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Dáil Éireann debate -
Thursday, 24 Feb 2000

Vol. 515 No. 2

Ceisteanna–Questions. Priority Questions. - Cardiac Services.

Alan Shatter

Question:

4 Mr. Shatter asked the Minister for Health and Children his views on an average waiting time of two years for paediatric heart surgery; and the action, if any, he will take to ensure all necessary paediatric heart surgery is speedily undertaken. [5627/00]

Our Lady's Hospital for Sick Children, Crumlin, is the national paediatric cardiac centre and my Department has been aware that there has been concern over waiting times for children in this speciality. The development of this speciality at the hospital has been the subject of discussions with my Department and the hospital for some time.

Some of the measures cited by the hospital as contributing to the increasing pressure on this service were the lack of theatre space and ICU beds, shortage of ICU trained nurses and advances in surgical and intervention techniques available.

In December 1997 the hospital was allocated a sum of £500,000 from the cardiac waiting list initiative to implement measures aimed at reducing pressures in the most effective and appropriate manner. The hospital proposed to use the funding for a number of measures. These included the provision of an additional four ICU beds, the implementation of a training programme for ICU nurses and the purchase of cardiac procedures from appropriate UK paediatric hospitals.

In 1998 and in 1999 under the same initiative the hospital was allocated sums of £878,550 and £340,000 respectively. In addition, approval for a third cardiac surgeon has issued, the recruitment procedure has been finalised and the selected candidate is expected to take up duty in July this year. Included in the hospital's allocation for 2000 is the provision of £0.7 million to continue the initiative and the details of the funding will be discussed with the hospital in the context of their service plan for 2000.

It has been agreed that hospital's cardiac surgical capacity should be increased and in this regard a design team for the theatre development has been appointed. When completed, the new theatre development will provide five new operating theatres complete with ancillary accommodation, a day surgery area and a central sterile supplies department. The existing theatre facilities will also be upgraded to provide a further two theatre suites. When these theatres are fully commissioned it is expected that Our Lady's Hospital for Sick Children will be in a position to perform an additional 100 paediatric cardiac procedures per annum, which is an increase of 40% on its existing capacity. The estimated completion date for the development is 2002.

The waiting times referred to by the Deputy are for non-urgent cases only. It is important to note that the prioritisation of the waiting list is a matter for the clinicians concerned and that immediate medical treatment is provided to all urgent cases.

I am confident the appointment of additional consultant staff and the completion of the theatre development will have a positive impact on the reduction of waiting times in this speciality.

Would the Minister acknowledge that it is a national scandal, in the context of the prosperity of this country, that any child should have to wait an average waiting time of two years for cardiac surgery? Would he acknowledge that the current difficulties in this area have resulted in approximately 100 children on the cardiac surgery waiting list, and perhaps the Minister would confirm the exact up-to-date position in that regard? Would he acknowledge that the total failure of the Government to provide resources at the Crumlin Children's Hospital at a much earlier stage has resulted in there being little prospect of any substantial reduction in waiting times or in the paediatric cardiac surgery waiting list until after 2002, and that that is entirely unacceptable? Would the Minister indicate what steps he intends to take during the course of this year to ensure there is a very substantial reduction in the number of children on the cardiac waiting list and a substantial reduction in waiting times?

It is unacceptable that children should have to wait an average of two years for cardiac surgery, irrespective of the nature of the surgery in terms of urgency and so forth. I do not want to engage in party-political dispute on this, but the bottom line is that capacity is a key issue at this hospital. I have outlined what we intend to do in terms of the capacity issue, which is to increase surgical capacity.

It should have been done two years ago.

It should have been done perhaps five years ago, when Deputy Shatter's party was in Government. From 1997 onwards, significant progress has been made in terms of making additional finance available, which could have been done in 1996 or in 1995 – I do not know why it was not. One thing I have discovered in three or four weeks in the Department of Health and Children is that there is a lead-in time both in terms of the provision of additional human resources and in terms of equipment and buildings. We are doing everything we can to increase the surgical capacity. A decision was taken in 1997-98 to take interim measures in terms of increased funding under the waiting list initiative pending the working up of design teams and the completion of the extension. Those involved referring children to the United Kingdom. We have 96 public patients awaiting cardiac surgery procedures. Fourteen have been waiting for up to three months, 19 have been waiting for between three and six months, and 63 have been waiting for more than six months.

Most of them have been waiting for well more than 18 months.

We are doing everything we can both in the medium term and in the interim.

Would the Minister acknowledge that this waiting list has escalated during the Government's term of office, that the extent to which it has escalated is entirely unacceptable, and that the strains under which parents are being put as a consequence of children having to await cardiac surgery are unacceptable? These were well illustrated in a story in the Evening Herald yesterday about a young child who has been on a waiting list for some 15 months on very expensive medicines for which the parents can no longer afford to pay. Does the Minister acknowledge that the plight of such parents is something which this Government has failed to address?

One issue that my predecessor, Deputy Brian Cowen, was both committed to and concerned about was that of children within the health system, and accelerating the provision of services for children right across the board, particularly in relation to cardiac facilities and cardiac surgery. We made a crucial decision. The only way to ensure we can reduce waiting lists is to increase surgical capacity and to increase the human resources available within the hospital, which we have done.

This is proceeding at a snail's pace.

The urgent cases are being dealt with as they come to the hospital.

Every parent regards their child's surgery as urgent.

I accept that.

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