The most senior NHS manager in Northern Ireland has admitted that there are problems in A&E departments, but said that she is “not so hung up about waiting times”.
Valerie Watts, who took over from John Compton as chief executive of the Health and Social Care Board last summer,insisted that A&E waiting times are improving but said that the “quality” of care is more important than waiting times, an area where A&E departments have been in breach of ministerial targets for more than seven years.
In an interview with the News Letter in her Belfast city centre office, Ms Watts said that the health department had not secured from the Stormont Executive the money which it believed was necessary to provide the best healthcare to people across Northern Ireland.
But she said that the NHS had to live within the parameters which it has been set.
Ms Watts also denied that healthcare managers had failed to provide adequate increased capacity at the Royal Victoria Hospital’s accident and emergency department when the City Hospital’s A&E department was closed in 2011. When asked if she accepted that managers had failed to adequately plan for the closure of the City A&E, leading to chronic problems at the Royal, she said: “No I don’t accept that at all.”
She insisted that the situation at A&E departments, which have been under particular strain over recent years, was improving: “I have been very pleased by the performance in our emergency departments , where the waiting times and the performance indicators around the waiting times [are] improving ... things have improved dramatically over the last 12 months.”
When asked if it is true that Northern Ireland has the worst A&E waiting times in the UK, Ms Watts said: “Well certainly that’s how some of our media colleagues are portraying it at the moment.
“However, for me it’s all about quality of care. And more importantly than anything else it’s about ensuring the safety of patients in terms of when they turn up at the front door of the emergency department and also the continuation of their journey and their stay with us in any of the hospitals across Northern Ireland until we safely discharge them into the community.
“So for me, I’m not so hung up about waiting times or numbers. It’s all about safety and quality for me.”
When pressed on the original question of whether Northern Ireland has the worst waiting times in the UK, a press officer intervened to explain that Northern Ireland’s waiting time data is collected in a slightly different way to the rest of the UK.
He said that Northern Ireland is close to Wales on the target for treating and discharging or admitting patients within four hours (where the figures are more comparable with GB), but that both Wales and Northern Ireland “do lag behind England and Scotland”.
According to the most recent waiting times, during December just 73 per cent of patients at the largest A&E departments were treated within four hours, while 91 per cent of patients at smaller A&E units were treated within that time. The target is for 95 per cent of patients to be treated within four hours.
In England, the most recent quarterly figures show that 92 per cent of patients were seen within four hours – figures which were described as “the worst in a decade”.
When Ms Watts was asked why Northern Ireland has such a problem in its A&E departments, she said: “Again, for me it’s all about having the expertise to be able to look at that patient flow issue from when people first present until they are actually discharged from hospital again ... what we need to do is break down those sorts of barriers or blockages in the system.”
She said that at weekends “there seem to be a greater number of blocks or blockages in place” and that a lot of work is being done to examine the potential for seven-day working patterns for medical staff”.
When asked if financial constraints will lead to an increasing use of private healthcare companies by the NHS, Ms Watts said that she would have to look at “the number of private sector partners that are set up to do business in Northern Ireland”.
She said there was also a need to improve competition in healthcare “to drive out best value” but added that she was “a great believer in and supporter of” what she could see being done by core NHS staff, and did not believe that “going totally down the private road is the right way to go”.
Asked if she opposed increasing the use of private companies by the NHS, she said: “No, as long as they are the best in class.”
But Ms Watts said that she had never used private healthcare herself, other than for dental work.