Vol. 419 No. 6
56 Mr. R. Bruton asked the Minister for Health if he will give details of the system he has put in place to oversee (a) the waiting time of public patients for their first appointment with a consultant, (b) the provision of an individual timed appointment of patients being seen by consultants at outpatient and (c) the delays experienced by patients when they come for their timed appointment.
88 Mr. Noonan (Limerick East) asked the Minister for Health if he will give details of the system he has put in place to oversee (a) the waiting time of public patients for their first appointment with a consultant, (b) the provision of an individual timed appointment of patients being seen by consultants at outpatients and (c) the delays experienced by patients when they come for their timed appointment.
I propose to take Questions Nos. 56 and 88 together.
As the Deputies may be aware, the Third Report of the Dublin Hospital Initiative Group published last September contained a series of detailed recommendations in relation to the organisation and delivery of out-patients services. The implementation of these recommendations is being actively pursued with all acute hospitals. In particular, each hospital has been asked to establish an out-patient services group representative of medical, nursing and administrative staff to assist in the co-ordination and day-to-day operation of out-patients services and to devise strategies to tackle key problems. In addition, hospitals have been requested to put in place effective appointment systems for patients attending out-patient clinics.
Would the Minister agree that it is not sufficient to extol the various hospitals to perform better and that we need some efficient system of reporting? Would he agree, for example, that it is typical that in some specialties people have to wait a year for a first appointment to see a consultant, which is unacceptable? Would he accept that it is common practice to make all appointments for 9 a.m. and that frequently people have to wait most of the day before they are seen? Would he, therefore, accept that we need a system whereby the Minister can report to us on the performance in terms of these recommendations rather than just telling us that he has recommended them to hospitals?
I agree with the Deputy. I am unhappy about the long delay in patients obtaining appointments at outpatient departments. Such delays are unacceptable and I have to see how we can solve this problem. As regards appointment times, I have made this point clear to each of the hospitals when I visited them. They tell me that the problem arises where patients arrive before their appointed time and, second, because patients from outlying areas come to the hospital by way of ambulance or minibus, and, therefore, all arrive together. These two problems result in the appointments system not working to schedule. Patients should not be expected to wait for long periods. It should be possible for them to be seen within 15 to 20 minutes of their appointment. We have to get hospitals around to that way of thinking and by highlighting the problem we will ensure that that is done to the benefit of patients.
With the greatest respect to the Minister, would he agree that each predecessor before him urged hospitals along similar lines? Would he agree that the problem is that all appointments are made for 9 a.m. and that it is not an administrative problem relating to minibuses? Will the Minister undertake to report to this House on a regular basis on progress on these issues just as he has undertaken to report on waiting lists because this matter is as important to the quality of service provided to patients?
First, it is my intention to bring in a new authority to replace the Eastern Health Board. This authority will effectively be in charge of management and bringing about the co-ordination of all the health services in the Eastern Health Board area. It would be in the better interests of the State, and the Department of Health, if such an authority formulated policy and did not become involved in day-to-day management, as suggested by the Deputy. I agree that there should be proper monitoring.
A questionnaire has issued to each hospital with questions along the following lines: has a systematic review of outpatients' services been undertaken recently in your hospital, and, if so, when? Is an outpatients' services group representative of medical and nursing staff in your hospital? Is there a designated person with overall responsibility for the operation of the outpatients' department? Have operational policies and procedures been developed? How are patients given an appointment for outpatients clinics — by specific appointment or block booking? Each hospital in the Dublin area stated that specific appointments are made except for fracture clinics, with the exception of the Mater Hospital which, for some inexplicable reason, operates block bookings. We have received much information in reply to the questionnaire and hospitals tell us that the system is fully operational. I would be glad to show this document to the Deputy because it is not confidential information.
It is not for my knowledge that I want this information. I would like to see the Minister directing each hospital to publish, for the benefit of its patients, indicators of its performance in respect of these matters so that any patient visiting or telephoning the hospital will know how the hospital is performing. If that information was available the system would operate successfully and it would not need to be addressed by the Minister or by me.
That is a very good suggestion by the Deputy but, unfortunately, we have not reached the stage where patients can pick and choose between hospitals.
