- guardian.co.uk, Monday July 4 2005 12.01 BST
The government today announced sanctions to cut "intolerable" NHS waiting lists in Northern Ireland, where hundreds of patients are waiting for more than 18 months for treatment.
Trusts unable to provide treatment within 12 months will be forced to offer patients a fully funded "second offer" at another hospital, in line with a similar scheme in Wales.
The move is part of NHS reforms being planned for the province, where concerns are growing over the wide variation in service delivery across the 19 Northern Ireland health trusts.
Northern Ireland minister Sean Woodward expressed concern over the poor NHS performance in the province, where patients face the longest waiting times in the UK, with some waiting as long as four years for treatment.
Mr Woodward admitted today that far from improving waiting times, Northern Ireland was witnessing a "slowdown in performance" for April and May, with some trusts reporting increases in the number of excess waiters, and waiting time figures likely to get "slightly worse before they get better" over the coming months.
"I am concerned the system is still not getting better," he said. "That it is still underperforming."
A total of 4,000 patients are waiting more than 12 months, while 800 are waiting at least 18 months despite an extra 11% in health spending compared with England, which has totally eradicated its 12-month waits.
Mr Woodward pledged to eliminate waits for both in-patient and day case operations for patients waiting more than 12 months by next March by pushing the system on the side of patients through the "second offer" system. "We are going to hold trusts to account," Mr Woodward said.
The system will require trusts that fail to treat patients within agreed time frames to offer fully funded treatment elsewhere.
Once patients have waited nine months, a trust will have to give the patient a date for local treatment or put them in a clearing system where they will be offered two alternatives to secure treatment.
Mr Woodward also announced new waiting targets for hip and knee operations (nine months), cardiac surgery (six months) and cataract operations (six months).
He added that the government intended to make "full use" of the independent sector to reduce waits for cataract operations.
But he warned patients that they would also be expected to uphold their end of the bargain by showing up for treatment and accepting the alternatives they are offered.
"We cannot continue with the present system in which some patients refuse to take up reasonable offer after reasonable offer of treatment," he said. "Some of the 4,000 on inpatient lists waiting more than 12 months are these people."
Patients who fail to accept a reasonable alternative through the "second offer" scheme will be taken off the waiting list and referred back to their GP, he warned.
