Dáil Éireann Debate, Wednesday - 8 March 2017
23. Deputy John Curran asked the Minister for Health the targets in place for reducing outpatient waiting times in the three children’s hospitals in Dublin, in which 3,289 children were waiting 18 months or more for an appointment in January 2017. [12111/17]
Amharc ar fhreagraFigures from the NTPF indicate that at the end of January 2017, 3,289 children were waiting for over 18 months for an outpatient appointment. I think the Minister will agree that is an extraordinary figure and a very long time for a child to be waiting. What steps is the Minister going to take immediately to address this across the three children's hospitals in Dublin? Will he set specific timelines and targets to reduce this figure significantly?
I thank Deputy Curran for an important question. I agree that those waiting times are too long. What we are actually going to do about it is the most important thing. During 2016, as the Deputy knows, there has been evidence of a considerable increase in demand for health services as our population continues to grow and age. Therefore, in order to reduce the numbers of long-waiting patients, we are developing through the HSE action plans for inpatient day cases and, specifically with regard to the Deputy's question, outpatient day services, as well as the issues in paediatric scoliosis. My Department is currently reviewing these plans and I expect to be in a position to share them with Members of this House very shortly.
In addition, in November 2016, the HSE launched the Strategy for the Design of Integrated Outpatient Services 2016-2020. The HSE has significantly progressed the development of its outpatient waiting list plan. It will focus on the longest waiters first.
The three hospitals in the children's hospital group are working closely together to manage waiting times. This is quite important. They need to co-operate. They are ultimately going to be under the banner of the new national children's hospital. Specific measures include additional paediatric outpatient sessions in Tallaght Hospital that will commence later this year, an additional ear, nose and throat, ENT, clinic in Temple Street and the re-organisation of existing clinical capacity to facilitate extra outpatient clinics.
I understand that Tallaght Hospital is currently working with the children's hospital group and with the NTPF with regard to paediatrics to secure funding to outsource some of the longest waiters. The hospital has secured two consultants who will commence additional paediatric sessions from October of this year. The hospital has also confirmed that it is currently trying to source locum consultants in conjunction with Our Lady's Children's Hospital, Crumlin. If successful, these consultants will provide additional capacity until the permanent consultants come on board in October.
The hospital is currently undertaking a cross-city ENT review with the children's hospital group to look at sustainable and permanent solutions to deal with the ENT situation, which is particularly acute. A validation process is under way in Temple Street Children's University Hospital to identify patients who may be on a list but no longer require the treatment or have been treated somewhere else. This should reduce numbers and enable them to focus on those needing care. They are also due to commence an additional ENT clinic shortly, which will see approximately ten new patients per week. They are looking at the possibility of running an additional clinic which would see approximately 12 to 15 new patients a week. That will be a general paediatric clinic. They are running a rapid access clinic to see emergency GP referrals and internal referrals. There is a lot of work under way and I can share this detail with the Deputy.
There are two elements that I wish to put to the Minister. Will the steps the Minister is taking address the backlog or just stop the problem getting worse? It is worth reflecting for a moment that in January 2016, there were only 117 children waiting more than 18 months for that outpatient appointment. That figure was almost 3,300, 12 months later. It is very significant.
The Minister has said that the hospitals need to work together and I acknowledge that. However, the increase has been seen across all areas in all three hospitals. The figures are staggering and it is staggering to see what has happened in one 12-month cycle.
Let us reflect for a moment on the fact that the 3,300 children who went on waiting lists in July 2015 remain on the lists today. In the same month the Minister's predecessor indicated that no one would be waiting for more than 18 months. This has occurred radically and rapidly in the past 12 months. The Minister intends to publish a plan. Will he set specific deadlines to reduce the numbers over time incrementally? The rate at which the change has occurred in 2017 is extraordinary.
I think the Deputy has honestly and fairly assessed the situation in terms of needing to deal with the backlog and those waiting longest as well as the fact that many new people are coming on to waiting lists each day. Previously, there were 25,000 referrals per month from general practice to the acute hospital sector. Last year, we saw approximately 35,000 per month on average. More and more people are, rightly, using our health service and seeking specialist treatment. Moreover, our population is growing. All these factors produce pressure points in respect of our health service.
However, specific actions are being taken. The level of detail the three children's hospitals have provided me with in terms of the additional clinics and co-operation is helpful. These three hospitals are, relatively speaking, geographically well-placed to work together. They will come together under the new paediatric model of care for the national children's hospital. This will include putting in place the ear, nose and throat clinic, hiring more consultants and using locum cover in the interim. Those responsible in Children's University Hospital, Temple Street are looking at putting in place a new paediatric post for cardiology as well as insourcing and outsourcing options for urology.
Several of these initiatives will be undertaken as a result of the funding provided by the National Treatment Purchase Fund and as a result of the large budget that has been provided to the HSE. The target for this year is that by the end of October no one will be waiting longer than 15 months for an outpatient, inpatient or day-case procedure. A specific target has been given by the director general in respect of scoliosis to the effect that by the end of this year no child will have to wait longer than four months.
I thank the Minister and I acknowledge the efforts that he and the hospitals are going to in respect of the various initiatives announced. The challenge is for the Minister to set out to us in a clear manner how those goals will be achieved.
Although more people are accessing the services, the result is that in one 12-month period, more than 3,000 children were waiting for more than 18 months. This has a devastating impact on a young person and the time waiting represents a significant proportion of the life of these young people. From that point of view it is significant.
The Minister has announced initiatives today. However, I wish to remind him that across all three hospitals in the 18-month period, the waiting lists for children have gone up significantly, not by minor amounts but significant amounts. I acknowledge the efforts the Minister is making but I urge him to publish a strategy or work programme that will be developed over a 12-month period to arrest the rate of increase and then show a decline in the timeframe indicated by him.
We intend to do that. Even as we speak, HSE officials are in Stanmore in the UK looking at the possibility of utilising a facility there to help to deal with what Deputy Curran correctly categorises as a backlog in terms of procedures, especially in treating scoliosis. We can open an additional theatre here or there or hire additional consultants and use other hospitals like the hospital in Cappagh to provide support. However, if we are serious about radically reducing the waiting times, we are going to need to do something above and beyond the norm to get the lists to a level where they are sustainable.
It is fair to say that after several years of an inability to invest in specific waiting list initiatives, we have a massive hill to climb to get this back to what the public deems to be an acceptable level. The level at the moment is, frankly, not acceptable.
I believe there are particularly exciting opportunities in respect of children's health care with the plan shortly to build the new national children's hospital. It is about far more than a building. It will be about a new paediatric model of care. It will be about consultants and specialists working together and pooling of resources that should benefit all children not only in this city but throughout the country.
