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Monday, 24 September, 2001, 13:01 GMT 14:01 UK
Pressures on fracture services increase
Thousands are in the queue for treatment in Northern Ireland
BBC Northern Ireland health correspondent Dot Kirby reports on the pressures on orthopaedic services as people wait longer for operations.

New figures released on Monday have shown that some people are waiting up to three years for a hip or knee replacement in Northern Ireland.

There are 4,445 people on the in-patient waiting list for operations at Musgrave Park Hospital in Belfast - Northern Ireland's main orthopaedic hospital.

Almost a quarter had already waited more than 18 months - which is the government's "maximum wait".

Musgrave Park said one contributory factor to its lengthy queue was that it had been asked by the Department of Health to allow its theatre time to be used for emergency fracture patients.

Green Park Healthcare Trust Chairman Ian Doherty said: "Musgrave Park Hospital has been able to respond quickly to the most recent request in September to help relieve the fractures crisis, providing beds, theatre access and staff.


Waits of over a week for surgery have become commonplace.

Dot Kirby

"Green Park Healthcare Trust does not wish to see patients wait in pain for treatment.

"However, the demand on the fracture service is no longer a winter crisis, but an all year round problem.

"We need a regional plan for investment in trauma and orthopaedics, a long-term solution that copes with the demands in the fracture service but does not ignore the investment needed in the elective orthopaedic service."

It was over the Christmas period of 1998 that Northern Ireland's orthopaedic services went into a tail spin.

Lengthy backlogs for operations built up. At one stage there were more than 80 people waiting.

The Department of Health swung into action. The minister of the day appeared on a BBC Northern Ireland television debate.

He promised more orthopaedic surgeons, 4m and that the service would be re-organised.

Service

The re-organisation happened in the autumn of 1999.

The City Hospital in Belfast stopped doing fracture surgery and instead the service was centralised into the Royal Victoria Hospital in the city.

The money was gratefully accepted - and spent.

More surgeons were employed (although more are still needed along with more anesthetists and specialist nurses).

Crisis over? Not quite. Now, nearly two years after the re-organisation, fracture surgery is in as bad a state as ever - and now other orthopaedic work is joining it in the quagmire.

Fractures surgery is composed of the broken bones - everything from a fractured femur to a broken wrist - the fractures which should receive expert attention straight away - or as quickly as the system can manage.

Target

In Northern Ireland, the government says such injuries should be dealt with within a maximum of 48 hours. In England, the clinical standard is even shorter - 24 hours.

Sadly putting something down in writing as a target does not solve the problem.

In Northern Ireland, hundreds of people have waited far longer than 48 hours for their operation so far this year.

Waits of over a week for surgery have become commonplace.

Indeed, at one point, there were over 90 people in the queue.

The net result is that orthopaedics are in crisis. And there is no "quick fix" solution in sight.

See also:

04 Dec 00 | Northern Ireland
Hospital faces services cutbacks
12 Sep 00 | Northern Ireland
Highest ever NI waiting lists
25 Dec 99 | Northern Ireland
Crucial time for NI health
28 Sep 00 | Northern Ireland
'Major investment' needed in NI health
12 Oct 00 | Northern Ireland
Beds shortage hits hospitals
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