Simon Harris (Wicklow, Fine Gael) | Oireachtas source

Yes. I will try to be as concise as the Chairman requested. Deputy Kelleher asked about the situation regarding scoliosis. I acknowledge the huge work of the advocacy groups not only in advocating but also in trying to engage with the HSE to come up with solutions. One such example is the paediatric scoliosis services co-design group in which parents and advocates are involved with the HSE and the children's hospital group in looking at how to better ensure there is a patient-centred approach to service delivery. It addresses a number of the issues raised about how people are interacted with from the moment they enter the health service system until the moment they have their surgery and come out the other side, regardless of where they live in the country and what doctor or hospital they are referred to.

I will ask the HSE to comment in a moment on the issue the Deputy raised on waiting times for MRIs. I thank him for bringing it to our attention.

I am very pleased that significant progress is being made in the area of scoliosis. We have set a very ambitious target to make sure no child waits longer than four months. By the end of the year children awaiting surgery should not have to wait longer than four months. That will bring us in line with countries like the UK and the NHS but it is a significant and dramatic improvement on the scenario that families were facing in this country. We have seen good progress in the opening of the new theatre, additional theatre sessions, the recruitment and retention of more theatre nurses, the use of facilities abroad outside of this jurisdiction and the use of other facilities within the Irish health service.

The figures factor in a growth in the waiting list, in other words, new people coming onto the list as they are diagnosed. If nobody new was diagnosed a total of 312 patients would require treatment by the end of the year to ensure no one breaches the four-month waiting target but we have also factored in anticipated growth of approximately 135, which means that about 450 patients will need to be treated by the end of the year if we are to ensure we reach that target. I am pleased to say we are seeing weekly progress towards meeting the target. I am getting a weekly report on this. I thank everybody involved in that regard.

I will ask the Minister of State, Deputy Jim Daly, to comment on the south-west child and adolescent mental health service in a moment. As for the GP contract, first, I question the assertion by Deputy Kelleher that half of GPs or anybody else is waiting outside the door. There is significant cross-over between the two organisations in terms of membership. If the GPs to whom Deputy Kelleher has spoken are anything like the ones in my constituency or those around the country to whom I speak– perhaps the Chair can attest to this – one will meet many GPs who are members of both associations. I know people present different numbers but there is significant cross-over between the two organisations. This is a more inclusive engagement with GPs than we have ever had. Before I became Minister there was no formal engagement with the NAGP. It was not just half way out the door but completely out the door. There is now formal consultation with the NAGP. I have personally suggested to the NAGP that it should see this as an evolving process and an opportunity to be involved and be consulted. We cannot get away from the fact that the IMO has a signed framework agreement with my predecessors and with the Department with regard to being the negotiating body but there is a real opportunity for the NAGP and the IMO to have their imprint on a new GP contract. I share Deputy Kelleher's view on the need for buy-in from all stakeholders, including the NAGP in this regard. I envisage this as an important step in the evolution of the relationship between the NAGP and the Department and the State and I encourage its members to work within that framework and to build on that.

In respect of the Herity report, like Deputy Kelleher I express my sincere condolences to the family of Thomas Power on what can only be an unbearable time for them all. I have commented on the wider issues not the individual case, which will be examined in the normal procedures and they will establish the facts. It would not be appropriate for any of us to talk about that but on the wider issue relating to the Herity report, as Minister for Health I stand over independent clinical evidence when I receive it. I stand over it in the exact same way as Deputy Kelleher's party correctly stood over the report on cancer care when it was in government and, to be honest, when political parties in opposition then, including my own, were not helping Fianna Fáil out. I understand what it is like when one is in opposition and Deputy Kelleher understands what it is like when one is in government. The Minister for Health, whosoever he or she may be, has a long-established precedent of following independent clinical advice that has served this country well.

However, we are doing four things in respect of Waterford. Based on the Herity report, I will put in additional resources - this is covered and funded in the service plan - to increase the number of opening hours of the existing cath lab. That will ensure more procedures are provided in Waterford. Second, a mobile cath lab is on the way and will be there as part of an interim measure to reduce waiting times for planned cardiology procedures. Third, after the benefit of those two measures have come into effect, I am happy to have another independent review of the situation in Waterford to ascertain whether, as a result of the mobile cath lab and the additional hours, more people are using the service in the south east. Fourth, we will have a national review.

To be clear, the issue in the Herity report is the view that there should be a consolidated number of primary percutaneous coronary intervention, PPCI, centres around the country. That is the foundation from which I am starting but the review will be completely independent of Herity above and beyond that. If Deputy Kelleher and I accept, based on best medical evidence, that there can only be a limited number of those centres, the purpose of the national review is to decide where it is best to locate them to ensure the maximum possible number of people can access a centre within the required clinical time. That is an aspiration we all share and we want to get there.

The issue does not just affect people in the south east. There is no 24-7 PPCI centre in the midlands. If one lives in parts of County Kerry one has to go to Cork University Hospital. If one lives in counties Monaghan, Louth or Sligo, one also has to go elsewhere. The national review is needed given that in any country, there is only an ability to provide a limited number of such facilities and we need to see where it is best to provide them to ensure the maximum number of citizens have access to them. That is the rationale behind it.

Deputy O'Reilly has raised the issue of Brexit a number of times in oral and written parliamentary questions. I have received detailed analysis from my Department, which I will share with the committee. I will circulate it to members. It answers a number of the questions the Deputy asked regarding how many people in this country have used the treatment abroad scheme in the UK and Northern Ireland; how many have used the cross-border directive; what is the cost of that each way; how many Irish pensioners benefit from medical cards and medical services in the UK and how many British pensioners benefit here. The analysis provides a lot of the data Deputy O'Reilly was seeking. I had a Brexit meeting in my Department yesterday with the HSE and Department officials on those issues. The data are available. However, in fairness to everybody involved, a lot of those issues come under the broader issue of the common travel area and as part of the broader negotiation this country and the EU must undertake with Britain on the common travel area and the free movement of people. The same is true of the Department of Social Protection where a number of issues arise. I already have had a meeting with the UK Secretary of State for Health, Jeremy Hunt and have written to him requesting another meeting on Brexit. I have met the European Commissioner for Health and Food Safety three times on Brexit. I have had bilateral meetings where Brexit has been an agenda item with many health Ministers – more than a dozen – from around the European Union. I also have had engagement with the then Northern Ireland Minister for Health and I hope to be in a position to have engagement with the future Northern Ireland Minister for Health shortly, as we all do. There is a lot of work going on. As the Deputy is aware, we cannot negotiate bilaterally with the UK during the process of Brexit, as we have to negotiate as part of the EU bloc. We have provided significant data and information to the Department of the Taoiseach on the health needs from Brexit. In September, I hope to host a specific session on health as part of the all-island civic dialogue. We very much welcome the involvement of members of this committee, along with stakeholders from North and South. I will keep the committee informed in that regard.

Deputy O'Reilly inquired about consultants. I will refer that to the HSE and it will come back with the information. On the GP contract, I hope we will have enough work-----