Priority Questions. - Hospital Waiting Lists. – Dáil Éireann (28th Dáil) – Tuesday, 2 Mar 1999

Priority Questions. - Hospital Waiting Lists.

Alan Shatter

Ceist:

44 Mr. Shatter asked the Minister for Health and Children the number of persons on the waiting list at 31 December 1998 including the detailed in-patient hospital waiting lists in respect of each health board, each hospital within each health board area and each speciality within each hospital; and, if this information is not available, the reason for the delay in the collation of the necessary information and its furnishing to Members of Dáil Éireann. [5784/99]

Minister for Health and Children (Mr. Cowen)

The number of persons on in-patient waiting lists on 31 December 1998 was 36,883. I am forwarding a detailed breakdown of this figure by hospital and by speciality to the Deputies.

While these figures show an increase over the September position, I again remind the House that there is no simple, immediate or quick fix solution that can be applied to the problem of lengthy waiting lists. The Review Group on the Waiting List Initiative, which I established to advise me on these issues, emphasised in its report that an integrated series of short-term, medium-term and long-term initiatives must be taken to address this issue. Towards this end, I have taken a number of important steps for the financial year. These include allocating £20 million this year for the treatment of patients on waiting lists – this represents an increase of two thirds over the 1998 figure and is two and a half times higher than the amount allocated by the previous Government for waiting lists in 1997 – providing £9 million to services for older people so that acute hospital beds can be freed up for elective work and providing £2 million to selected accident and emergency services. This will again ensure that acute facilities are more easily available for elective work, including treatments for those on waiting lists and issuing a new policy circular and guidelines to all relevant agencies regarding the way in which the waiting list initiative should be operated in future. The policy circular and guidelines issued by my Department on 7 January 1999 outline revised and updated procedures on improved liaison and communication arrangements between acute hospitals and general practitioners; more effective management of waiting lists at acute hospital level; improved management of out-patient waiting lists and clarifying the criteria for inclusion on a public in-patient waiting list.

As indicated by the review group, some of these important initiatives will take some time to have an effect, but I am confident they will do so from the early part of this year onwards. While waiting lists have increased, it is important to also consider the length of time patients have to wait for treatment. Waiting times for cardiac surgery and ophthalmology in adults and for orthopaedics and plastic surgery in children have declined since September 1998.

I am determined to take the necessary medium and long-term steps to tackle the underlying causes of unacceptably long waiting lists and waiting times. This will take considerable effort on the part of many agencies, but I believe we will now begin to show progress in what is a complex problem.

Public In-Patient Waiting List at end: December 1998

Eastern Health Board

Beaumont Hospital

Speciality Name	Procedure Type	Public Waiting List
Cardiology		231
Dental		114
ENT	Adults (all ENT procedures)	490
ENT	Children (other procedures)	33
ENT	Children (tonsils/adenoids)	47
Endocrine		8
Gastro-enterology		15
Gynaecology	All procedures	44
Medicine		5
Nephrology		55
Neurology		42
Neurosurgery		391
Orthopaedics	Other elective procedures	143
Pain		38
Plastic Surgery	Adults (functional)	31
Respiratory		12
Rheumatology		4
Surgery	All procedures	227
Urology	All procedures	156
Vascular	Other procedures	311
Vascular	Varicose veins	90
Sub-Total	Beaumont Hospital	2,487

Coombe Women's Hospital

Speciality Name	Procedure Type	Public Waiting List
Gynaecology	All procedures	116
Sub-Total	Coombe Women's Hospital	116

James Connolly Memorial Hospital (Blanchardstown)

Speciality Name	Procedure Type	Public Waiting List
Gynaecology	All procedures	1
Orthopaedics	Other elective procedures	2
Plastic Surgery	Adults (functional)	75
Plastic Surgery	Children (all procedures)	12
Rheumatology		2
Surgery	All procedures	46
Urology	All procedures	21
Vascular	Varicose veins	10
Sub-Total	James Connolly Memorial Hospital (Blanchardstown)	169

