Vol. 510 No. 5
1 Mr. Shatter asked the Minister for Health and Children the special arrangements, if any, being put in place to address the backlog which accumulated as a consequence of the nurses' strike; and his Department's views on the impact of the strike on the in-patient hospital waiting lists. [23069/99]
2 Ms McManus asked the Minister for Health and Children the number of operations or other medical procedures cancelled as a result of the nurses dispute; the number of patients on hospital waiting lists prior to the start of the strike; the number currently on these lists; the steps, if any, he will take to deal with the increase in numbers; and if he will make a statement on the matter. [23065/99]
I propose to take Questions Nos. 1 and 2 together.
The provisional total numbers on in-patient waiting lists on 30 September 1999, shortly before the nurses dispute commenced, are now to hand. They stood at 33,381, a decrease of 343 over the figure for 30 June. This brings to 3,302 the reduction in numbers since the beginning of the year. My Department sought initial total figures on the number of persons awaiting in-patient treatment on 31 October 1999, some days after the ending of the industrial action. These figures are provisional estimates only and will be subject to validation. They indicate that there was a total of 37,200 on in-patient waiting lists on 31 October, an increase of 3,619 over the September figure. Information provided by the health boards and hospitals during the course of the industrial action indicated that approximately 3,300 procedures were cancelled during the dispute.
Since the conclusion of the nurses dispute my Department has been working with the health agencies to ensure that services to patients return to normal as quickly as possible. This includes measures to address any backlogs emerging as a result of the industrial action.
My Department has invited all agencies concerned to a series of meetings tomorrow morning to establish in detail from them the current position in relation to their activity levels and the arrangements they propose to make to ensure that their service plan targets are met by the end of this year. My Department has already emphasised to agencies the importance of achieving these targets by using their resources to maximum effect. This would include optimising the use of theatres, streamlining discharge arrangements, maximising the use of step-down and convalescent facilities and encouraging appropriate staff to participate fully in local plans to meet targets for the year.
I am determined to ensure that services to patients are delivered as efficiently and effectively as possible and that all agencies work intensively to achieve normal services following the recent industrial action.
Will the Minister acknowledge that waiting lists as at 31 October, standing at 37,200, are the highest for some years? Will he accept his negotiations with the nursing unions and the outcome achieved should have been undertaken at a much earlier stage to avoid the disastrous increase in the waiting lists, which can best be described as an escalated waiting list crisis? Will he indicate how many consultation appointments, arranged with consultants attached to various hospitals during the course of the strike, were cancelled and if any action plan will be put in place to ensure the waiting lists are substantially reduced as rapidly as possible?
Having inherited an escalating waiting lists problem, we not only stabilised it but were starting to reduce it for the first time in five years.
It is now worse.
Obviously it is worse, having had an industrial dispute. Any major statement by the Deputy that the waiting lists would increase does not require any great insight on his part. Clearly the nine-day industrial action, the biggest in the history of the State, has had a detrimental effect on the downward trend in waiting lists which was continuing as at 30 September. Having obtained the factual position, so far as we can gauge, at 31 October the waiting lists are significantly lower than the figures bandied about by the Irish Hospital Consultants Association and by Opposition politicians who seem to have the ability to gauge the increase without having the facts available to them. It is ironic, they may be disappointed that 3,619 were delayed or postponed rather than a figure of, I think, 12,000 mentioned by the Deputy at some stage.
Clearly the biggest industrial action in the history of the State has had an impact. The impact was assessed at 3,619. With a view to getting back to normal service levels as quickly as possible we have arranged for a series of meetings as and from tomorrow morning to see how we can meet service plan targets before the end of the year. This figure, which has come about as a result of the worst industrial action, is a setback. However, it does not take from our comprehensive way we are dealing with the waiting list initiative, as a result of our task force report and the increased resources put into this area, not only in acute hospital services but in the wider services for the elderly etc., which will be evidenced from the Estimates returns today, confirming that the commitment of the Government has been strengthened in dealing with this issue.
