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Seanad Éireann debate -
Thursday, 8 May 2008

Vol. 189 No. 12

Hospital Waiting Lists.

I welcome the Minister to the Chamber and I wish her well in her new role in the Department of Social and Family Affairs. She and I will have plenty of interaction with the decentralisation of departmental offices to Buncrana, as well as the social welfare consolidation office.

I wish to speak about the need for the Minister for Health and Children to outline the efforts being made to reduce waiting lists at Letterkenny General Hospital, and to ascertain whether the supports being given under the National Treatment Purchase Fund are equal to other parts of the country for those waiting over three months for operations. I am doing this in order to find out the impact of the NTPF and to ensure that people become more aware of it and choose it as an option. I recently received a letter from the Minister for Health and Children which indicated that around 130,000 people will have used the NTPF by the end of this year, and that 98% to 99% of them are very happy with their experience of it.

There are 2,900 people across the country waiting longer than 12 months for an operation, but half of them are centred in four hospitals, namely, Letterkenny, Sligo, Tallaght and Tullamore. For that reason I have been encouraging people to use the NTPF. I issued a press release telling people that it was as good an option as any other, and it meant that people could speedily get their operation carried out and have it paid for by the Government. I also asked the general manager of Letterkenny General Hospital about the waiting lists. Thankfully, he indicated that there has been a substantial drop in the number of people waiting for over one year in Letterkenny. There are currently 400 people waiting more than 12 months there. However, he also pointed out that a person must now be waiting 12 months to be referred from Letterkenny to the NTPF, which is very different from three months' waiting time for the rest of the country.

My good work in trying to persuade people to avail of the NTPF if there is a long waiting list for a particular operation seems to be undermined by all this. It is discriminatory if patients from other parts of the country are put on the NTPF waiting list after three months, while patients in Letterkenny are only put on it after 12 months. I also spoke to representatives from the NTPF, and they are anxious to get the 12 month list reduced. They want to ensure priority for those people who spend more time on the list. However, my concern is that somebody should not be penalised because of geography. If I have a serious health problem and I cannot wait 12 months to be put on the NTPF, I will be forced to consider the private option. That is not right.

This Government has put substantial resources into the NTPF, which has driven down waiting times and waiting lists. It has a very good satisfaction rating and 130,000 people will have used it by the end of this year. Are the supports being provided to the NTPF equal in Letterkenny to the rest of the country? No matter who is responsible for this, I am only interested in the welfare of the patients, who must come first. General practitioners, the representatives of the hospital and the NTPF should advocate the wonderful work that is being done and should encourage people to go to somebody other than the consultant to whom they have been referred. It is a very successful, well funded project, and we in Letterkenny should not be different to the rest of the country.

I will take this matter on behalf of my colleague, the Minister for Health and Children, Deputy Harney. The National Treatment Purchase Fund was established as a statutory body in May 2004 to treat public patients who are longest on surgical inpatient waiting lists. Access to treatment under the auspices of the NTPF is open to patients who are waiting more than three months on a surgical waiting list and who may qualify for treatment through it. In general, non-surgical treatment does not qualify for consideration under the fund. It is open to the patient, or anyone acting on his or her behalf, to contact the fund directly in relation to each case. The NTPF operates a nationwide lo-call line for this purpose. A person may also be referred to the fund through the NTPF liaison officer attached to the hospital.

The NTPF to date has arranged treatment for 100,000 people. The 100,000 patients are a combination of approximately 78,000 inpatients and 22,000 outpatients. The NTPF has consistently increased the number of patients for whom it has arranged treatment annually and is on target to do so again in 2008. The specialties in which the highest numbers have been treated are ophthalmology, ENT, orthopaedics and plastic surgery. The annual allocation to the fund has been increased from €5 million in 2002 to €100.4 million for 2008.

The NTPF compiles the national patient treatment register which details the public patients waiting for treatment in public hospitals based on information supplied by the hospitals. The NTPF has advised that for the most common procedures the median waiting time for surgery in a public hospital is now down to two to four months for adults and two to five months for children.

Significant investment in recent years in Letterkenny General Hospital has allowed for key service developments including a new 29 bedded modular ward which opened in 2007. The HSE advises that this has allowed the day services unit at the hospital to return to providing a dedicated elective service, which has improved the hospital's ability to see and treat outpatients, day cases and inpatients. Since the opening of these extra beds and the protection of the day unit, the HSE has advised that the hospital has reduced the number of patients waiting over 12 months for admission. The executive advises that this will continue to reduce waiting times for surgery at the hospital over the coming year.

The HSE advises that plans are at an advanced stage for an emergency department with an integrated medical assessment unit and three acute inpatient wards. It also advises that it is planned to go to tender on this project in the current year.

The executive has advised that interim measures have been put in place to address pressures which were resulting in increasing deferral of elective admissions. This involved the need to accommodate emergency admissions in the hospital's day surgery unit and in the outpatient department waiting room.

The new short stay ward will provide a facility to accommodate those increasing emergency admissions and obviate the need to use the day surgery and outpatient areas whilst awaiting the development of the new emergency department and accompanying wards. As a result, the clinicians in the hospital will be able to resume normal elective activity levels and the HSE has indicated that this will improve access times for treatment at the hospital.

The NTPF has indicated that the treatment register shows that there are currently 1,266 surgical patients over three months on inpatient waiting lists at Letterkenny General Hospital. Of this number, some 400 patients have been waiting over twelve months for their operation. The NTPF indicates that Letterkenny General Hospital is one of a small number of hospitals in this situation. The Minister for Health and Children has asked the fund to give urgent attention to this matter in 2008.

I understand that the NTPF has indicated to Letterkenny General Hospital that it is prepared to facilitate treatment for these 400 patients quickly, if they are appropriately referred under the scheme. The HSE has advised that Letterkenny General Hospital is currently working with the NTPF to refer the maximum number of patients interested in treatment through the fund.

I ask the Minister to bring to the attention of the Minister for Health and Children that the fundamental question I raised was not answered in the reply given. Are people who have been waiting for operations for more than three months treated as a matter of priority, or must they wait until the 400 people on the waiting list have been dealt with before they are treated as priority cases? This is a difficulty I foresee. We do not want a position to develop whereby people, because they live in Letterkenny or elsewhere in Donegal, must wait longer for treatment, until the longer waiting list is dealt with first, whereas people who live in any other part of the country, who are eligible for treatment under the fund, would be able to obtain it under the fund. Patients do not have to wait longer for treatment in the rest of the country. However, I appreciate the investment in this area to date.

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