Mater Misericordiae Hospital

Speciality Name	Procedure Type	Public Waiting List
Cardiac Surgery	Adults (CABG)	694
Cardiology		604
Dermatology		29
ENT	Adults (all E.N.T. procedures)	370
Endocrine		64
Gastro-enterology		84
Gynaecology	All procedures	79
Haematology		1
Maxillo-Facial		36
Nephrology		12
Neurology		8
Opthalmology	Adults (cataracts)	602
Opthalmology	Adults (other procedures)	216
Orthopaedics	Other elective procedures	124
Pain		2
Plastic Surgery	Adults (cosmetic)	104
Plastic Surgery	Adults (functional)	257
Respiratory		26
Rheumatology		30
Surgery	All procedures	156
Urology	All procedures	174
Vascular	Other procedures	51
Vascular	Varicose veins	132
Sub-Total	Mater Misericordiae Hospital	3,855

Naas General Hospital

Speciality Name	Procedure Type	Public Waiting List
Surgery	All procedures	63
Vascular	Varicose veins	85
Sub-Total	Naas General Hospital	148

National Maternity Hospital, Holles Street

Speciality Name	Procedure Type	Public Waiting List
Gynaecology	All procedures	92
Sub-Total	National Maternity Hospital, Holles Street	92

Our Lady's Hospital, (Crumlin)

Speciality Name	Procedure Type	Public Waiting List
Cardiac Surgery	Children (all procedures)	73
ENT	Children (grommets)	9
ENT	Children (other procedures)	21
ENT	Children (tonsils/adenoids)	307
Opthalmology	Children (all procedures)	12
Plastic Surgery	Children (all procedures)	79
Surgery	All procedures	59
Sub-Total	Our Lady's Hospital, (Crumlin)	560

Rotunda Hospital, Dublin

Speciality Name	Procedure Type	Public Waiting List
Gynaecology	All procedures	277
Sub-Total	Rotunda Hospital, (Dublin)	277

Royal Victoria Eye and Ear Hospital (Dublin)

Speciality Name	Procedure Type	Public Waiting List
ENT	Adults (all E.N.T. procedures)	153
ENT	Children (grommets)	3
ENT	Children (other procedures)	6
ENT	Children (tonsils/adenoids)	52
Opthalmology	Adults (cataracts)	259
Opthalmology	Adults (other procedures)	267
Opthalmology	Children (all procedures)	46
Sub-Total	Royal Victoria Eye and Ear Hospital (Dublin)	786

St. Mary's Hospital, Cappagh

Speciality Name	Procedure Type	Public Waiting List
Orthopaedics	Other elective procedures	1,081
Orthopaedics	Total hip replacements	384
Orthopaedics	Total knee replacements	231
Sub-Total	St. Mary's Hospital, Cappagh	1,696

St. Michael's Hospital (Dunlaoire)

Speciality Name	Procedure Type	Public Waiting List
ENT	Adults (all ENT procedures)	102
ENT	Children (other procedures)	15
Medicine		14
Orthopaedics	Other elective procedures	44
Surgery	All procedures	43
Urology	All procedures	21
Sub-Total	St. Michael's Hospital (Dunlaoire)	239

St. Vincent's Hospital (Elm Park)

Speciality Name	Procedure Type	Public Waiting List
Cardiology		77
ENT	Adults (all ENT procedures)	546
Endocrine		6
Gastro-enterology		65
Gerontology		3
Gynaecology	All procedures	239
Nephrology		6
Neurology		30
Opthalmology	Adults (cataracts)	88
Opthalmology	Adults (other procedures)	3
Orthopaedics	Other elective procedures	75
Pain		298
Plastic Surgery	Adult (cosmetic)	30
Plastic Surgery	Adults (functional)	149
Psychiatry		20
Respiratory		77
Rheumatology		4
Surgery	All procedures	325
Thoracic		41
Urology	All procedures	102
Vascular	Other procedures	73
Vascular	Varicose veins	290
Sub-Total	St. Vincent's Hospital (Elm Park)	2,547