Will the Minister agree, in believing he inherited a problem, he must be one of the few people who do not believe that he managed, through his own incompetence, to exacerbate it enormously to a stage where waiting lists have lengthened despite a Government commitment to tackle the problem? The strike has deepened the existing problem to an extraordinary degree. The Minister did not answer the previous question which was about out-patient appointments. What are the details regarding out-patient appointments? My understanding is that approximately one third of out-patient appointments are first time appointments as opposed to recalls. Will the Minister assure the House there is a timeframe to ensure that those first time appointments, at the very least, will be cleared well before Christmas? Will he agree it is extraordinarily tardy to have a meeting tomorrow – it should have been held last week – to ensure the agencies have in place practical measures, including the extension of out-patient clinic times and the setting up of emergency sessions at night time, weekends or whatever? The Minister should ensure hospital services do not wind down as early as usual for the Christmas period but that work is carried on to the latest possible date in December. Is he aware of rumours that Tullamore hospital, in his constituency, will wind down procedures from 1 December? Surely he would consider this is grossly unacceptable, given the waiting lists for elective procedures and out-patient clinic appointments.
The Deputy may not be getting accurate information given that her party has no representative in that constituency.
It might be better if we had.
In relation to the local situation, Tullamore hospital is one of the most efficient hospitals in implementing its service plans. It received £300,000 from the money I had held back under the waiting list initiative, as a result of the progress being made by hospitals in regard to waiting lists. For those who are interested in the Deputy's views on Laoighis-Offaly, we will be making an unprecedented investment in the Midland Health Board area to ensure the regional insufficiencies, which existed during her administration, are dealt with.
The Minister should answer the question.
I make that point just in case the Deputy wants to raise local issues. I have answered the question that I have been asked to deal with, which is related to the numbers on the waiting lists. I do not have the other figures sought by the Deputy in respect of the numbers on outpatient waiting lists but they can be obtained.
The nine day all-out strike has had an effect but, to the disappointment of the Opposition, not to the extent that there are 45,000 on the waiting lists, the figure mentioned in a daily newspaper today. Journalists should sometimes recognise that individuals have a vested interest in suggesting that the numbers are higher than they are in an attempt to obtain more funds for their members and are not as objective as they claim to be. Up to the commencement of the strike there was a continuing reduction in the numbers on the waiting lists – 9 per cent since the beginning of the year, the first reduction year on year in four years.
The Deputy used the word "tardy". The Administration of which she was a member witnessed a rise of more than one third in the short period it was in office. There is not any question of tardiness. Since the ending of the strike I have indicated to all managements and agencies that there is a need to resume normal services as quickly as possible. I took the opportunity to meet the Nursing Alliance earlier this week to reassure it on the need to move forward positively on the issues it wants addressed. All managements have been in touch with the Department outlining their scenario in writing. We will discuss with them tomorrow everything that can be done to enhance services for the remainder of the year to clear the backlog which has arisen from the unprecendented all-out nurses strike.
Will the Minister acknowledge that the manner in which he dealt with this issue has had disastrous human consequences for those waiting – some for many months, others for a number of years – for essential surgery? Is he telling the House that he does not know how many outpatient appointments have been cancelled and how many patients awaiting to see a consultant for the first time have been left waiting? What arrangements have been made to clear the backlog? Does the Minister know how many patients are affected?
If the Deputy tables a question he will receive an answer.
The question relates to the backlog that accumulated during the strike.
Order, please. The Deputy should allow the Minister to reply.
The Deputy can resume his seat while I am replying. I will not be deflected by crass political assertions presented by him as facts.
The Minister does not know what the backlog is.
What has been exposed are the attempts made by the Deputy for the past two weeks to suggest that up to 12,000 appointments have been postponed.
I did not say that.
The figure mentioned in the newspaper today, 45,000, in incorrect to the tune of more than 8,000.
It did not come from us. The Minister does not know what the backlog is in respect of the number of patients waiting to see a consultant.
Because of the strike, elective procedures have been postponed. I have given the numbers. The estimated number was 3,300. The actual number is 3,619.
How many outpatient appointments have been cancelled? This is bluster. We do not know what the consequences of the strike are for the health services. It is outrageous.
I must call Question No. 3. We have far exceeded the time available for Questions Nos. 1 and 2.
All we have got from the Minister is bluster.
Will the Deputy, please, resume her seat? Will the Minister, please, take Question No. 3?
We are entitled to have answers to reasonable questions.
The Deputy has received the information sought.
All we have got is bluster – not one practical measure.
It has been answered.
