some ways, it's worthy of a Monty Python sketch...
The Dept of Social Welfare paid for my eye test and a problem was found. I went to the Dept of Health (hospital) who refused to deal with me and told me to go private. Another Govt dept, Revenue, would cover some of the costs if I stayed local and hired non_HSE staff. A fourth 'dept', the HSE* will, however, pay almost 100% of the cost if I go to a foreign country and hire foreign staff.

(* I know the HSE is not a Govt Dept but you get my gist, hopefully)

Arbie · 03-12-2018 9:58pm

Dubwat wrote: »

If I go private (to the Doctors who won't see me publicly), it'll cost c. €2.5k-3k and I'll get 20% back via tax rebate.

If you are talking about the Mater then it's not that they won't see you, it's that they physically can't. The clinics there are bursting at the seams, often running several hours over. There is huge turnover among clerical staff there as the workload is so high.

The consultants are also run off their feet, I think 2 of them have recently gone part time or taken career breaks because of it. The most limiting factor is that they have 1 single eye theatre which is used by all the eye consultants and caters for both elective (planned) lists, like cataracts, as well as for emergencies.

I hope you get sorted soon but I also hope that you will write to the hospital CEO and copy in the Minister for Health and Taoiseach, explaining your story and asking that they provide more funding for the unit. That is the only way that it will improve.

Dubwat · 04-12-2018 11:46am

Yeah, it is the Mater. I don't want to blame them because they're not at fault. It's the Health Service in general. I find it annoying because the number of 'eye problems' per annum is probably predictable and the HSE should be able to plan for this. It's not like there's been a sudden upsurge in people poking their eyes out in the past decade

Sure, as the population gets older, the number of cataracts increases; but the 'experts' in the HSE should be able to account for that as well.

Anyways, phoned a clinic up 'North' this morning and got an appointment for late next week. If all goes well, I'll have the cataract surgery in Jan. The cost is pretty much what the HSE will pay for a cataract...https://www2.hse.ie/file-library/cross-border-directive/cross-border-directive-ready-reckoner.pdf

Gael23 · 21-12-2018 3:59pm

It’s likely just that the waiting list is so long they are not adding anyone else on

Dubwat · 13-02-2019 8:12pm

I'm the OP who started this thread. I was going to wait until I got my money back from the HSE (via the CBD) so I could tell the whole story from beginning to end. Unfortunately, according to the Indo today, the HSE admin unit that deals with CBD payments is so overwhelmed with applications that the processing time has gone from 20 days out to 50 days.

Extra staff needed to deal with surge in cross-border patient figures

So what to say? The private clinics in NI are set up for ROI patients. Getting an appointment was easy but obviously money is involved. My initial appointment was in mid-December. After the initial exam, they apologised and said that with Xmas etc, they couldn't do the operation until mid-Jan 2019. I laughed considering the Mater won't even put me on their list for an appointment.

The initial exam consisted of a lot of measurements and so on. They did try to upsell me to a fancier lenses but since it was approx double the price, I declined.

I went up to Belfast in mid-Jan for the surgery. The nurses started the pre-surgery treatment on time and the cataract surgery took only a few minutes. I was sent home with an eye patch and eye drops. I came back the next day for the post-surgery exam. Everything was fine. There was no pain at any stage.
The advisory notes say that if you're a bouncer (sic), you should avoid getting hit in the face for a few weeks!

There's lots of eye-drops before, during and after the surgery!

The improvement in my vision was phenomenal and noticable the day after surgery.

The longest wait was for a new lenses in my glasses. They're temporary because, apparently, it can take a month for your eye to settle down with the new lenses implant. I was waiting a week for the glasses to come from some central laboratory in the UK.

So, all-in-all, things went very well on the medical/optical side of things.

The only negative is waiting for the HSE to pay me back my money. I have a cataract in my other eye as well but it's not as advanced. I was hoping to use that money to pay for a second operation and all before Brexit happens at the end of March. I have booked in for the second operation but now I'll be raiding the communion money to pay for that

P.S. Because of my cataracts in both eyes (and my personal circumstances), the Belfast surgeon said he would leave one eye a little bit short-sighted and the other a little bit long-sighted and they would balance each other out in my brain. That's my interpretation of what he said to me!

P.P.S. from the Indo story above:
1. Simon Harris is the Minister for Health :mad: (that's for the search engines)
2. "There are around 70,000 public patients waiting for surgery and more than 511,000 for an outpatient appointment."

Public hospital won't accept me onto their list - options?

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