St. James's Hospital

Speciality Name	Procedure Type	Public Waiting List
Cardiac Surgery	Adults (other surgery)	406
Cardiology		3
ENT	Adult (all ENT procedures)	212
ENT	Children (tonsils/adenoids)	17
Gynaecology	All procedures	9
Maxillo-Facial		155
Orthopaedics	Other elective procedures	45
Plastic Surgery	Adults (cosmetic)	106
Plastic Surgery	Adults (functional)	189
Plastic Surgery	Children (all procedures)	14
Rheumatology		4
Surgery	All procedures	113
Urology	All procedures	60
Vascular	Other procedures	36
Vascular	Varicose veins	627
Sub-Total	St. James's Hospital	1,996

Tallaght Hospital

Speciality Name	Procedure Type	Public Waiting List
Cardiology		129
Dermatology		1
ENT	Adults (all ENT procedures)	195
ENT	Children (tonsils-adenoids)	70
Endocrine		24
Gastro-enterology		9
Gynaecology	All procedures	3
Nephrology		20
Orthopaedics	Other elective procedures	580
Orthopaedics	Total hip replacements	215
Orthopaedics	Total knee replacements	120
Rheumatology		2
Surgery	All procedures	45
Urology	All procedures	180
Vascular	Other procedures	17
Sub-Total	Tallaght Hospital	1,610

Temple Street Children's Hospital (Dublin)

Speciality Name	Procedure Type	Public Waiting List
ENT	Children (grommets)	103
ENT	Children (tonsils-adenoids)	443
Opthalmology	Children (all procedures)	49
Orthopaedics	Other joint replacements	21
Plastic Surgery	Children (all procedures)	109
Surgery	All procedures	67
Urology	All procedures	2
Sub-Total	Temple Street Children's Hospital (Dublin)	794
Health Board Total	Eastern Health Board	17,372

Mid-Western Health Board

Regional Hospital, (Dooradoyle) Limerick

Speciality Name	Procedure Type	Public Waiting List
Cardiology		19
Dental		139
ENT	Adults (all ENT procedures)	128
ENT	Children (tonsils-adenoids)	98
Gynaecology	All procedures	461
Opthalmology	Adults (cataracts)	615
Opthalmology	Adults (other procedures)	55
Opthalmology	Children (all procedures)	73
Surgery	All procedures	151
Vascular	Varicose veins	43
Sub-Total	Regional Hospital, (Dooradoyle) Limerick	1,782

Regional Orthopaedic Hospital (Croom)

Speciality Name	Procedure Type	Public Waiting List
Orthopaedics	Other joint replacements	330
Orthopaedics	Total hip replacements	135
Orthopaedics	Total knee replacements	60
Sub-Total	Regional Orthopaedic Hospital (Croom)	525

St. John's Hospital (Limerick)

Speciality Name	Procedure Type	Public Waiting List
Gynaecology	All procedures	27
Medicine		18
Surgery	All procedures	125
Sub-Total	St. John's Hospital (Limerick)	170
Health Board Total	Mid-Western Health Board	2,477

Midland Health Board

Longford-Westmeath General Hospital (Mullingar)

Speciality Name	Procedure Type	Public Waiting List
Gynaecology	All procedures	137
Sub-Total	Longford-Westmeath General Hospital (Mullingar)	137

Portlaoise General Hospital

Speciality Name	Procedure Type	Public Waiting List
Gynaecology	All procedures	14
Surgery	All procedures	153
Vascular	Varicose veins	6
Sub-Total	Portlaoise General Hospital	173

Tullamore General Hospital

Speciality Name	Procedure Type	Public Waiting List
ENT	Adults (all ENT procedures)	714
ENT	Children (grommets)	70
ENT	Children (other procedures)	189
ENT	Children (tonsils/adenoids)	437
Orthopaedics	Other elective procedures	553
Orthopaedics	Total hip replacements	165
Orthopaedics	Total knee replacements	33
Surgery	All procedures	30
Valcular	Varicose veins	69
Sub-Total	Tullamore General Hospital	2,260
Health Board Total	Midland Health Board	2,570

