Ceisteanna Eile - Other Questions

Hospital Waiting Lists

Brendan Smith


8. Deputy Brendan Smith asked the Minister for Health when additional capacity will be provided in orthopaedics to reduce delays in assessments and procedures for patients in counties Cavan and Monaghan; and if he will make a statement on the matter. [41188/19]

As I have previously outlined to the Minister through representations, debates and parliamentary questions, patients in Cavan and Monaghan experience considerable delays in accessing orthopaedic assessments and follow-up procedures. I am anxious that additional capacity be provided for those two counties and for the north east in particular. The figures I received at the end of August, unfortunately, indicated a further increase on previous waiting list numbers. What hope is there for additional orthopaedic capacity for patients in Cavan and Monaghan in 2020?

I thank the Deputy for his important question about orthopaedics in the Cavan-Monaghan region. I am conscious that waiting times are often unacceptably long and that this places a burden on patients and their families. We are committed to improving waiting times for hospital appointments and procedures. We have made some progress on hospital operation waiting lists, which have fallen.

The HSE advises that the acute element of the orthopaedic service for this region is currently provided through Our Lady of Lourdes Hospital in Drogheda. The elective component of the service is provided via the regional orthopaedic unit in Our Lady’s hospital in Navan and consultants also work out of Cavan and Monaghan to provide clinics for orthopaedic patients, which is the germ of the Deputy's question. I understand that the delivery of orthopaedic services in this region is kept under review by the HSE.

More broadly, the Government announced in budget 2020 that it has further increased investment in tackling waiting lists, with funding for the National Treatment Purchase Fund, NTPF, increasing to €100 million in 2020. I know that is an issue of importance to the Deputy. This year-on-year increase to the NTPF provides opportunities to further improve waiting times.

My Department is now working with the HSE and the fund to develop the scheduled care access plan for 2020. The HSE service plan for 2020 will set out the planned activity level for the year ahead, while the NTPF will work with the hospital system to provide additionality to improve access to inpatient day case treatment, with a particular focus on hospital outpatient services. I encourage individual hospitals and hospital groups to put forward proposals for that 2020 funding. We now have a significant access fund of €100 million and we will be inviting proposals on what more can be done, whether in Cavan, Monaghan or other parts of the country, of which hospital groups are aware.

I will raise the issues noted in the Deputy's question directly with the NTPF and the HSE. I encourage the hospital group to bring forward proposals because I am happy to do whatever can be done to drive down orthopaedic waiting times in Cavan and Monaghan. I believe we now have the level of funding to make that a reality.

I would be glad to see an improvement in the delivery of both assessments and follow-up procedures where they are necessary. People come to all of us on a weekly basis who are obviously in pain and suffering but who are still waiting on an assessment and follow-up procedure. They are often told that the procedure could be carried out without delay if they were private patients. I welcome the Minister's commitment to make additional funding available to hospitals in the north east with orthopaedic capacity. I sincerely hope that proposals that are put forward are acted upon and additional services and capacity are put in place in early 2020. I do not want to talk this time next year about funding having been provided but not yet drawn down or allocated. I would like an assurance that when hospitals put forward realistic and viable proposals, they will meet with a quick response and that additional capacity will be put in place. Many patients, some of whom may be listening to us, are suffering and in pain. They are often older persons whose mobility is damaged as well. It is important that we address this particular issue as rapidly as possible.

I do not disagree with a word the Deputy said. I have been advised that Cavan Monaghan Hospital has not yet submitted any proposals to the NTPF. I take this opportunity to encourage all of our hospitals, hospital groups, and community health organisations, CHOs, to bring forward proposals.

There are excellent management and staff in the Cavan Monaghan Hospital. I have had the pleasure of visiting both hospitals and meeting the Deputy regarding how we can make Monaghan Hospital busier and build its capacity. I urge both hospitals to engage with the hospital group and bring forward proposals to the NTPF, as it has funding going into 2020 that should make new proposals viable.

Cavan Monaghan Hospital currently has no orthopaedic patients on its inpatient day case waiting list, due to the reasons I outlined. There are currently 86 patients living in Cavan or Monaghan on the outpatient day case orthopaedic waiting list. Some 58% of the patients in this area are also on the corrective and preventative action plan, CAPA, list. The latest NTPF list shows that 93% of those on CAPA are waiting nine months or less. We are making progress on the inpatient day cases, but we need to make more progress on outpatient cases and I would welcome proposals on that.

I welcome the additional funding for the NTPF, for which our party spokesperson advocated strongly. I also welcome the progress that has been made with the cross-Border scheme. Many patients go to Northern Ireland to access services, as I mentioned during a previous debate. Those who read Belfast newspapers, particularly the nationalist ones, as I do on a daily basis, will see advertisements from our private hospitals seeking patients from Northern Ireland to avail of the cross-Border directive. Surely the Department, the Minister, or the HSE could pull this together. If there is capacity to carry out procedures here, let them be carried out here instead of people having to head to Belfast or elsewhere in Northern Ireland. It would cost less if those people could undergo those procedures in our own State. It does not make sense that clinics and hospitals in Northern Ireland are looking to attract our patients while private hospitals in our State are looking to attract patients from Northern Ireland. Surely this can be managed in a much better way for the same money.

The Deputy referenced the cross-Border directive. As a Border Deputy, he will be particularly concerned about and pleased with the work we have done in this House to protect reciprocal health arrangements in the event of a no-deal Brexit. The Brexit omnibus Bill we passed in April means that reciprocal healthcare rights, which apply to people travelling between North and South and, indeed, east and west, will continue regardless of the political environment into which a no-deal Brexit could bring us.

I do not disagree with the Deputy about ensuring we utilise all the capacity here, though we are making progress in that regard. The NTPF thankfully no longer just spends its money on private hospitals. It has invested €1 million in Nenagh to open a new cataract theatre, which is bringing real progress in that mid-west. It has also opened theatres in Bantry General Hospital. When I visited Monaghan, I was told at great length that the fund could be doing more there, but the NTPF needs to receive proposals from the hospital and hospital group first. I am satisfied that we, working with Fianna Fáil, have provided the NTPF with a level of funding that should allow it to respond positively to such proposals.

We will now return to Priority Question No. 4. I am glad to see that the Minister of State battled through the traffic and got here eventually.

I apologise. I was stuck in traffic.

I ask Deputy Barry to put his question.

There is much anticipation.