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In the Euro Health Consumer Index (EHCI) 2014, it was reported that Macedonia made the most “remarkable advance” in the history of the Index, moving from 27th to 16th place, largely due to essentially eliminating waiting lists by implementing a real-time e-booking system.
The benefits of the Macedonian system, which allows for direct specialist care bookings, were also discussed in the EHCI 2017.
In Macedonia, GPs can go online during a consultation with a patient and access consultants’ diaries, see what physicians have vacancies, and refer appropriately.
At the NTPF board meeting in December 2017, the minutes of which were seen by MI following a Freedom of Information request, board member Mr Jack Nagle advised that he had completed a piece of work in relation to the potential of the Macedonian scheme being applied in the Irish setting.
It was noted that the NTPF had reviewed the Macedonian model as part of a report titled The Feasibility of Progressing to a More Integrated Approach to Waiting List Management at Hospital Group Level, and that this report had been submitted to the Minister for Health Simon Harris.
“The NTPF reviews international waiting list management and reporting models as a matter of course in order to inform its own work,” a spokesperson for the Fund told MI. “The Macedonian scheme is one such model considered.”
Other countries, such as Serbia, have also implemented the model to reduce waiting lists.
The EHCI 2017 shows Montenegro has achieved a similar improvement to what Macedonia did in 2013 by introducing a national real-time e-referral system.
“If countries with limited means can achieve virtual absence of waiting lists — what excuse can there be for countries such as Ireland, the UK, Sweden or Norway to keep having waiting list problems?” according to the EHCI 2017.
In 2017, Ireland was ranked worst in terms of accountability, while the Netherlands took top spot overall.
The Netherlands is the only country that has consistently been among the top three in the total ranking of any European Index that Health Consumer Powerhouse has published since 2005.
The document notes the country probably has “the best and most structured arrangement for patient organisation participation in healthcare decision and policy-making in Europe”.