3 Mr. R. Bruton asked the Minister for Health if he has satisfied himself with waiting times, supervision and conditions in the outpatient departments of the major Dublin hospitals; and if he will make a statement on the matter.
80 Mr. S. Barrett asked the Minister for Health if he has satisfied himself with waiting times, supervision and conditions in the outpatient departments of the major Dublin hospitals; and if he will make a statement on the matter.
I propose to take Questions Nos. 3 and 80 together. The need to improve hospital out-patient services has been recognised and, indeed, a commitment has been given in theProgramme for Economic and Social Porgress to introduce measures to minimise waiting times by patients, provide comfortable waiting areas with appropriate amenities and provide patient information leaflets.
I have recently received the third report of the Dublin Hospital Initiative Group. In drawing up this report, the group carried out a major examination of out-patient services in the Dublin hospitals covered by their work. The group have highlighted the deficiencies they found in the present organisation of this service and have made extensive recommendations concerning the improvement of the operational management of out-patient departments.
I will be publishing the report in the near future and circulating copies to all the acute hospitals, asking them to immediately draw up plans to implement its recommendations. I will also be establishing an implementation group, representative of members of the Dublin Hospital Initiative Group and officials of my Department, to oversee the implementation process and to be available to advise the hospitals, as required.
Would the Minister not agree that the talk about administrative reform is a lot of waffle when the Dublin Hospital Initiative Group, to which he referred, recommended in their first report that by October 1990 — eight months ago — this problem would be resolved? The reality is that it is common place for people to have to wait from morning until late at night to receive care in outpatient departments. Is the Minister aware of the recent report by the non-hospital consultant doctors of the IMO concerning the lack of supervision of these doctors by consultants who work in outpatient departments? Would he not agree that there is a need to give proper priority to outpatients where half the admissions are now coming through casualty?
I am aware of the report to which the Deputy refers as it appeared in a medical newspaper. That report was never submitted to my Department. We are aware of the report and what is contained in it but I have not seen the official document.
Does it not concern the Minister?
It might be of interest to Deputies opposite to note that in the Dublin area the number of outpatients increased from 442,241 in 1989 to 478,048 in 1990, an increase of 8 per cent in the number of patients seen at outpatient clinics.
A number of the issues which were addressed by the Dublin Hospital Initiative Group need to be looked at in some detail. We have done much work on a number of them, including asking the hospitals to improve the timing of out-patient appointments, for example, to try to ensure that patients are not kept waiting and that outpatient appointment times are staggered throughout the morning. However, there are difficulties from time to time. There may be difficulties in the nature of GP referrals and sometimes the patient does not have an appointment and turns up at the outpatients department.
I accept the point that occasionally patients have to wait too long. We wrote to the hospitals about that issue as far back as February 1990. Obviously, when patients arrive too early for their appointments that results in a longer wait for them. Problems are caused when patients do not arrive for appointments because it means the time which could be given to other patients is wasted.
There is also the question of the physical condition of outpatient departments. A great deal of excellent work has been done in this area. I opened a major out-patient department in St. James's Hospital — a public hospital for public patients — and the standard there would compare favourably with any similar out-patient service in the world.
The Minister will have to accept that a long wait is common place rather than the exception. The Minister will have to accept also that nurses in the Mater Hospital have threatened a go-slow because of the impossibility of dealing with the conditions there; and lack of supervision is common place. I would ask the Minister to set about getting the October 1990 date implemented within weeks.
There are three other priority questions to be disposed of.
As I have said, the nature of hospital outpatient departments is such that there will be some wait. Because of the more sophisticated methods of investigation patients are investigated in outpatient departments rather than having to go into an inpatient bed. This means that patients are in the outpatients departments much longer than they were, say, ten or 15 years ago when they were generally taken into hospital for two or three days. We have been in touch with the hospitals about improving the position of waiting times and staggering the appointments system to ensure that patients do not have to wait. I have stated frequently in the House that it is unacceptable that 30 or 40 patients should be asked to attend the outpatients departments at 9 a.m. and some are still there at 11 a.m.
