Vol. 424 No. 1
9 Mr. Connor asked the Minister for Health if he will give a progress report on the filling of the vacant post of orthopaedic consultant at Merlin Park Hospital, Galway; if his attention has been drawn to the serious build-up in the waiting list for hip replacement surgery in the Western Health Board area as a result of the delay in filling this post; and if he will make a statement on the matter.
15 Mr. J. Higgins asked the Minister for Health the reason an applicant (details supplied) in County Mayo who was told in a letter dated 6th April, 1992, that he would be called for admission for a hip replacement operation within six months of that date has now been notified that it will be approximately 18 months before he can be called for surgery; and if he will make a statement on the matter.
I propose to take Questions Nos. 9 and 15 together. The patient in question was notified in April last that he would be called for a hip replacement operation within six months. Unfortunately, the consultant in charge of the patient's case died in May. Despite every effort, it has not been possible for the Western Health Board to obtain the sevices of a locum consultant orthopaedic surgeon in the interim.
The vacant post of consultant orthopaedic surgeon was advertised by the Local Appointment's Commission in August last with a closing date of 17 September 1992. It is expected that interviews will be held shortly and the successful candidates appointed without delay.
I am aware that the waiting list for hip replacement operations has grown since the untimely death of one of the consultant orthopaedic surgeons at the hospital last May. The position is that the three remaining orthopaedic surgeons are concentrating on emegency cases. Should any patients feel that this condition has deteriorated, they should contact their general practitoner who would be in the best position to emphasise the urgency of their case to the hospital directly.
Is the Minister aware that as of 30 September there were 1,738 patients awaiting hip replacement operations in this hospital? Would he agree that by any standards this is a primitive service and one would have to go a long way in the underdeveloped world to find anything as bad? Is he aware that one will have to wait for about four and a half years on the waiting list before gaining entry to the hospital?
When one provides a service one creates a demand. Whereas some years ago people were content to endure their arthritic hips, unfortunately the increased demand cannot be met from within the resources that are available. This is normal in the case of most operative procedures but especially this one as it allows a person to return to full mobility within a short time. I recognise that there is a great demand for certain procedures and as soon as new medical technology is available there will be a massive increase in a number on the waiting lists for other procedures. No country in the civilised world at present can cope with the financial implications of new medical technology for a health service; it is increasing at a phenomenal pace. This should be borne in mind. We have to recognise also that we do not have the required number of surgeons trained, or available at short notice to cope with the increased demand in this field alone.
Would the Minister agree that the situation has been exacerbated given his failure to take action? There are three new clean air theatres in this hospital which are funded by the Minister's Department and which have been completed since 1990 but because no extra funding has been provided for extra staff during the past two years the position in relation to the waiting lists at this hospital and health board area has been greatly exacerbated.
I am so aware. When I became Minister for Health in February the allocation for 1992 had been made. This matter is being considered in the context of the Estimates for 1993, taking into account that there is a number of competing demands on the 1993 budget. However, I will bear in mind what the Deputy has said.
Would the Minister agree that the position in Galway is not unique, that there is a national crisis in the whole area of orthopaedic surgery? Will he carry out a comprehensive assessment of the problem with regard to hip implants? In some health board areas there is a four-year waiting list for a first appointment and thereafter it can take two to three years before surgery takes place. Would the Minister accept that a person with £6,000 can have the operation straight away whereas people with medical cards and public patients have to wait for up to six years for the operation? Would the Minister investigate the position whereby hip implants provided by health boards are being used for private patients?
That is a separate matter.
That is a specific allegation.
If the Deputy has information to that effect I suggest that he bring it to my attention——
It relates to the Southern Health Board area.
——and I will be glad to have it investigated.
I will supply the names to the Minister.
As regards the question of hip implants being made available for private patients, first, there is a great shortage of orthopaedic surgeons——
I am referring to one consultant.
If the Deputy bears with me I will exlain the matter. There is a shortage of orthopaedic surgeons and even if we had sufficient resources we would still have difficulty in providing the number of orthopaedic surgeons required to carry out all the operations necessary. I visited Galway and I am very conscious of the needs there. I do not think an investigation of this matter is required on a national basis. There is a problem in this area, as there is in the areas of cardiac surgery and renal dialysis, and we must address them as best we can. My job as Minister for Health is to consider the priorities with a view to allocating funds to the greatest needs in an area, and I will continue to do that. I realise there is a problem in the area mentioned by the Deputy. In the next three years the number on the waiting lists will have doubled or trebled because these services are very successful in restoring mobility. This service is a great boon in modern medicine. However, funds are limited and no matter who is in power the problem will exist.
Has the Minister responded to the recent request from the Western Health Board for the filling of 12 consultant positions in Merlin Park Hospital and University Hospital, Galway? Is he aware that since one of the orthopaedic consultants died in May, this post has not been filled? Would the Minister make available the grant for the clean air clinic which would enable those operations to be carried out in the summer months. We were informed at the last health board meeting that people have to wait four or five years for hip, knee and other orthopaedic operations as a result of the Department's failure to fill the 12 consultant posts.
I have dealt with a number of these matters but the question does not relate to the filling of posts. In May 1992 the consultant orthopaedic surgeon at Merlin Park Regional Hospital passed away and the Western Health Board sought and obtained approval from my Department in June to fill that post. On 3 July 1992 Comhairle na nOspidéal formally approved the filling of the post and on 16 July the Western Health Board requested the Local Appointment Commission to advertise the post. The advertisement was placed on 27 August with a closing date of 17 September and interviews will take place shortly. The Western Health Board endeavoured to recruit a locum consultant orthopaedic surgeon but were unsuccessful. As the existing three orthopaedic surgeons have to concentrate on emergencies, the waiting lists have increased. We hope that the interviews will result in the appointment of a consultant.
I think Members will agree that very little progress has been made today at Question Time.
The people in the west owe a great debt of graditude to the late Mr. Ronan Gorczak who provided a tremendous service over the years. I would put it to the Minister that there seems to be some inconsistency in relation to the whole question of waiting lists. Yesterday the Minister said that there are 886 people on the waiting list for heart by-pass surgery and the estimated annual throughput in 700; for hip replacement operations, there is a waiting list of 1,658 and an estimated annual throughput of 2,300. Therefore the annual throughput exceeds the waiting list. The same applies in the case of cateract operations for which there is a waiting list of 2,260——
Deputy Higgins is imparting much information to the House and this is quite superfluous.
There is a waiting list for cateract operations of 2,260.
The Deputy should ask direct, succinct and relevant questions.
Excuse me, a Cheann Comhairle, I am entitled to elicit information on this matter. There is a waiting list for cateract operations——
Sorry, the Deputy is imparting information.
May I finish my question?
No, the Deputy may put questions. The Deputy is imparting quite a lot of information to the House.
I am asking a question in relation to No. 15.
I am seeking to facilitate the Deputy in eliciting information. He and the House must proceed by way of relevant supplementary question.
May I ask the Minister if there is not an inconsistency in that the waiting list for cateract operations is 2,260 while the estimated annual throughput is 4,300, almost double the number on the waiting list? How does this arise?
Some people have been on the waiting list for four years.
New people are being put on the waiting list all the time and there will always be a waiting list. However, the matter is not relevant to this question. The question relates to a specific person in County Mayo who was told that he would be called for operation.
That man was under the care of Mr. Gorczak.
No. 10, Deputy Richard Bruton's question.
The Minister is running away from the problem.
I am very surprised at that statement from the Deputy.
Why is there a four-year waiting list?
The Deputy knows me better than that.
Let us have a reply to No. 10, please.
