Dáil Éireann Debate, Tuesday - 14 May 2013
76. Deputy Billy Kelleher asked the Minister for Health the measures he will take to tackle the regional disparity in outpatient waiting times particularly in relation to those waiting more than four years; and if he will make a statement on the matter. [22954/13]
Amharc ar fhreagraIn 2012 the National Treatment Purchase Fund initiated a national project to compile, for the first time, an outpatient waiting list database based on patient-level information from individual hospitals. Collaborating with individual hospitals, the NTPF, together with the special delivery unit, SDU, in the HSE, has developed the outpatient waiting list minimum data set that allows for these data to be submitted to the NTPF from hospitals on a weekly basis. This builds on the work previously undertaken by the HSE outpatient data quality programme. Clear data on the outpatient waiting list are now being reported for the first time. It is rather astonishing that for the first time in the history of the State we have actually gone to the trouble of counting the number of people who have to wait on an outpatient list before they can see a consultant to get on a list for whatever treatment a consultant might consider appropriate. The waiting list for outpatients is updated monthly. The data show numbers waiting over the various timebands for a first appointment at a consultant-led clinic. In a further enhancement of the reporting, future updates will for the first time include numbers reported by specialty in addition to the breakdown by hospital. Currently, the focus is on ensuring that hospitals continue the validation of waiting lists. All hospitals have been engaged in this process, which is expected to be complete by the middle of this month.
Reform of the delivery of outpatient services is being addressed through the outpatient service performance improvement programme. This programme encompasses the HSE, the SDU, the NTPF and all hospitals providing outpatient services. It is a national programme which is being implemented between 2012 and 2015. The overall aim of the programme is to ensure timely and appropriate access to outpatient services so that the most appropriate member of the clinical team sees the right patient at the right time. Key elements of this large programme of reform will include: ongoing validation of waiting lists; systematic and standardised management of referrals from primary care; a reduction in unacceptably high non-attendance rates; appropriate discharging from outpatient services when clinically appropriate; and strict chronological management of the longest waiters.
Additional information not given on the floor of the House
For 2013, a maximum waiting time target of 12 months has been set for a first-time consultant-led outpatient appointment and this is reflected in the HSE service plan. The total number of people waiting on the outpatient waiting list as at 3 May 2013 was 376,751. This is a reduction of 7,881 in comparison with the NTPF-published figures to March 2013. The data also show that of the total number of people waiting, 199,513, or 52.6%, have been waiting less than six months and almost 278,666, or 74%, have been waiting less than 12 months.
The arrangement for supplementary questions and answers is one minute for each question and reply during the four minutes.
The figures are quite alarming. The Minister made great play of the fact that an outpatient waiting list is now being compiled for the first time in the history of the State. However, some 384,000 people are waiting for a first-time appointment as an outpatient at a consultants' clinic. Approximately 100,000 have been on the waiting list for more than a year, with 23,000 waiting for between two and three years. Another 7,750 have been waiting for between three and four years, with almost 7,700 waiting for four years or more.
The most alarming issue is the regional disparity among those waiting to see a consultant for an outpatient appointment. For example, in the mid-west large numbers of people have been waiting for a protracted period for their first outpatient appointments. What is the reason for the regional disparity? Clearly, at this stage, this must have come to light.
In many respects the question is disingenuous, given that Fianna Fáil was in power for so long and failed to do anything about it. At least the Government has tried to identify the problem and throw it open to the broad light of day so it can be dealt with in a fair and equitable fashion, in the same way as we dealt with the emergency department trolley waits and, more particularly, in the same way as we dealt with inpatient waiting times where the longest waiters are dealt with first after urgent cases and cancer cases have been dealt with. The real scandal is that more than 16,000 people have been waiting for longer than four years. Four years is twice the length of time the Government has been in power. I will keep my response short, as the Cathaoirleach wishes, but it is important to point out this problem was stewing away in the background being ignored by a Government which held the reins for 14 years. We are not ignoring it; we are dealing with it.
The Minister spoke about the question being disingenuous but the reply is even more disingenuous. He campaigned on promises but is governing on broken promises. There is regional disparity, and the fact these data have been compiled shows large groups of people in the mid-west have been waiting four years or more for their first outpatient appointments. The key question I am asking is what measures the Minister will take to tackle regional disparity in outpatient waiting times, particularly with regard to those waiting for more than four years. It is a very clear and concise question. I want to know whether the Minister has identified the reasons for regional disparity and if so whether he will do anything about it.
I will do something about it and as we speak Mr. Ian Carter, the new chief of the hospital directorate, and Ms Liz Nixon, head of the special delivery unit, are in Limerick examining the situation as it relates to inpatient and outpatient treatment times, the trolley situation and the capacity issue which has arisen. What we have done on the inpatient side is very clear, with 95% of people who had been waiting longer than nine months now being treated within this timeframe, and we are heading towards eight months this year. In the short period of time we have had the honour and privilege of being in government we have done more than was done for several years prior, despite the countless billions of euro poured in.
To put it in one sentence, it was simply a case that Fianna Fáil, and Deputy Micheál Martin in particular, were prepared to sweep the problem under the carpet and not expose it to the light of day or else throw money at it and keep their fingers crossed in the vain hope it would go away.
