Under-pressure NHS bosses are having to send patients for private treatment to meet waiting time targets.
Increasing numbers of people waiting for orthopaedic and neurology treatment, combined with staff shortages, have led to more Fife patients having to be treated outwith the region.
In June alone, 56 patients were sent to other hospitals for orthopaedic surgery just over a quarter of the total monthly average treated in Fife at a cost of £260,000.
People waiting for treatment for neurological conditions are also being offered private treatment to cut waiting times, although NHS Fife was unable to supply figures.
But assurances have been given that private referrals were made only with the agreement of patients, who were usually happy to be treated more quickly.
NHS Fife also said no-one was forced to travel long distances unless there was a clinical reason.
George Cunningham, director of acute services, said NHS Fife’s budget for orthopaedics was just over £9m but this did not include theatre costs.
”As of July 2, 626 available patients were waiting for orthopaedic surgery. We are starting the process of recruiting an additional orthopaedic surgeon,” he said.
Labour’s Scottish health spokesman Richard Simpson said the situation was further proof that the health service was under increasing pressure.
He added that while NHS Fife’s use of the private sector was neither unusual nor inappropriate, it should only be used on a temporary basis until there was capacity in the region.
”I’m sympathetic because staff are working incredibly hard to deal with the issues,” he said. ”Orthopaedics have also been a problem so I’m not surprised it’s a continuing problem.”
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The Scottish Government has set a national target that all patients must be given an outpatient appointment within 12 weeks of referral, and they must be treated within 18 weeks of referral.
In Fife, almost 12,000 people attended as new outpatients in May, 19% more than in the previous month and 8% more than in the same month last year.
Of those, 299 patients waited longer than 12 weeks, 18% more than last year.
Dr Simpson, MSP for Mid Scotland and Fife, said the situation was becoming more difficult because of government cuts.
”I’ve been trying to say for 18 months the health service is under huge pressure but the cabinet secretary is not really listening.”
Andrea Wilson, director of clinical delivery with NHS Fife’s operational division, said referrals to acute outpatients were continuing to show an upward trend.
”The number of people waiting over 12 weeks has increased and that is something we have been spending a lot of time on trying to address,” she said.
”One of the reasons is due to a specific staffing issue we have had, particularly in orthopaedics. A number of these are resolving and we have seen solutions in place.
”I would not like to give the impression we are absolutely under control on that but I would expect to see an improvement in the next few months.”
She added: ”On waiting times, the biggest pressure is in orthopaedics and neurology. We’ve managed to bring others back in line and we have plans in place to continue that.
”We continue to work with orthopaedics and neurology to find the capacity to meet our targets and we are using the private sector to help us meet the waiting time guarantee.
”It’s very small scale and it’s because of our need for additional capacity. Our plan is to use it as a short-term solution.”