Dáil Éireann Debate, Tuesday - 19 June 2012
109Deputy John Halligan asked the Minister for Health the reduction in the number of outpatients seen at the orthopaedic, dermatology and ophthalmology outpatient departments at Waterford Regional Hospital in 2012 brought about by budgetary cuts; if he will report on all current initiatives to specifically address the backlog in outpatient waiting times at Waterford Regional Hospital; and if he will make a statement on the matter. [29781/12]
Amharc ar fhreagraThere has been no reduction in 2012 in the number of scheduled outpatient clinics for the specialties referred to due to cost containment at Waterford Regional Hospital. I have circulated a table with the activity for the hospital for the first five months in 2011 and 2012. The current initiatives to address waiting times at the hospital are as follows: the existing patient administration system is being modified to facilitate reporting of patients waiting for an outpatient appointment to the National Treatment Purchase Fund from July 2012; all referrals are being uploaded to the patient administration system; and validation of the waiting list will commence once this upload is complete
I refer to regional dermatology services. In line with the Health Service Executive's southern area service plan for 2012, extra resources have been allocated to support the appointment of two additional consultant dermatologists to assist the existing single-handed consultant. One of these posts is a national cancer control programme, NCCP, post to assist primarily with the skin cancer workload. The second post is in the HSE's dermatology outpatient clinical programme.
The regional orthopaedic service provides the south-east trauma orthopaedic service based at Waterford Regional Hospital as well as the elective orthopaedic surgery service at Kilcreene Orthopaedic Hospital. There are 84 orthopaedic clinics held each month, of which 33 are trauma clinics. The majority of clinics are at Waterford Regional Hospital, with other monthly outpatient outreach clinics taking place throughout the region.
In line with the service plan for 2012, three additional physiotherapist posts have been allocated in line with the roll-out of the HSE's national musculoskeletal clinical programme. Two of the three appointees are now in their posts and it is anticipated this will result in approximately 1,000 appropriately selected patients being seen from the regional orthopaedics and regional rheumatology waiting lists.
Additional information not given on the floor of the House.
An internal initiative with nurse-led arthroscopy clinics is to commence, which is anticipated to reduce the orthopaedic waiting list by 500 patients annually. In addition, two other nurse-led clinic initiatives are due to commence - a glaucoma clinic and a macular degeneration clinic – both of which will assist with the provision of new clinic slots for patients requiring a consultant appointment. The fourth consultant post will be progressed once consultant appointment unit approval in place.
On assuming office, the Government indicated that tackling hospital waiting lists would be one of its top priorities in the area of health service provision. The Minister has spoken on several occasions about the pain and trauma associated with seriously ill people waiting months and years for treatment. The statistics for Waterford are horrifying, with 18,925 people on outpatient waiting lists for more than 12 months, one of the highest levels in the country. The main issue is not the total number of patients on the waiting list but the length of time they are waiting for treatment. For example, the latest figures show that 5,847 patients are waiting more than a year for orthopaedic outpatient appointments in Waterford, including 570 who are waiting more than four years. Surely the Minister will accept that these data indicate an index of pain that is unacceptable in the 21st century.
I assure the Deputy that it is the Government's priority to ensure waiting lists are tackled, and we have prioritised action in this area in a very logical fashion. The most acutely suffering patients are those awaiting treatment in emergency departments, a situation that is being tackled by the special delivery unit. I am pleased to report that the first five months of this year saw a 20% reduction in the number of patients on trolleys in emergency departments. There are still far too many in that situation, however, and a great deal of work remains to be done. Several clinical programmes will be implemented to address the problem, including the intermediate care programme which will ensure, in the first instance, that older people are admitted to a specialist ward and their acute medical care needs are addressed. Rehabilitation will commence immediately on the ward for such patients and, where it has to be prolonged beyond a week, they will be moved to an intermediate care facility for six to ten weeks. If, following a careful assessment which rules out the feasibility of a home care package, they are found to require long-term care, they will be accommodated in a transitional facility until their preferred long-term position is available.
To sum up, unscheduled care was the first priority of the Government on assuming office, and we are now moving to address problems in the area of scheduled care. Every hospital in the country, apart from Galway and another facility in the west, met its target of ensuring patients are waiting not longer than 12 months for an appointment. We have only recently begun, for the first time, to get the figures for outpatients. These are not complete figures, although we hope such will start to become available from the end of next month. I have no problem with people knowing the full extent and truth of the situation. The end figure may be 200,000, or it might even be greater. To put that in context, 200,000 people are seen every month at outpatient facilities throughout the country. I am very pleased Deputy Halligan agrees with me that those waiting longest should be treated first, once the urgent cases have been dealt with. It is not fair that people are left waiting years for treatment. We never had a handle on outpatient figures before this Government came into office but we are getting a handle on them now and are determined to address the problems in this area.
The response to what the Minister has said is coming from the staff of Waterford Regional Hospital, some of whom have publicly stated that the present situation is untenable. The problem must be addressed. I also understand data for differential waiting times for medical card and privately insured patients are not collected annually. The Minister spoke about tracking trends, but one cannot track them. Despite the lack of disaggregated data for waiting times, does the Minister accept that we would not find too many private patients who have been waiting for as long as public patients?
I have no difficulty in accepting that, which is why the Government has made it a priority that a system of universal health insurance will be introduced during its lifetime in order that people will be treated based on their medical need, not on what they can afford.
