Patients wait 45 weeks for ENT consultant
It has emerged that people in Belfast are waiting 45 weeks to see an ear, nose and throat consultant.
GPs say that a pilot scheme in east Belfast was helping to keep those waiting lists down.
Now a row has developed between the health and social care board and the British Medical Association over the scrapping of the GP service.
The service was designed to reduce demand on the Belfast health trust and saw GPs perform ENT procedures.
In a statement, the health board said the pilot scheme, which started in September 2011, had come to an end and was currently being evaluated.
The scheme was originally meant to run for a year but was extended to November 2012 with the last patients seen in January 2013.
In total 1427 patients were seen as part of the pilot.
Each year about 17,000 new ENT patients are contracted to be seen at the Belfast and South Eastern Trust.
The HSC board said, in the statement, that it has agreed volumes and associated funding with the Belfast trust to ensure that no one waits longer than 15 weeks for an ENT outpatient appointment and 30 weeks for ENT treatment.
More than 1,200 patients had been treated at Holywood Arches health centre by GPs who specialise in ENT procedures.
BBC NI health correspondent Marie-Louise Connolly said: "The benefits were two-fold.
"Patients were seen quickly, while pressure and cost was removed from the Royal Victoria Hospital.
"This method of shifting care out into the community is the over-riding principle behind the document Transforming Your Care, the Department of Health's new road map for delivering some local services.
"While the health board says the scheme was only ever a pilot, sources have told the BBC that some officials didn't like the idea of GPs having so much control over patients or resources.
"If health reforms are to work here, tensions will need to be resolved between the BMA and the Health and Social Care Board."
In a statement, the Belfast trust confirmed that the waiting time to see a consultant was approximately 45 weeks.
"The target we have agreed, and are working to from 1 April 2013, is 15 weeks for adult ENT from receipt of GP referral for a new routine referral," it said.
"However urgent referrals are seen within six weeks from receipt of GP referral or within a week if referred to the Rapid Access Clinic.
"Under the targets, no-one waits longer than 30 weeks for treatment."
The trust apologised to anyone who had had to wait for an ENT outpatient appointment.
The clinical director of ENT at the Belfast Trust, Dr Joe Toner, claimed patients waiting 45 weeks for treatment was unusual and that 35 weeks was a fairer reflection of waiting times.
He also said that some NHS consultants were being paid to carry out ENT procedures in private clinics in a bid to lower the waiting lists.
"We are referring significant numbers," he said.
"It's hundreds of patients going out for outpatient care and then, if they need a procedure thereafter, then that's done by usually NHS consultants working at weekends in these other facilities.
"I would image the nurses, doctors, anaesthetists, admin staff who are working in the private hospitals to deliver that care are all being paid for it."
The chair of the British Medical Association general practitioners committee in Northern Ireland, Dr Tom Black, blamed what he called "vested interests" for the demise of the ENT service which he said was working well.
"When something stops, you have to look to see who benefits from this," he said.
"You really wonder where this has gone wrong, this is obviously a very good service that should be continued, it will be continued because wise heads will now come together and put this back in place."
The BBC has learned that the waiting list for ENT referral in the northern trust is 18 weeks, with a further 18 weeks for a procedure to be carried out.
In the south-eastern trust, there is a 15-week wait for an outpatient appointment and a further 28 weeks for any procedures.
In the southern trust, the average wait for a patient for a routine first appointment is 10 weeks. The trust said at present it had one patient who had been waiting 17 weeks for a very specialised appointment.
There is a nine-week wait for referral in the western trust area.
John Compton, chief executive of the Health and Social Care Board said the scheme was being evaluated along a number of lines.
"Firstly, whether or not clinically it's turned out to be safe and sound, secondly, what the patient and general practitioner experience of the scheme was and thirdly, whether it is value for money," he said.
Mr Compton said he expected the report would be available within the next 4-6 weeks.