Pensioner's cataract delay 'proves NHS has two tiers': Fundholding GPs' patients seen sooner

AN 80-YEAR-OLD man has had to wait more than 11 months for a hospital appointment to have his cataracts assessed when the patients of fundholding GPs are being seen within a month, a family doctor in Bradford complained yesterday.

The case was 'a clear example of a two-tier health service', said Dr Sue Towers, who cares for the man, Walter Bennett. Her practice is non-fundholding.

This month, Bradford NHS Trust offered fundholding GPs in the city a fortnightly ophthalmology clinic 'exclusively for GP fundholding practices'. Dr Towers was told on Friday that the next appointment available under this offer was at the end of June. At the same time, the hospital confirmed that the next routine appointment for non-fundholding patients was not until March next year, 10 months away.

She said Mr Bennett had first been referred to have cataracts in both eyes assessed in May 1993, when he was given an appointment in April this year. Just before the appointment, Mr Bennett suffered a mild stroke from which he has since recovered but which meant he had to cancel the appointment. He was offered a replacement slot in January next year - a date that has been moved back to a 'provisional' appointment for 4 July after Dr Towers' protests.

'When you look at how long Mr Bennett has had to wait, that he has only a provisional appointment, and that GP fundholders' patients can now be seen within a month, you feel it really is not fair and is plainly a two-tier system,' Dr Towers said.

David Blunkett, Labour's health spokesman, moving to exploit the case in the Bradford South by-election, said: 'Brian Mawhinney, the Minister for Health, spends all his time denying that there is a two-tier system operating in the health service. Yet here is conclusive proof that there is one rule for patients of GP fundholders and another for everybody else.'

Sue James, the Bradford Trust's director of business development, said that Bradford Health Authority, which bought most of the area's ophthalmology, specified that no patient should wait more than 12 months for an outpatient appointment, and the trust delivered that. But GP fundholders had started sending their patients to Leeds for the shorter waits available there. Bradford NHS Trust had responded by offering a quicker service for fundholders.

The faster service would take pressure off other clinics, 'with knock-on benefits for patients of non-fundholding practices'. While the next routine appointment for non-fundholding patients was 10 months away, the average wait was shorter because some were seen as urgent cases.

'We understand that Bradford Health Authority is planning to review the level of ophthalmology service we are asked to provide for it,' Miss James said.

Mr Bennett said he felt he had waited far too long. 'My eyes are a bit hazy and reading and watching TV is all getting more difficult. It's a long time to wait.'

His daughter Irene, 52, protested that patients with similar conditions would be seen more quickly if their GP was a fundholder. But she said: 'We can't be going changing GPs and stuff like that to try to get a quicker service. We've been with this practice for 50 years now and they've always been very good to us. We don't want to change.'

(Photograph omitted)