North-Eastern Health Board

Cavan General Hospital

Speciality Name	Procedure Type	Public Waiting List
ENT	Adults (all ENT procedures)	27
ENT	Children (other procedures)	15
Gynaecology	All procedures	42
Surgery	All procedures	223
Sub-Total	Cavan General Hospital	307

dt8,0p6r0,21,0p6r0,5,3g>Louth County Hospital, Dundalk

Speciality Name	Procedure Type	Public Waiting List
Gynaecology	All procedures	12
Sub-Total	Louth County Hospital, Dundalk	12

Our Lady of Lourdes Hospital (NEHB)

Speciality Name	Procedure Type	Public Waiting List
ENT	Adults (all ENT procedures)	62
ENT	Children (other procedures)	32
Surgery	All procedures	34
Sub-Total	Our Lady of Lourdes Hospital (NEHB)	128

Our Lady's General Hospital, Navan

Speciality Name	Procedure Type	Public Waiting List
Orthopaedics	Other elective procedures	344
Orthopaedics	Total hip replacements	176
Orthopaedics	Total knee replacements	32
Sub-Total	Our Lady's General Hospital, Navan	552
Health Board Total	North-Eastern Health Board	999

North-Western Health Board

Letterkenny General Hospital

Speciality Name	Procedure Type	Public Waiting List
Gynaecology	All procedures	97
Orthopaedics	Other elective procedures	90
Orthopaedics	Total hip replacements	44
Orthopaedics	Total knee replacements	29
Surgery	All procedures	230
Urology	All procedures	169
Vascular	Varicose veins	146
Sub-Total	Letterkenny General Hospital	805

Sligo Regional Hospital

Speciality Name	Procedure Type	Public Waiting List
ENT	Adults (all ENT procedures)	651
ENT	Children (grommets)	18
ENT	Children (other procedures)	119
ENT	Children (tonsils-adenoids)	217
Gynaecology	All procedures	74
Opthalmology	Adults (cataracts)	264
Opthalmology	Adults (other procedures)	68
Opthalmology	Children (all procedures)	55
Orthopaedics	Other elective procedures	140
Orthopaedics	Total hip replacements	39
Orthopaedics	Total knee replacements	15
Surgery	All procedures	118
Vascular	Varicose veins	2
Sub-Total	Sligo Regional Hospital	1,780

Health Board Total

North-Western Health Board

2,585

South-Eastern Health Board

Orthopaedic Hospital, Kilcreene

Speciality Name	Procedure Type	Public Waiting List
Orthopaedics	Other elective procedures	470
Orthopaedics	Total hip replacements	125
Orthopaedics	Total knee replacements	63
Sub-Total	Orthopaedic Hospital, Kilcreene	658

Our Lady's Hospital, Cashel

Speciality Name	Procedure Type	Public Waiting List
Surgery	All procedures	33
Urology	All procedures	22
Sub-Total	Our Lady's Hospital, Cashel	55

St. Joseph's Hospital, Clonmel

Speciality Name	Procedure Type	Public Waiting List
Gynaecology	All procedures	249
Sub-Total	St. Joseph's Hospital, Clonmel	249

St. Luke's Hospital, Kilkenny

Speciality Name	Procedure Type	Public Waiting List
Gynaecology	All procedures	195
Surgery	All procedures	303
Vascular	Varicose veins	133
Sub-Total	St. Luke's Hospital, Kilkenny	631

Waterford Regional Hospital, Ardkeen

Speciality Name	Procedure Type	Public Waiting List
ENT	Adults (all ENT procedures)	112
ENT	Children (grommets)	17
ENT	Children (other procedures)	21
ENT	Children (tonsils-adenoids)	152
Gynaecology	All procedures	216
Nephrology		20
Opthalmology	Adults (cataracts)	237
Opthalmology	Adults (other procedures)	25
Opthalmology	Children (all procedures)	66
Orthopaedics	Other elective procedures	219
Pain		50
Rheumatology		15
Surgery	All procedures	165
Sub-Total	Waterford Regional Hospital, Ardkeen	1,315

Wexford General Hospital

Speciality Name	Procedure Type	Public Waiting List
Dental		142
Gynaecology	All procedures	278
Surgery	All procedures	22
Vascular	Varicose veins	86
Sub-Total	Wexford General Hospital	528

