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Health Services

Dáil Éireann Debate, Tuesday - 19 October 2021

Tuesday, 19 October 2021

Ceisteanna (94)

Denis Naughten


94. Deputy Denis Naughten asked the Minister for Health his plans to address the chronic waiting lists within the health system; and if he will make a statement on the matter. [49955/21]

Amharc ar fhreagra

Freagraí ó Béal (6 píosaí cainte) (Ceist ar Health)

As I stand here, our people have been waiting three and a half years in acute pain for an orthopaedic appointment and a whopping four and a half years for a respiratory appointment while we are in the depths of a respiratory pandemic. Appointments for services in the community are not much better, with waiting list of two to three years for occupational therapy appointments. We urgently need to do things differently and address these appalling waiting times once and for all.

I agree with everything the Deputy just said. Therefore, where do we start? We start as a Parliament and a Government by saying that the waiting lists before Covid-19 arrived were completely unacceptable. They are higher now because of Covid-19 and a cyberattack. The current situation is completely unacceptable. We must, therefore, act. It is my absolute priority as Minister for Health and a priority for all Ministers of State in their respective areas.

Right now, we have 760,000 patients on the acute hospital inpatient day case, outpatient and gastrointestinal scope lists. A higher figure of approximately 900,000 is often quoted, although this includes people who have appointments for scheduled care cancellations and suspensions and so forth. On top of the National Treatment Purchase Fund, NTPF, list, however, as the Deputy rightly said, there are people waiting in the community. People are waiting on mental health and disability services and on diagnostics. The situation is very serious indeed.

At the beginning of this month, I published an acute waiting list action plan. The plan was drawn up between my Department, the HSE and the NTPF. It is using the €210 million access to care fund that I allocated for this year to improve access immediately. The plan is to fund an approximate additional 150,000 interventions for people who are on those lists. As I know the Deputy will appreciate very well, the waiting lists are continuing to rise and the no-policy change numbers go up a lot. The first thing we must do, therefore, even though we are dealing with a pandemic and a rise in Covid-19 again, and even though our hospitals are under pressure, is to stop the increase and then use every resource available to the State to bring it down. I can tell the Deputy that all four Ministers with responsibility for health are absolutely committed to doing everything that can be done in their respective areas to get people the treatment they need.

I appreciate the Minister's comments. Next year, we will spend €40,000 every minute on our health service. We have seen in the past, however, that just throwing money at our waiting lists does not work within our health service. We need to see structural reform and not just reward those who work within our private hospitals.

In the programme for Government in 2016, for example, a commitment was secured to look at expanding the Sligo hospital cataract surgery model, which had slashed waiting times by providing the follow-up care in the community by ophthalmologists. Five years later, the only expansion of that service has been to Letterkenny University Hospital where today, just 32 people are awaiting cataract surgery. Is it not ironic that two of the closest hospitals to Northern Ireland have slashed their waiting lists and people from Munster have to travel as far as Belfast to get cataract operations?

Money is not the only answer but it is part of the answer because without money, this is not going to move. Next year, I have allocated a total of €350 million. The Deputy will be aware that I am appointing a ministerial task force to look at this issue. We are taking the learnings from the very successful vaccine task force and bringing them to bear. As the Deputy quite rightly said, we are going to do this differently. We are going to use all of the capacity we can, first of all within the HSE but then also within the private sector. That €350 million is a lot of money and can do a lot of good. I could not agree with the Deputy more. It is not enough. Using that kind of money can be effective in terms of dealing with the backlog but we must bring the day-to-day capacity of our public health system up to a point where it can meet the day-to-day demand. Only then can we seriously talk about universal healthcare and exactly the kind of reforms about which the Deputy spoke and that are needed, including the cataracts model in Sligo.

I will give the Minister two more examples. Take the rapid access haematuria clinic, that is, the blood in urine clinic at Roscommon University Hospital, RUH, where 10% of patients have been diagnosed with cancer. It treats 70% of patients in one visit and 100% of patients - all of them - are seen within the 28-day target time for urgent cases, and yet this has not been rolled out anywhere else. Look at the state-of-the-art theatre sterilisation room that was constructed in 2016 at RUH. It has been used for storing beds and wheelchairs for the last five years because the HSE will not approve funding to equip the facility in order that we could fully utilise the two theatres in that hospital and reduce waiting times across the west. Of course, if we did that and reduced waiting times across the west with regard to our waiting lists, that would undermine the case for the new elective hospital in Merlin Park. It is, therefore, better to spend money on treating patients in private hospitals than supporting public hospital innovation, which can make a real difference in the long term to waiting lists.

If we are going to get this right and we have to get it right, we have to be able to identify exactly the kind of projects the Deputy has referenced. We have to replicate and scale them. All over the HSE, brilliant initiatives are happening. Tallaght hospital has been running advanced nurse practitioner-led community teams in various disciplines such as neurology and urology and the results are spectacular. I may be wrong, but I am pretty sure the Sligo model the Deputy mentioned is referenced in the programme for Government. It is an example I brought into those talks having met opticians and ophthalmologists in Wicklow who raised this with me. We have to do things differently. We have to bring care closer to the patient. When we see examples of excellence such as those the Deputy referenced, we will have to get better at replicating and rolling them out across the system.