Charles Flanagan
Question:1 Mr. Flanagan asked the Minister for Health the number of new appointments to be made in the health care area in order to tackle hospital waiting lists.
Ceisteanna — Questions. Oral Answers. - Hospital Waiting Lists.
Martin Cullen
Question:30 Mr. Cullen asked the Minister for Health the number of additional consultants, non-consultant hospital doctors, nurses and paramedical staff that will be hired in each health board area to implement the £20 million waiting list action plan.
I propose to take Questions Nos. 1 and 30 together.
Following my announcement on 19 May of the major action programme on waiting lists in 1993, the relevant agencies have been informed of their individual allocation under the programme and are currently putting the necessary arrangements in place. The employment of staff is a matter for each agency in the first instance and it will be some time before my Department has an overview of additional recruitment throughout the country.
The main impact of this initiative will be in the form of short term temporary employment. Given the range of options for implementing the initiative in each health board area, e.g. contracting out, after hours working, reopening of beds and extra use of theatres, the total employment impact cannot be predicted with any certainty at this stage.
I wish to express my disappointment at the Minister's brief reply on this important matter.
The replies are short because the Deputy said that previous replies were too long.
I welcome the initiative on the £20 million but I put it to the Minister that the relief consequent on this £20 million will be merely temporary and that, in effect, what is happening in hospitals is the postponement of elective surgery to allow for the use of the theatres to crack his waiting list and that the same staff will be employed. It is gravely disappointing that the Minister has not stated there would be one new appointment of a permanent nature in the health care area arising out of the spending of £20 million.
I am not surprised that the Deputy opposite would give a less than enthusiastic welcome for this initiative. An additional 17,254 procedures will take place this year. I have contracted out the normal requirements in advance and I was careful to ring fence the £20 million to ensure it would not simply be absorbed in current procedures. An additional 17,254 operations in the range of areas I outlined, ENT, opthalmology, orthopaedics and plastic surgery, will be carried out. I know the Deputy opposite welcomed my announcement in relation to Mullingar, Tullamore and Portlaoise. There will be be improvements around the country in terms of facilities. There will be recruitment, some temporary, and better utilisation of available resources. The main thrust of the initiative will have a considerable impact on those waiting for vital procedures for a long time.
Is the Minister not concerned with the ratio of consultants to non-consultant hospital doctors? Does he not accept there is a need to increase the number of hospital consultants from the present 1,100? Could the Minister elaborate on a point made in his brief reply when he stated that the object of the exercise was the re-opening of beds? Could the Minister be specific on the re-opening of beds? Would he not accept that what is taking place in hospitals is the widespread closure of beds during the months of June, July and August? Could I ask the Minister to reply to the point made in my initial supplementary? Will he confirm that in order to clear the waiting lists the postponement of elective surgery on a wide scale basis is occurring in many of our hospitals? This is postponed until the end of the year and the £20 million initiative will be successful only in so far as it will clear waiting lists in the areas of ENT and orthopaedic surgery. The backlog, in terms of elective surgery, will increase in October and November.
The Deputy is, as usual, wrong on almost all counts. His first comment in relation to the ratio of consultants to NCHDs will not be dealt with now because a question is forthcoming in relation to that and it would be unfair to the Deputy who tabled it.
I thought the Minister said he was taking Questions Nos. 1 and 13 together?
Nos. 1 and 30 are being taken together. In relation to the bed closures, because of this initiative there will be fewer this year than any previous year. Bed closures are a feature of hospital services in every country. Consultants, doctors and nurses take holidays and unless locums are recruited to run the service throughout the year at optimum bed closures in the summer months will take place. Hospitals programme their lists accordingly and this waiting list initiative will minimise that this year, although it is a normal feature of the service. The primary impact of this initiative is not to reopen beds, but to make available elective operations to arrange for people who are waiting for longer than 12 months. A total of 17,254 people will benefit from this initiative.
In relation to postponement of elective surgery I have said that what I did in relation to this initiative was to deal with each hospital and each health board in advance of their requests for additional procedures. I was aware of the exact amount of contracted work that was to take place from the initial annual allocation. That was put to one side so that I could ensure that the £20 million would be an addition and would not involve a postponement or reduction of any other service.
The Minister's reply stated that the beds could be reopened.