Waits of over a week for surgery have become commonplace.

Dot Kirby

"Green Park Healthcare Trust does not wish to see patients wait in pain for treatment.

"However, the demand on the fracture service is no longer a winter crisis, but an all year round problem.

"We need a regional plan for investment in trauma and orthopaedics, a long-term solution that copes with the demands in the fracture service but does not ignore the investment needed in the elective orthopaedic service."

It was over the Christmas period of 1998 that Northern Ireland's orthopaedic services went into a tail spin.

Lengthy backlogs for operations built up. At one stage there were more than 80 people waiting.

The Department of Health swung into action. The minister of the day appeared on a BBC Northern Ireland television debate.

He promised more orthopaedic surgeons, �4m and that the service would be re-organised.

Service

The re-organisation happened in the autumn of 1999.

The City Hospital in Belfast stopped doing fracture surgery and instead the service was centralised into the Royal Victoria Hospital in the city.

The money was gratefully accepted - and spent.

More surgeons were employed (although more are still needed along with more anesthetists and specialist nurses).

Crisis over? Not quite. Now, nearly two years after the re-organisation, fracture surgery is in as bad a state as ever - and now other orthopaedic work is joining it in the quagmire.

Fractures surgery is composed of the broken bones - everything from a fractured femur to a broken wrist - the fractures which should receive expert attention straight away - or as quickly as the system can manage.

Target

In Northern Ireland, the government says such injuries should be dealt with within a maximum of 48 hours. In England, the clinical standard is even shorter - 24 hours.

Sadly putting something down in writing as a target does not solve the problem.

In Northern Ireland, hundreds of people have waited far longer than 48 hours for their operation so far this year.

Waits of over a week for surgery have become commonplace.

Indeed, at one point, there were over 90 people in the queue.

The net result is that orthopaedics are in crisis. And there is no "quick fix" solution in sight.