I propose to take Questions Nos. 430 and 432 together.
It is recognised that waiting times for scheduled appointments and procedures have been impacted in the last year as a direct result of the Covid-19 pandemic. Elective hospital care was curtailed for the first quarter of 2021, in line with the rapid increase in Covid-19 hospital admissions, with only critical time dependent elective procedures undertaken.
On 23 March the HSE published the “Safe Return to Health Services Plan”. This plan outlines a three phased approach for the proposed restoration of services across Community Services, Acute Hospital Operations, Cancer Services and Screening Services. It sets target times for their safe return and details the conditions and challenges that will have to be met. Every phase of the plan has been informed by clinical guidance and putting patient and staff safety first. Decisions in relation to the type and volume of activity will be made at site level based on local Covid-19 numbers, available capacity and guidance from national clinical leads.
The schedule outlined in the plan for resumption of services will be regularly monitored by the HSE and updated as appropriate, dependant on public health advice and healthcare capacity. Patient safety remains at the centre of all hospital activity and elective care scheduling. To ensure services are provided in a safe, clinically aligned and prioritised way, hospitals are following HSE clinical guidelines and protocols.
The work of the HSE to improve access to elective care and reduce waiting times for patients is supported by the National Treatment Purchase Fund (NTPF). This includes increased use of private hospitals, funding weekend and evening work in public hospitals, funding “see and treat” services where minor procedures are provided at the same time as outpatient consultations, funding hybrid services where public and private hospitals contribute to the treatment of patients, virtual clinics and clinical validation.
At the end of March 2021, nationwide there were 11,629 patients waiting for an adult or child orthopaedic IPDC procedure, a reduction of 8.8% (-1,125) compared to the same period last year. At the end of March 2021 there were 80,039 waiting for a first outpatient appointment across all hospital groups, an increase of 14% (+9,937) compared to the same period last year.
Specifically in terms of the hip and knee replacements, the NTPF have advised the Department that at the end of May 2020 there were 3,042 patients waiting for such a procedure. Through focused activity, and with the support of the NTPF, at the end of March 2021 this figure had fallen by 26% to 2,252 patients.
The NTPF continues to work closely with public hospitals to arrange treatment for clinically suitable long-waiting patients on hospital outpatient and inpatient/day case waiting lists. Year to date at the end of March 2021, the NTPF had arranged 6,951 Outpatient appointments, of which 1,971 were Orthopaedic appointments. During the same period, 5,877 patients on the Inpatient/Day Case waiting lists had accepted offers of treatment funded by the NTPF, of which 1,221 were for Orthopaedic procedures.
The NTPF have advised my Department that they have approved one IPDC orthopaedic initiative so far in 2021 for Galway University Hospital, which will facilitate treatment for 82 patients on orthopaedics waiting lists.
Furthermore, the Programme for Government, Our Shared Future, commits to continuing investment in our health care services in line with the recommendations of the Health Service Capacity Review and the commitments in Project Ireland 2040. In regard to the second operating theatre in Merlin Park University Hospital, the HSE has advised my Department that a contractor has been appointed and works commenced on site in February 2021. Construction is expected to be completed by the end of 2021.
Officials in my Department engage on an on-going basis with representatives from the HSE and NTPF to monitor demand for scheduled care services, through the continual surveillance of waiting lists and activity levels. €240 million has been provided in Budget 2021 to improve access to care, €210 million of which has been allocated to the HSE and a further €30 million to the National Treatment Purchase Fund. This will be used to fund additional capacity to address the shortfall arising as a result of measures taken in the context of Covid-19, as well as to address waiting lists.
In this context the Department of Health, together with the HSE and the NTPF, is currently working on drafting a Sláintecare multiannual waiting list plan to address backlogs in waiting lists and to bring waiting times in line with Sláintecare targets over the coming years.
