Are hospital waiting times a political priority? And can the island have a modern first world health service when health expenditure as a percentage of gross domestic product is lower than Latvia?
These were the decisions that Tynwald members were left with following an update from the Department of Health on its work to reduce waiting times for elective surgery.
Chief clinical information officer Dr Iain Kewley said over the last 16 months, waiting times have fallen in many outpatient and inpatient areas, but remained ‘unacceptable’ in others.
Proposed solutions such as increasing consultants in dermatology and rheumatology, and additional theatre time for orthopaedics all require additional resources.
For December 2013, the longest waiting times included 20.4 months for dermatology (down from 36.3 months in October 2012), 39.5 months for management of chronic pain (up from 38.1), 29.5 months for endocrinology (up from 17.4) and 15.7 months for ENT – ears, nose and throat – (up from 10.7).
Funding to reduce waiting times compete against other priorities, including the increased costs of drugs such as chemotherapy.
Meanwhile Mr Kewley said investment in community services would be needed to reduce the ‘extremely high’ rate of emergency admissions compared with the UK.
Latest figures (2011) show health expenditure per capita in the island was $2,945 (£1,766), lower than the UK.
In fact, to have matched investment in England between 1997 and 2010, would have cost the island an extra £7m per year.
Over the last 16 months, outpatients’ attendance has risen by 6 per cent, the number waiting has fallen by 7 per cent, and the average wait has fallen by 8 per cent.
For inpatients, admissions has risen by 7 per cent, the number waiting has increased by 10 per cent, and the average wait has increased by 3 per cent.
Minister David Anderson said: ‘Our work on waiting times is encouraging, but extremely challenging and it is clear that fundamentally addressing some of the longer waiting times will require significant further investment.’
He said a ‘third way is required if we are to sustain a health service fit for the 21st century’.