Billy Kelleher (Cork North Central, Fianna Fail) | Oireachtas source

I welcome everyone to the meeting. I apologise for missing some of the meeting. I was speaking in the Dáil on water services and I imagine those present were listening to me with interest. I read the Minister's opening address and I was present for Mr. O'Brien's presentation.

The Minister referred to the fact he is now 100 days in office. We wish him well in this regard. This is my first opportunity to do so at a committee meeting with HSE representatives present as well. They are two sides of the one coin, and I do not mean that in a disrespectful manner.

I become concerned when I listen to the official replies to questions on the current provision of health care. While I do not expect Health Service Executive officials to be self-critical or critically analyse their organisation, it is clear that some areas of the health service are severely deficient. The pressure on emergency departments is one example, as is health service employees protesting outside health care facilities because patient safety is being compromised. Front-line staff are professionals and consistently advocate on behalf of patients. They believe patient safety is being compromised in emergency departments. The representatives of the HSE should take into account the views expressed by their employees, rather than lightly dismiss them, as sometimes occurs.
Mr. O'Brien referred to a report in The Sunday Business Postwhich alleged manipulation of waiting lists and denied any memorandum had been issued by the Health Service Executive. Is he satisfied that a full trawl of HSE information technology services has been carried out and all correspondence between area managers and others checked? Is he certain that there is no such memorandum in the HSE's information technology services?
I received a large number of redacted letters from the Cavan area which were written, I presume, by a general practitioner. While they might not have indicated official manipulation, they showed that the Health Service Executive had been referring patients from its outpatient waiting lists to private health care providers. These patients subsequently rejoin the waiting lists. When their names are included in a waiting list for a second time, are they placed at the bottom of the list or at the point at which they were referred initially? It is critically important to establish the position in this regard. If it is the case that such persons rejoin the lists as new patients, it would indicate manipulation of waiting lists. Patients who have been waiting for a long period for an outpatient appointment are referred to a private service provider. While I have no ideological problem with this practice, the issue is whether they subsequently rejoin the waiting list as new patients. If that were to be the case, it would indicate that the figures were being manipulated because the person concerned would have to wait to have the same procedure carried out. What is the official view of this practice, about which I have major concerns?
There is considerable merit in The Sunday Business Post story about waiting lists, which are a key political priority. The Health Service Executive has been under severe pressure on this issue. It has been consistently pointed out that the numbers waiting to have procedures carried out as outpatients are increasing. We have been informed time and again, however, that this was not a major concern because 250,000 people attended outpatient clinics each month. There is a crisis in waiting lists. This continues to be a major problem.
A couple of months ago I received a letter from the orthopaedic department of the South Infirmary-Victoria University Hospital informing me that one of my constituents who was on an urgent waiting list would, happily, be given an appointment two and a half years hence. I will circulate the letter to the Minister and Mr. O'Brien to give them an idea of what is happening. The lady in question is crawling around in agony. I do not wish to be alarmist, but I am not the only Deputy who has received letters of this nature. Many others have received similar letters. This is a major problem and rather than dancing along the surface and pretending everything is all right, the HSE must acknowledge it and not only because we have a new Minister. I hope the Minister will assess and address the problems in the health service in a realistic manner because what we had on some previous occasions can best be described as camouflage.
Patients are waiting 15 weeks to have an assessment made under the fair deal scheme. Why are assessments taking longer than in previous years? Given that the scheme does not apply retrospectively, I am beginning to take the view that the reason for the delays is to kick payments into the subsequent calendar year. The Health Service Executive is under pressure as a result of the wholly insufficient budget it received last year, as was well documented in the committee's discussions at the time. Why is it more difficult to assess a person now than it was in previous years? Has something changed, other than the fact that there is no money available at the end of the process? The process is being delayed until such time as the expenditure can be moved into the subsequent accounting year.
Representatives of the Mental Health Forum came before us this morning to discuss progress on mental health services, including child and adolescent services and other pressure points. In acknowledging the work being done and advances being made in certain areas, they were highly critical of the level of progress made in some other areas. We must address the underlying difficulties in the mental health service. It appears that a sum of €35 million which has been ring-fenced for mental health services cannot be spent because I have been hearing about it for three years. I have also heard about difficulties in the recruitment of personnel and delays in interview processes. These delays seem to be never ending. I ask the Minister of State, Deputy Kathleen Lynch, to comment.
The Minister boasts that the Government has frozen prescription charges, whereas the programme for Government refers to their abolition. The Government has a long way to go to achieve its objective on prescription charges.
Yesterday I received a telephone call from a councillor in County Roscommon informing me that dental surgery for children in the county had been cancelled. Is that correct? It would be very alarming if it were to be the case. I am referring to cases involving children who require surgery under anaesthetic. The councillor in question was informed that his son would not have surgery.
We have been hearing for three years that addressing the problem of 700 patients staying in acute hospitals unnecessarily is a priority. How does the Minister propose to address this issue and move patients from hospital care into community or home care settings?