Hospital Waiting Lists

Dáil Éireann Debate, Wednesday - 8 March 2017

Wednesday, 8 March 2017

Questions (22)

Louise O'Reilly

Question:

22. Deputy Louise O'Reilly asked the Minister for Health when the National Treatment Purchase Fund, NTPF, will be requested to lead a project team to undertake a feasibility study of progressing to an integrated approach to waiting list management at hospital group level; if departmental, HSE and external advice will be sought on this feasibility study; if the terms of reference can be extended to examine waiting list management across hospital groups; and if he will make a statement on the matter. [11888/17]

Oral answers (6 contributions)

Deputy Louise O'Reilly

The Minister advised me previously that the HSE waiting list action plan will not specifically incorporate technology solutions. I and my party, Sinn Féin, strongly believe it should. My question concerns when the NTPF will be asked to lead a project team to undertake that feasibility study.

Deputy Simon Harris

I thank the Deputy for this question. It is an issue we often discuss and I think we are due to meet. The Government is committed to reducing waiting times for patients, both for patients waiting for inpatient and day case procedures and for outpatient appointments. It is unnecessary for people to have to wait excessively long periods for necessary care.

In order to reduce this burden for patients and to ensure that best practice is applied in how waiting lists are managed, I am open to evaluating new approaches to waiting list management in our health service. I agree that greater integration of hospital waiting list management systems is a step in the right direction and that IT can play a significant role in underpinning these integrated approaches.

On this basis, on 15 February during a Private Members' business debate from the Deputy's own party in the Seanad regarding waiting lists, I committed to asking the NTPF to examine the feasibility of progressing to the more integrated system that Deputy O'Reilly advocates for.

Following on from that debate, on 23 February officials from my Department wrote on my behalf to the NTPF to request that it establish and lead a project team of relevant experts and stakeholders to conduct a feasibility study regarding integrated approaches to waiting list management at a hospital group level. The NTPF informs me that it is in the process of scoping out the structure and format of this study and I expect to receive the preliminary plan in the coming weeks. The NTPF has been asked to report to me within six months on the finalisation of that report, which I expect will be published.

I think Deputy O'Reilly has a view that this can be done quicker. That is usually a good guess anyway. If the Deputy would like to meet with officials from the NTPF who, as I say, are scoping the work and will present to me a preliminary plan in the coming weeks to have the work completed within six months, I will be more than happy to facilitate that.

Deputy Louise O'Reilly

For once, the lack of haste might be fortuitous. Why did the Minister pick the NTPF to lead this? The reason I ask is because the chief executive of the NTPF, who I think is on secondment from a State agency, stated that the private sector is the most efficient and clinically effective way of having patients seen quickly. The person who heads up the organisation that the Minister has tasked with reviewing what I believe is and should be a very important pillar of any waiting list management system has already publicly stated a preference for the private sector against his own substantive employer. Why must it be the NTPF that leads out on this? The Minister said the review will consider waiting list management at hospital group level. This is a bit of a blinkered and short-sighted approach. I believe we should be looking at this on a national basis. That is possibly the most efficient way to go. Why was the NTPF chosen for this? Does the Minister have any comments to make on the indicated preference of the chief executive for the private sector?

Deputy Simon Harris

I always have a preference for the public sector. I am the Minister for the Irish public health service. That is why we are investing heavily in it. That is also why I have told the Deputy on a number of occasions that it is my view that we must be pragmatic about this. When I hear from people who are waiting for operations and procedures in hospitals, and I am sure when they talk to Deputy O'Reilly, they do not have an ideological preference as to where their treatment should be carried out. They just want it done. After years of an inability to invest adequately in our public services, it is going to take time to ramp up public services to the level we want to get them to. Therefore, I believe we should unapologetically utilise every possible resource at our disposal to make sure that patients get their treatment in the quickest time possible.

I think the Deputy has a fair point about the national basis for the NTPF. I will relay that to the NTPF. My understanding of the reason is that the hospital group structure is the way in which our health service is currently functioning. The Deputy asked me why I asked the NTPF. This body of work is not a debate about public versus private. It is a debate about systems. It is the statutory agency that manages waiting lists and waiting list systems on behalf of the Minister for Health of the day. We felt it was the most prudent and appropriate agency.

Deputy Louise O'Reilly

I asked the Minister to comment on what the chief executive of the NTPF said. I would be very grateful if he could. That to me indicates a preference before this important work has even started. As part of the waiting list plan, I know the Minister is considering a number of options. I wonder why we are not at this stage integrating the digital options as part of that. Since we have limited time, perhaps the Minister could use all of the time he has to comment on the remarks made by the chief executive. I believe it is very worrying that the person who is going to examine waiting list options has publicly stated a preference for the private sector over the public sector. I fully respect the fact the Minister comes into the House and says that he is very focused on the public. He is indeed the Minister for the public sector. However, he is channelling money into the private sector. As I have said before, he will never improve the public service by putting money into the private sector. I think he knows that. I ask him to respond specifically to the comments that were made by the chief executive.

Deputy Simon Harris

We are putting €20 million into the NTPF out of a budget for the health service of over €14 billion. It needs to be seen proportionally when the Deputy makes those comments. With regard to the acting CEO of the NTPF, that is a position that is currently being advertised and interviewed for to find a person through the Public Appointments Service. I am not familiar with the context in which the comments were made, but I will put my view on the record. I want to see investment in the public health service. I want to see procedures delivered in the public health service. In fairness, it is the job and responsibility of the NTPF to procure services in both the private sector and through insourcing. The acting CEO of the NTPF, whose comments I will review, has a view and was expressing that view honestly, I am sure. We are utilising both the public and private sector in the interests of our patients. In fairness, in this work the NTPF is not being asked to do exactly as the Deputy has characterised it. It is being asked to look at the greater integration of hospital waiting list management systems. It is an IT piece of work. It is trying to make sure that the hospitals talk to each other and the consultants with waiting lists talk to each other in order that a patient who could be seen quicker in another hospital will be seen.