Health Board Total

South-Eastern Health Board

3,436

Southern Health Board

Cork University Hospital

Speciality Name	Procedure Type	Public Waiting List
Cardiac Surgery	Adults (CABG)	50
Cardiac Surgery	Adults (other surgery)	6
Cardiology		66
Gynaecology	All procedures)	13
Neurosurgery		23
Opthalmology	Adults (cataracts)	270
Opthalmology	Adults (other procedures)	33
Opthalmology	Children (all procedures)	36
Plastic Surgery	Adults (fuctional)	260
Plastic Surgery	Children (all procedures)	70
Rheumatology		7
Urology	All procedures	142
Sub-Total	Cork University Hospital	976

Mercy Hospital, Cork

Speciality Name	Procedure Type	Public Waiting List
Gynaecology	All procedures	26
Surgery	All procedures	36
Urology	All procedures	24
Vascular	Varicose veins	442
Sub-Total	Mercy Hospital, Cork	528

South Infirmary/Victoria Hospital Ltd.

Speciality Name	Procedure Type	Public Waiting List
Cardiology		1
ENT	Adults (all ENT procedures)	512
ENT	Children (grommets)	6
ENT	Children (other procedures)	17
ENT	Children (tonsils/adenoids)	64
Gynaecology	All procedures	256
Surgery	All procedures	72
Sub-Total	South Infirmary/Victoria Hospital Ltd.	928

St. Mary's Hospital, Gurranebraher

Speciality Name	Procedure Type	Public Waiting List
Orthopaedics	Other elective procedures	455
Orthopaedics	Total hip replacements	149
Orthopaedics	Total knee replacements	108
Sub-Total	St. Mary's Hospital, Gurranbraher	712

Tralee General Hospital

Speciality Name	Procedure Type	Public Waiting List
ENT	Adults (all ENT procedures)	68
ENT	Children (grommets)	9
ENT	Children (tonsils/adenoids)	5
Gynaecology	All procedures	59
Orthopaedics	Other elective procedures	74
Orthopaedics	Total hip replacements	19
Orthopaedics	Total knee replacements	10
Surgery	All procedures	176
Sub-Total	Tralee General Hospital	420

Health Board Total

Southern Health Board

3,564

Western Health Board

Mayo General Hospital, Castlebar

Speciality Name	Procedure Type	Public Waiting List
Surgery	All procedures	72
Sub-Total	Mayo General Hospital, Castlebar	72

Merlin Park Regional Hospital, Galway

Speciality Name	Procedure Type	Public Waiting List
Orthopaedics	Other elective procedures	163
Orthopaedics	Total hip replacements	139
Orthopaedics	Total knee replacements	100
Sub-Total	Merlin Park Regional Hospital, Galway	402

Roscommon General Hospital

Speciality Name	Procedure Type	Public Waiting List
Surgery	All procedures	10
Sub-Total	Roscommon General Hospital	10

University College Hospital, Galway

Speciality Name	Procedure Type	Public Waiting List
Cardiology		118
ENT	Adults (all ENT procedures)	555
ENT	Children (grommets)	38
ENT	Children (other procedures)	12
ENT	Children (tonsils/adenoids)	163
Opthalmology	Adults (cataracts)	775
Opthalmology	Adults (other procedures)	170
Opthalmology	Children (all procedures)	25
Plastic Surgery	Adults (functional)	462
Plastic Surgery	Children (all procedures)	110
Surgery	All procedures	363
Urology	All procedures	457
Vascular	Other procedures	16
Vascular	Varicose veins	132
Sub-Total	University College Hospital, Galway	3,396

Health Board Total	Western Health Board	3,880
National Total		36,883

Mr. Shatter

Does the Minister accept from the figures he has given that there was an increase of 1,500 on the waiting lists from the September figure of 35,405 to the end December figure of 36,883? Does he agree that is completely unacceptable and scandalous in the context of the current state of the public finances and that the primary reason for the ongoing escalation in the hospital waiting list is his failure until now to take appropriate action to make the necessary structural changes required to tackle the problem?

Will the Minister indicate to the House, in the context of the checks he requested health boards to undertake, the number of people currently on the cardiac waiting list and the number who were removed from the waiting list figures as at 31 December 1998 because they had deceased prior to essential surgical procedures being undertaken?

