Dáil Éireann Debate, Wednesday - 25 February 2015
9. Deputy Billy Kelleher asked the Minister for Health when he expects an improvement in both the numbers on waiting lists and the numbers on trolleys in emergency departments; and if he will make a statement on the matter. [8031/15]
View answerWhen does the Minister for Health expect to see an improvement in the numbers on the waiting lists and the numbers on trolleys in emergency departments and will he make a statement on the matter?
Emergency department, ED, overcrowding and eliminating very long waits for inpatient, outpatient and day case treatment are key priority issues for me and for the Government and I acknowledge the difficulties the current surge in ED activity is causing for patients, their families and the staff who are doing their utmost to provide safe, quality care in very challenging circumstances.
All hospitals have escalation plans to manage not only patient flow, but also patient safety in a responsive, controlled and planned way. The Government has provided additional funding of €3 million in 2014, secured in the Supplementary Estimate, and €25 million in 2015, secured in the Estimates for this year, to address delayed discharges and actions being taken include the provision of additional home care packages, additional transition beds in nursing homes, of which there have been several hundred, 300 additional fair deal scheme places and an extension in community intervention teams. Building upon these initiatives, the HSE is currently finalising an action plan under the auspices of the ED task force to address ED issues with a view to a significant reduction in trolley waits over the course of 2015.
My Department is also working with the HSE to put in place a plan to eliminate very long waits by the end of the year. This will involve both operational improvements and better waiting list management.
As I have stated publicly in the context of the significant emergency pressures currently being experienced by hospitals, realistically I do not envisage significant improvement in elective waiting times in the early part of the year. However, based upon the high priority attached to this area in the HSE service plan and the first overall increase in the HSE budget in seven years, it is expected that some improvement will occur later in the year.
We have referred to the fair deal scheme problem in detail in a previous question. When one adds all the waiting lists together, there are 76,666 patients waiting for inpatient, day case or gastro-intestinal procedures, according to the most recent report from the National Treatment Purchase Fund, NTPF. The Minister is as aware of the figures as I am.
We cannot just acknowledge that it is bad and might get worse before it gets better. We need to see some clear commitment on how it will be addressed. We cannot tell people live horse and eat grass or if they hang on long enough, they will be seen to. The Minister needs to outline a roadmap and accept that additional resources are required and the Economic Management Council has to support the Minister in announcing additional funding in advance of the panic stations between next October and December with a supplementary budget landed in to the Dáil at the end of the year to keep the show on the road. The Minister needs to achieve a sustainable funding model so that he can plan for the crisis situation of waiting lists and people on trolleys.
The figure the Deputy gives may also include people waiting a few weeks-----
I accept that.
There is a big difference between somebody waiting a few weeks for an appointment or investigation and somebody who is waiting several months. It has been the case for a very long time, including when the Deputy’s party leader as Minister for Health promised to abolish waiting lists in two years and broke that promise, but we can both accept that in Ireland there have been far too many people waiting far too long for appointments, diagnostics and treatments.
There is a roadmap. I have outlined it several times. It has three elements, first, transparency, which involves online waiting lists and strict adherence to chronological order which is not happening in some hospitals where people are going up and down lists although they are not sicker than others. The second element is efficiency, more day surgery, 20,000 more cases this year, more day of surgery admissions, an improved ratio of new patients to returns, which is really important, and reduced numbers of non-attenders, which are still very high and above international averages. There are specific initiatives and there is additional funding in place for scoliosis – we are trying to get a plan in place to make that happen but the resources are there for additional cases – ophthalmology and some other areas that are being prioritised such as general practitioner, GP, access to ultrasound and a minor surgery list for GPs. There is a roadmap.
The Minister’s party outlined a roadmap in advance of the election and in the programme for Government. We can travel that road for a long time but it did make many promises and campaigned on many issues, none of which has been implemented, including free GP care for everybody, Roscommon, Mallow and Bantry hospitals etc. - name them and the Minister’s party campaigned on them. Anywhere there was a lorry they were up on it, shouting to the high heavens. With all that talk, commitments have not been made. What is definite now is that the 76,666 people waiting, admittedly some are only waiting a short time, are in the difficulty that there is an escalating number going into the system and they are not being treated or dealt with. The key pinch points are, as the Minister and Minister of State have accepted, lack of funding for the fair deal scheme, delayed discharges and recruitment of consultants. These are all well within the Minister’s gift to address but many measures were populism, such as cutting consultants’ pay when he knows in his heart and soul that to recruit people it is necessary to maintain a certain level of remuneration rather than hunt people out of the country and pretend that he wants them back again. The Minister needs to be consistent. That is not the case.
The Minister gave me figures recently for the waiting list in Beaumont Hospital. I was really shocked to see the number of people waiting for a date for an appointment or for letters to be read. I saw on the television that the Minister was in Castlebar.
We are over time.
He was speaking in a theatre with many empty chairs and laying down the law about other parties in this House-----
Please. The Deputy should not abuse the fact that I allowed him to ask a short supplementary question-----
-----regarding what we would like to do on health.
-----but not a political statement.
It is a question of money and resources. The Minister will not spend the money because he is a neo-conservative financially.
It sometimes really amazes me that people actually elect Deputy Broughan. I can absolutely assure him that there is no money I am not spending.
But he needs more. He needs to ask for more, like Oliver Twist.
Whether I am a neo-conservative is entirely irrelevant. I absolutely assure the Deputy I will spend-----
Is the Minister confirming he is a neo-conservative?
-----any money that I-----
He was always a neo-con.
Is this Question Time or just some sort of general circus?
Deputy Broughan should not abuse the fact that I let him in. I should not have done so. This is Deputy Kelleher's question and I ask the Minister please to reply to him.
The Deputy's follow-up question was about promises. I am not making any promises and that is-----
He made enough of them previously to keep him going.
The only promise I will make is to work night and day and do everything I can to improve our public services and make insurance affordable for more people. The Deputy mentioned specifically the issue of consultants. One thing I have achieved in office is an agreement on pay scales for new consultants. Over 30 new posts have already been advertised. I am in the same boat as the Minister of State, Deputy Kathleen Lynch, the senior officials in our Department, the HSE leadership team and everyone else working in the health service. We are doing our very best to deliver as good a health service as we can with very constrained resources and very limited time. Expenditure is some €1.5 billion less than seven years ago, and there are 15,000 fewer staff. Therefore, we are really struggling but we are doing everything we can to provide as good a service as we can.
