Dáil Éireann díospóireacht -
Thursday, 30 Apr 1998

Vol. 490 No. 4

Written Answers. - Hospital Waiting Lists.

Liz McManus

Ceist:

65 Ms McManus asked the Minister for Health and Children the terms of reference of the review group to examine hospital waiting lists; when the review group will report; the steps, if any, he will take to deal with the problem pending completion of the review; if it is intended to allow nurses to undertake medical duties currently performed by doctors; and if he will make a statement on the matter. [10191/98]

Minister for Health and Children (Mr. Cowen)

I have recently established a review group on the waiting list initiative with the following terms of reference:

To examine the underlying factors giving rise to waiting lists and waiting times and to make recommendations on the most appropriate means of addressing the underlying causes of substantial waiting lists and waiting times.

The review should have particular regard to:

— The net effect of the current waiting list initiative on waiting lists and waiting times;

— Any incentive effects of the WLI on participating hospitals in relation to their activity and treatment schedules;

— The extent to which hospitals can consistently and accurately validate their waiting lists; and

— The adequacy of existing information systems to permit routine evaluation of the WLI.

The purpose of the review is to identify the most appropriate means of building upon the present waiting list initiative so to meet the needs of public patients. I have asked the review group to report to me by the end of June so that its recommendations can be taken into account for the Estimates process in 1999 and subsequent years. The review group is holding its first meeting today.

I have already taken a number of important steps to deal with waiting lists and waiting times pending completion of the review. These steps include, first, much earlier notification to hospitals of the level of funding available to them. They received details of the funding in December, whereas in previous years the funding for waiting lists tended not to be allocated until around July. Second, a requirement on hospitals to specify targets for waiting list activity during the year. Third, an increased focus on waiting times as well as on waiting lists, with the objective of ensuring that children do not have to wait longer than six months and adults no longer than 12 months in the specialities targeted for attention. Fourth, designation of an individual in each hospital to act as a co-ordinator of waiting list work and as a contact point with the funding agency.

In addition I increased the funding for waiting list work by 50 per cent this year, from £8 million in 1997 to £12 million in l998.

I am conscious of the increasing demands being placed upon hospitals. One of the key issues that I expect the new review group to examine will be the capacity of existing hospital facilities around the country to meet the needs of patients, including those awaiting treatment under the waiting list initiative.

St. James's Hospital, Dublin is currently running a pilot project under which the post of emergency nurse practitioner, ENP, has been introduced in the accident and emergency department. The project involves an appropriately trained nurse providing definitive care to a defined group of patients who attend the department. The ENP can assess, diagnose, treat and refer or discharge patients, within strict pre-determined protocols, without reference to a medical practitioner. The benefits of the pilot project include a reduction in waiting times for patients with a minor injury and the freeing up of medical staff for more serious cases.