Colm Burke (Fine Gael) | Oireachtas source

I thank the deputations for appearing before the committee this morning. I have tabled question 5, which is a specific question on orthopaedic services in Cork, in particular those in the South Infirmary Victoria University Hospital. I note from the reply that there are 456 people waiting for a first appointment for more than 24 months. I am raising the question because of the case of one patient who is on the urgent waiting list. I was advised in March this year that the patient would be seen by June. Then in June I learned that the patient was eighth on the waiting list but would not be seen before the end of September. At the end of September I was told that it would be at least another three or four months before the patient is seen. This patient is on the urgent waiting list. I am concerned about how the list is managed and why the goalposts are constantly keep being changed. Will any action be taken to deal with the 456 people who are waiting more than 24 months for an appointment?

My second issue relates to orthopaedic services in Cork. I was advised that six people were referred for hip replacements under the National Treatment Purchase Fund. This was some time ago, not recently. The HSE paid for the procedures to be carried out. A total of four of the patients had private health insurance, but yet the HSE paid for the treatment. What cheques and balances are in place for the NTPF? How does that arise?

Another issue relates to retention of management in our hospital structure. If we have a system whereby managers keep changing, then we do not have continuity of management within individual hospitals. I know of one hospital where there have been ten managers in 18 years. Therefore, there is a problem with either the payscale or how the position is created. Will there be a review in respect of the whole issue of continuity of people in particular roles? This is fundamental. There are doctors and nurses in place for 15 or 20 years and that brings continuity. However, if we do not have continuity in management, there is a problem. Will that issue be reviewed? Is there a need to review the case of smaller hospitals and the status of managerial positions? If the positions are being under-graded, do we need to look at that rather than having constant rotation of managers and lack of continuity? Is there any review of that area at the moment?

The final issue I wish to raise relates to the recruitment of non-consultant hospital doctors. Of the 6,000 NCHDs currently employed how many are under agency contracts? What do we need to do to make those positions more attractive and to try to move away from agency contracts? If we can move away from agency contracts then it would cost less. What do we need to do? Do we need to improve training grants or additional resources for the educational process they are going through? Is that being reviewed as well?