Vol. 508 No. 2
7 Mrs. Owen asked the Minister for Health and Children if he has received a response from all acute hospitals in respect of the request he made to them for information on whether they allocate out-patient appointment times in accordance with the standard specified in the Patients' Charter of 1992; if he will make available the response of each hospital to his request; and if he has satisfied himself that the charter is being implemented fully in all hospitals. [17431/99]
As the Deputy will be aware, my Department recently sought information on out-patient appointment times from all acute hospitals to assess whether any particular difficulties had arisen in relation to adherence to the standards specified in the Patients' Charter. The Deputy will appreciate that it took time to collect all the relevant information. However, my Department has now received responses from all the acute hospitals and is currently finalising its analysis in this regard.
The initial analysis shows that in a small number of hospitals it has not been possible to date to fully implement the Patients' Charter guidelines regarding out-patient appointment times due to logistical and other factors. However, these hospitals have confirmed they are currently reviewing their practices with a view to offering individual appointment times. The survey also indicates that some hospitals offer appointments on a staggered basis with the interval between appointments set in line with the requirements of the individual clinics and experience has shown that this is the most effective way of operating these clinics. Once again, the hospitals have indicated that they are keeping this practice under review to ensure that patient interest is served. In addition, some hospitals are currently carrying out individual patient satisfaction surveys and the specific issue of out-patient appointments is being examined in this context. As I indicated to the Deputy in June 1999, once my Department's analysis on this issue is complete, I will take whatever steps are necessary to ensure that the provisions of the charter are being met.
The development of mechanisms for improvements in patient advocacy is an important task for my Department and, in this regard, my objective is to provide a patient focused service within which the priority must be equity of access to high quality of care based on clinical need. The Patients' Charter was an important step in developing awareness of patient's rights and I intend to develop a comprehensive policy which will build on the good standards of practice which the charter provides.
Is the Minister in a position to indicate to the House the hospitals which are not to date complying with the Patients' Charter and when they will start complying in the context of arranging specific appointments for out-patients? Does he agree it is unfair to keep patients waiting for hours for appointments and to give 30 or 40 patients the same time for an appointment when there is no possibility of most of them who turn up being seen for a long time after they arrive?
I agree with the Deputy that this is not satisfactory. Many of us would have received complaints from constituents in that regard. The initial analysis shows that 5 per cent of hospitals surveyed offer no individual appointment times, 32 per cent stagger appointments in line with the requirements of the clinic and 63 per cent offer individual appointments. In the case of those which do not have individual appointment times, the survey indicates that existing practices are now under review. There might be some improvement now that we are pushing this issue. When the analysis is complete, I will communicate with the interested parties.
Does the Minister agree it is unsatisfactory that 37 per cent or over one-third of our hospitals are not implementing the Patients' Charter many years after it was put in place? Does he agree that this issue should have been monitored on an ongoing basis by his Department to ensure the Patients' Charter was complied with? It should not require prompting by way of parliamentary questions from this side. Will the Minister acknowledge that without parliamentary questions being tabled about this issue, the current unsatisfactory position would have continued?
If that was the position, I would applaud the Opposition for doing something constructive. That is not a problem. In most cases the practice of staggered appointment times is working well but some hospitals indicated that they were reviewing the arrangement to ensure they could meet each patient's needs. The staggered appointment times do not necessarily mean that patients are being put to any great inconvenience if the staggering is, as the Deputy said, realistic and 50 people are not there for the same time, which is a nonsense. The initial analysis is the information I gave to the Deputy earlier. When the analysis is complete, more information and lessons can be learned.
Does the Minister know when it will be complete?
I expect it will be completed very shortly. I do not think it should involve much more work to sort it out.
(Carlow-Kilkenny): The Minister expressed dissatisfaction. Will he make the matter a priority because, as he comes from a rural constituency, he knows it is grossly unfair that people must leave their homes early in the morning for an appointment that cannot possibly be met and they are kept waiting for hours sometimes even without food? It is a major problem.
I agree with the Deputy. It is not a satisfactory situation and I am aware of one case involving an unfortunate person who is attending four different consultants in the one hospital and making four separate journeys. If there was some recognition of her situation and co-ordination at management level, there is no reason that her four appointments could not be on the same day. I have brought this to the attention of the management.
