Dáil Éireann Debate, Tuesday - 18 October 2016
26. Deputy Bobby Aylward asked the Minister for Health the reason that University Hospital Waterford has experienced an increase of 159% in inpatient and day case waiting lists since May 2013 when it became part of the South-South West Hospitals Group and that it now accounts for more than 40% of the group waiting list compared with 23% in 2013. [30687/16]
Amharc ar fhreagraI want to ask the Minister the reason University Hospital Waterford has experienced a 159% increase in inpatient and day case waiting lists since May 2013, when it became part of the South-South West Hospitals Group, to the point where it now accounts for more than 40% of the group waiting list compared with 23% in 2013. This is of major concern. The figures are alarming. Why is it happening and what can be done about it?
I thank the Deputy for the question. As he probably knows, I am due to visit Waterford hospital shortly and I look forward to discussing the issues with health care professionals in the hospital.
A key challenge for our health system is to ensure patients have timely access to health services in light of increasing demand. This is why we have to put a sustained focus on improving waiting times, especially for those waiting the longest, as I just discussed with Deputy O'Reilly.
The key issue is how long they wait. People appear on waiting lists, but it is when they are on waiting lists for too long that we have a problem. According to the September waiting list data published by the NTPF, 85% of patients on the inpatient or day case waiting list for University Hospital Waterford are waiting less than 15 months. I am not saying it is good enough.
Over the period 2013 to 2015, inpatient activity increased by over 11%, from 20,042 to 22,315. This is a contributing factor. The July HSE management data report points to a 4% increase in inpatient discharges and a 10% increase in day cases compared with the same period in 2015.
My Department works closely with the HSE and the NTPF to implement measures to reduce waiting times. At my request, in August, the HSE developed an action plan to reduce, by year end, the number of patients currently waiting 18 months or more, and then we go on proceeding with the NTPF, trying to drive down waiting lists throughout 2017. The endoscopy waiting list initiative started this year, and the NTPF will work with public hospitals, including University Hospital Waterford, to ensure the hospitals validate their waiting lists, identify patients who will be continue to be treated by the public hospital, and identify those patients who will be offered outsourcing of their procedure to a private hospital.
I should also mention that €7 million of the winter initiative funding is to be utilised to fund a targeted waiting list programme for patients waiting for orthopaedic, spinal and scoliosis procedures.
As part of the winter initiative, an additional five home care packages per week will be funded to support timely discharge from University Hospital Waterford. The hospital will also provide 15 additional surge capacity beds, and two complex delayed discharge cases will be transferred from the hospital by the end of the winter initiative reporting period. I accept the issue and will have it examined by the HSE.
Additional information not given on the floor of the House
The 2017 budget provides for the treatment of our longest waiting patients and allocates €20 million to the NTPF, rising to €55 million in 2018. Planning of this initiative is at an advanced stage by the NTPF, my Department and the HSE.
Waterford joined the South-South West Hospitals Group in May 2013 and the waiting list for inpatient day cases since then makes for interesting reading. My statistics do not compare with the Minister's. I will cite mine. Overall, the group's list is up 48% since May 2013, well below the national average of 62%, but Waterford has increased by 159% whereas Cork University Hospital, CUH, has decreased by 27%. In May 2013, Waterford accounted for 23% of the group's waiting list. Now, it accounts for 41%. Waterford also accounts for 60% of those waiting 12 months plus when no one there was waiting for that long in May 2013. Some 4,123 people were waiting on the inpatient day lists in August, an increase of 2,542 or 160.8%, on the 1,581 who were waiting in May 2013. While 1,120 people have been waiting longer than a year for treatment, none was waiting for more than a year in May 2013, and 168 people have been waiting for longer than 18 months. These statistics contradict the Minister's.
I thank the Deputy for bringing those to my attention. I will have my officials examine them with the HSE. In light of more home care packages, surge capacity beds and the activation of the National Treatment Purchase Fund, NTPF, for the Waterford area with dedicated funding to try to drive down waiting lists, though, we should see improvements.
I have been informed by the hospital that there have been significant increases in respect of ophthalmology, gastroenterology and general surgery. As to ophthalmology, we have seen an increase in the age profile, including the frail elderly, who require additional levels of care. The hospital is working with the HSE and the NTPF to source additional capacity for those waiting the longest. The hospital has only one gastroenterologist and is awaiting the appointment of a second consultant in early 2017, which will assist in the management of the endoscopy waiting list. The Deputy will be glad to know that this post is funded and has been submitted to the consultant application advisory committee for approval. University Hospital Waterford, UHW, is working with the NTPF to refer patients to private facilities in an effort to reduce waiting times and the number waiting.
The general surgery waiting list is affected by available theatre and bed capacity due to an overall increase in emergency referrals. The hospital is working with the hospitals group to determine where to find other elective capacity within the group.
The Minister stated that he was due to visit the hospital shortly. Will he put these figures to its management? Will he ask management to explain such a hike in the numbers? There are 30,992 people awaiting outpatient consultations, an increase of 16% since last December. Why is that? It would be remiss of me not to ask the Minister whether he will meet the consultants in Waterford and the rest of the south east and whether he will take issue with the finding of the Herity report on the second catherization laboratory, a finding that is debated in our part of the country. Even the Minister of State is having problems with it. That catherization laboratory is needed, given the concerns about the provision of a 24-7 service with the current laboratory. This is my priority. Will the Minister undertake to meet these people? There were problems with the risk assessment. The Herity report cited a risk rating of 16 out of 25 whereas the consultants and clinicians referred to a score of 20. The south east's catchment area has a population of approximately 500,000 people, but the Herity report claimed that it was only 220,000. There are contradictions. Will the Minister meet the consultants about this issue when visiting the hospital?
It is not the first time that I have been asked that question.
It is the first time by me, though.
Yes. I stand by the Herity report in full. That is why I published it in full. The report was carried out by an eminent external consultant cardiologist who examined all of these issues and arrived at his conclusions. The Herity report does not suggest that everything is rosy. It certainly suggests that there are areas that need improvement at UHW. It refers to the need for increased resources, staffing and equipment levels. I want to get on with delivering on the three issues outlined in the report in terms of improving the service before examining the situation next year to see what impact those additional resources, staff and equipment have had on the volume of patients using the hospital. This is a sensible approach. I will stand by the clinical advice provided to me by the Herity report, but I am happy to have the matter examined next year.
When I visit hospitals, as I will in Waterford in the coming weeks, of course I talk to health care professionals. I look forward to that opportunity. The Deputy might even come with me on that occasion.
What about the 24-7 service?
I stand by the Herity report and will make the improvements that it suggests.
