David Cullinane
Question:1. Deputy David Cullinane asked the Minister for Health to report on his plans for tackling the length of waiting lists for access to children's health services; and if he will make a statement on the matter. [9678/24]
Ceisteanna ar Sonraíodh Uain Dóibh - Priority Questions
Hospital Waiting Lists
The first question is with regard to the Minister's plans to reduce waiting lists for access to children's healthcare. In recent weeks, we have had some lengthy debates on children with scoliosis and spina bifida and this week we have discussed mental health services and child and adolescent mental health services, CAMHS. My question is specifically on the overall children's health waiting lists. What plans does the Minister have in place to reduce the number of children waiting and the length of time they are waiting?
While important progress is being made in ensuring quicker access for children, we all know the waiting lists are still too long. They have been too long for a very long time and Covid-19 made them worse. In response, we adopted a multi-annual approach and we have had several waiting list action plans. We will shortly publish the waiting list action plan for this year.
While I fully accept, as we all do, that the waiting lists for children are still far too long, particularly in some specialties, including spinal to which the Deputy referred, it is important to acknowledge that, thanks to the work of our healthcare workers, important progress is being made. Last year, the hospital waiting lists for children fell by approximately 3,800. That is 3,800 fewer boys and girls waiting for hospital care now than were waiting this time last year. Critically, there has also been a focus on those who were waiting longest, more than 18 months and more than 12 months. I am happy to report that the number of children waiting more than one year, which is one of the number I have really been pushing the HSE to bring down, is down 26% now versus last year. That means 6,100 fewer children have been waiting for more than a year, which is good to see. The number of those waiting more than a year and a half fell by 40% last year. There is still some way to go. As we look to the future, our goal is to have no child waiting more than ten to 12 weeks. Important progress was made last year and that will continue this year.
People will be wary of promises made, such as those that were made to children with scoliosis. I accept, however, the Minister's statement that this is a target and that everything needs to be done to ensure we reach it. It the Sláintecare goal and we have to implement it. There are still far too many children waiting beyond the Sláintecare targets. There are 9,910 children on inpatient waiting lists, of whom 72% have been waiting more than 12 weeks. There are 79,241 children on outpatient lists, of whom 74% have been waiting over ten weeks.
I read this morning that the Minister had asked the HSE board to look at potential sanctions for hospitals that do not perform. Children's Health Ireland, CHI, is not performing in some areas. The Minister said this week that there is an audit under way of the €19 million provided for children's orthopaedic services, specifically in the areas of scoliosis and spina bifida. If that audit finds that all the money was not spent for the purposes for which it was intended, what sanctions can the Minister or the HSE impose?
With regard to hospitals needing to comply with relativity measures, I have instructed the HSE to pause capital investment into any hospital that is refusing to join the productivity drive. We have previously discussed the health performance visualisation platform, HPVP. The vast majority of HSE hospitals are on this platform, which is essential if we are to make sure we get as much patient care as possible. We identify where things are going well and where there are challenges. To date, a small number of hospitals have not been willing to sign up to a data-sharing agreement or felt they could not do so. I do not accept any of the arguments they have put forward. To that end, I have instructed the HSE to ensure that capital investment is linked to data sharing, which we need. I will come back to the Deputy on the question of CHI in my next response.
We all accept - I certainly do - that each and every hospital should comply with data sharing. It is very important for the health system generally and for clinicians to have data across all hospitals. It is also important for policy and the wider health services in terms of the Department, the HSE and the political system. I agree with that.
The difficulty with pausing capital investment is that patients suffer. At the end of the day, it is not the hospital manager who will suffer if that occurs. What will happen is that vital projects that need to proceed will then be paused. That is with regard to data sharing, however. There is also the issue of funding allocated to hospitals not being spent in an appropriate way or in the way in which it was intended. Last week in the Dáil, the Minister said he could not guarantee the €19 million provided for children's orthopaedic services had all been spent for the purposes for which it was intended. I know an audit is ongoing, and the Minister will not comment on that until it is complete. If, when the audit is complete, it finds the money was not spent for the purposes for which it was intended, what course of action can the Minister take?
These issues were raised with me by patient advocacy groups, and I took them very seriously. On the back of that, I spoke directly with front-line clinicians involved in providing paediatric orthopaedic services. I asked them whether they felt they got dedicated beds, dedicated theatre space and priority access to MRI, theatre, etc. The answer I received was that they did not. I have therefore taken the unprecedented step, which I have never had to do before, of instructing the HSE to send in its internal audit team.
We need to wait to see what it comes back with but I would like an answer very quickly. This is not going to be a piece of work lasting several months. It is a fairly discrete piece of work that asks where this money was spent. Let us not prejudge it but if it is the case that there was a material allocation outside of the intended Government purpose, and the purpose of this Oireachtas which votes through the budgets, that will be a very serious matter.