ONE Tuesday in July 2013, a retired man noticed pains in his hip and decided to see a local GP. He got an appointment later the same day and the GP requested a CT scan. This was performed at 10am the following morning at a specialised Radiology centre some distance away.
He returned to his GP on Thursday and was told the CT scan confirmed arthritis bad enough to need an operation. He was free to take up the first available date for surgery – the following Monday! After a successful hip replacement he was discharged on Friday, ten days after first seeing his GP.
Read More:
Longer wait for NHS patients in north than in England
Nursing workforce shortages hit 'highest known' level
This must be a very wealthy man with expensive, private health care? Not at all - the events took place in a small town in southern France and all care was delivered by the French public health system.
Surely then, the French government must spend far more on healthcare than the UK? Well, a little more - about the equivalent of £3,600 per person per year compared with about £3,200 in the UK.
The UK's NHS is admired by many countries and highly valued by its citizens.
Read More:'Scourge' of hospital waiting times to be tackled with new centres for planned surgeries
But no country's healthcare system is perfect and the NHS has one glaring weakness - access to care at the time it is needed.
People with stable conditions experience long waiting times to get a GP or hospital outpatient appointment.
Even unstable patients can endure long waits in Emergency Departments and to be admitted to hospital wards. Many even experience delays in getting out of hospital once they are fit for discharge.
Waiting times for planned (elective) care in Northern Ireland are among the longest in the NHS. Why?
The reality is that the current organisation of health care here has inefficiency built into it and until things change, access will continue to deteriorate.
The greatest inefficiency of all comes from undertaking planned surgery in hospitals whose primary focus is emergency care. Amazingly, two-thirds of all elective surgical procedures in are performed in hospitals with emergency departments.
When elective and emergency patients have to compete for the same resources, emergency patients always win.
So what can be done?
The answer is surprisingly simple: separate emergency care from elective care and deliver them in different hospitals. Northern Ireland has 11 hospitals with emergency departments and six elective care hospitals. These six are only undertaking about a third of planned operations.
We need to find capacity for about an extra 90,000 day case procedures.
There is now room for optimism. The Department of Health has committed to deliver a network of Elective Care Centres - which ultimately will aim to deliver all day case surgical procedures.
Patients say have no problem travelling beyond their local hospital to access care.
Converting emergency hospitals into elective hospitals is sometimes described as "downgrading". In fact, in activity terms, it is the opposite because the scale of elective care dwarfs emergency care.
About 770, 000 people attend Emergency Departments here each year and there are about 203,000 urgent or emergency hospital admissions. Elective activity is nearly four times bigger.
Sometimes we fail to recognise just how much waste is created by keeping people on long waiting lists.
The development of specialised Elective Care Centres is a great opportunity and to achieve it, some hospitals will need to shift their focus away from emergency care. The wider benefits of doing so are clear - for communities, for the public but most importantly for patients.
:: Dr Niall Herity headed the NI review team that developed the elective care centres concept.
