Richard Bruton
Ceist:3 Mr. R. Bruton asked the Minister for Health if he will agree to the publication of a maximum waiting time for elective surgery, as recommended by the Health Commission; and if he will make a statement on the matter.
Ceisteanna—Questions. Oral Answers. - Elective Surgery Waiting Time.
Jim Higgins
Ceist:53 Mr. J. Higgins asked the Minister for Health if he will agree to the publication of a maximum waiting time for elective surgery, as recommended by the Health Commission; and if he will make a statement on the matter.
I propose to take Questions Nos. 3 and 53 together. In relation to the recommendations made by the Commission on Health Funding I understand that the thinking behind the commission's recommendation in relation to the publication of maximum waiting periods for access to specific non-emergency procedures was that the setting of these would facilitate the monitoring of the performance of health agencies in meeting overall service objectives, particularly as regards the objective of ensuring equitable access to hospital services.
Maximum waiting periods, as envisaged by the commission were intended as a monitoring tool for management rather than a guide for individual patients. In the case of patients, the maximum safe waiting period for elective surgery will vary greatly depending on the precise medical condition of the individual patient. The admission of a patient to hospital is a clinical decision for the consultant in charge of the case. Waiting lists are kept under review and priority is given to urgent cases. Should a patient's condition deteriorate, it is open to his general practitioner to contact his consultant with a view to expediting matters.
Would the Minister agree that without a maximum waiting time we cannot say we are providing an adequate or equitable service for public patients? Would he also agree that what is for both himself and hospital managers a monitoring tool could mean the difference between waiting three years or a more acceptable period for a hip replacement operation? Would he further agree that it is time we set aside a fund so that we could give some guarantee about the maximum time a patient would be expected to wait for certain life improving operations?
The more successful an operation is the greater the demand for it. The reason there are long waiting lists for orthopaedic operations is that they are so successful. Whereas ten years ago people were content to put up with an arthritic hip, they are no longer prepared to do so. When they are made aware that this facility is available the list gets longer. Therefore it is a measure of the success of the operation or procedure.
The same holds true in the case of cardiac surgery. People seem to think that all their problems will be resolved if they undergo cardiac surgery, especially coronary artery by-pass grafts, but these do not prolong life. I wonder therefore whether we should rethink this question of waiting lists and rather than leave it up to one consultant to decide whether a person should be put on the waiting list if we should have a review committee in each hospital to monitor waiting lists and to see to it that those in need are given priority on the waiting list.
I recognise what the Deputy is trying to say, but waiting lists are a measure of the success of high-tech medicine. If it is noted that a particular waiting list is vanishing or disappearing, this means that there is no great demand for the operation. As the Deputy is aware, I am having the waiting lists validated, with regard to public and private beds, so that we have a much better picture of where we stand. Following a request to the head of a particular hospital — I have spoken to him — to validate the waiting list he discovered that almost one-third of patients had had their operation and someone had forgotten to remove their names from the waiting list. As soon as the figures become available I will give them to Members of the House.