HEALTH trusts are powerless to fix issues around Northern Ireland's unacceptable hospital waiting lists, the High Court has heard.
Counsel for two authorities being challenged over delays in treatment acknowledged that the current system is "suboptimal".
But Tony McGleenan QC argued that a legal target duty to provide healthcare has still been met.
"There is no suggestion of bad faith here, there is an acknowledgement that there are serious structural problems in the healthcare system, and they
are at the macro-level," he said.
"They are not being resolved, but as far as the Trusts are concerned there is virtually nothing they can do about that."
Judgment was reserved in cases brought by two Belfast women over hold-ups in providing them with treatment.
May Kitchen (77) and Eileen Wilson (48) claim the authorities have unlawfully failed to provide them with necessary medical care within a reasonable time.
They allege failures to meet the minimum legal standards in the running of a health service and a breach of their human rights.
Mrs Kitchen was diagnosed with cataracts in 2015 and was told that the waiting list for surgery was 42 months.
She used medical insurance for private treatment, but insists she should not be out of pocket due to her entitlement to free healthcare.
Ms Wilson, a mother-of-six, has been seeking an urgent consultation with a neurologist about her suspected multiple sclerosis since June 2017.
Judicial review challenges have been brought against the Department of Health and the Belfast and South Eastern Health and Social Care
Trusts.
During the hearing Mr Justice Colton was told one in seven people in Northern Ireland have spent longer than 12 months on a hospital waiting
list amid "catastrophic" delays in securing treatment.
Bleak figures in a specially obtained report also revealed prospective patients are 48 times more likely than those in Wales to face a year-long
wait for care.
Lawyers for the Department made no attempt to diminish the impact of both women's experiences, but insisted the court should not interfere in
political decisions on the allocation of finite resources involving no allegation of bad faith.
Mr McGleenan, representing both Trusts, backed those submissions and highlighted an affidavit which described the delay in treatment for Ms
Wilson as "unacceptable".
"Nothing we say on the legal question should erode that frank acknowledgment of the unsatisfactory nature of provision," he said.
But setting out a general target duty contained in legislation to provide healthcare services, the barrister claimed the grounds of challenge were
"ultimately ineffective".
"We are in a position where shortage of resources is being dealt with by equitable methods, no doubt causing extreme frustration, queues and waiting
lists, prioritisation," he said.
"Those (do not indicate) bad faith or illegality. Those are appropriate responses."
Mr McGleenan added: "The state has satisfied its positive obligations by putting in place the healthcare system, even if its functioning is
currently, as we have acknowledged, suboptimal".