Mr. Cowen

On the first matter, I am pleased Deputy Shatter now supports the need for a multifaceted approach to the resolution of this problem and that we have to take the structural changes that I propose in taking on board the recommendations of the review group. That is the first admission I have heard from the Opposition benches that this is required. In relation to the appropriate response, it is clear – the evidence for 1998 shows this – that despite the fact that we increased the amount of money by £4 million, or 50 per cent, from £8 million to £12 million, the number on the lists increased by about 3,000. That shows clearly that we cannot solve this problem in the context of the acute hospital sector alone. It is precisely because moneys totalling £9 million are being put into services for the elderly and other areas that we may have the ability to get the throughputs which the increased resources indicate we should have. Perhaps there is now a recognition in the House that moving on all fronts is the only way we will solve this problem and that it is not simply a question of increased resources in the acute hospital sector alone.

On cardiac surgery, the cardiac lists are being reduced because more cardiac operations are taking place. I do not have the type of statistics the Deputy seeks. It would be inappropriate, wrong and misleading to suggest that the reduction in cardiac surgery waiting lists is as a result of people dying. The reduction is as a result of more surgeries being done. We still have a long way to go in relation to cardiac surgery but, as the Deputy will know, the approval of a £6 million development at St. James's Hospital and provision for phase 1 of the UCG development will greatly increase our capacity in that respect and will take some of the pressure off the national cardiac centre.

Mr. Shatter

Does the Minister accept he or officials of his Department instructed health boards, prior to finalising figures and collating information as at 31 December 1998, to do a comprehensive check of waiting lists to ascertain whether some of the persons on waiting lists in September 1998 no longer required medical treatment and in-patient hospital care either because they had the necessary procedures undertaken through the private as opposed to the public route, which they were entitled to do, or they had died? Will he confirm that health boards carried out that check? Will the Minister indicate the number of people removed from the waiting lists at the end of December 1998 who were on it in September 1988 and who were removed solely because they had deceased or resorted to private medicine because they could not get what they were entitled to through the general medical service?

Mr. Cowen

I insisted on a full reply to this question being made today despite having had some inaccurate returns from a few hospitals which turned out to be greater than the waiting list they had suggested. We were not happy that they could have made some of the reductions they suggested had been made. I insisted on coming into the House at Question Time to give this detailed information which was finally collated this morning. The initial reaction would have been to wait for further validation from my Department, but I am satisfied the validation has been done and that these are the accurate figures.

As regards any suggestion that these waiting list figures were collated differently from other times, that is simply not the case. I answered the Deputy on the basis that we validated these figures as late as this morning and as a result of my insistence that I come into the House today to give them. I was not prepared to come in and say I will have them shortly. The detailed breakdown will be circulated with the reply in the normal way, as is always the case on such matters. The Deputy asked a question which is too specific for me to answer. If he has a particular query, I will answer it. I cannot be expected to come up with the detailed numbers for which he asked me. I have given him the overall figures, the hospital waiting lists and the specialties under which they arise. There is no big mystery about it.

Mr. Shatter

Will the Minister indicate the number of persons on the waiting list for ENT operations? Will he indicate the number of elderly people awaiting eye operations? Will he comment on a criticism of the health service made in the past few days by a doctor who pointed out that there are elderly people awaiting cataract operations for three to four years and who, at the end of their life span, are sitting at home unable to read and slowly going blind due to the failure of the public health system to meet their needs? What guarantee can the Minister give that all the people in that position will have the necessary procedures provided to them?

Mr. Cowen

The quote the Deputy made is wrong. The Deputy is, or should be, aware of the format in which these figures are outlined and, as I said, they were finalised this morning at my insistence that I come into the House today to give them. If I were to go through all ENT figures, I would delay the House. They are available in tabular form for the Deputy to add up in due course.

Dáil Éireann díospóireacht - Tuesday, 2 Mar 1999

Priority Questions. - Hospital Waiting Lists.

Alan Shatter

Dáil Éireann díospóireacht -
Tuesday, 2 Mar 1999