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

That is a major issue. The Minister said there were 312 on the scoliosis waiting list at the start of the year but that is now down to about 159. However, a backlog is already developing again on the outpatient list. They will move to the inpatient list eventually. We must acknowledge the situation. I like to think I am reasonably fair but we must accept that the outpatient system is unable to assess patients in a timely manner. When individuals are assessed they are eventually put on the inpatient waiting list, surgery is scheduled and they might be treated on time. However, the issue is that they are not seen on time and that is of critical importance. Approximately 80,000 people are scheduled for inpatient care but 600,000 plus are on outpatient waiting lists of one form or another. That is a major issue of concern. The gatekeeper is not allowing patients to flow smoothly through to the inpatient scheduled elective surgery area. I was going to raise these issues under the various subheads but I will get them all out of the way now.

On the broader issue of health service funding, I acknowledge that this is a very small Supplementary Estimate. I accused previous Ministers of presenting wholly unsustainable budgets at the start of the year knowing full well there would be €500 million or €600 million plus rammed through at the end of the year in a Supplementary Estimate. At least we are getting to a more orderly management of the budget. Some of the need for additional funding has come from third parties.

That is my point on scoliosis and waiting lists in general. The Minister cannot say all the progress is due to the policies. It is equally due to the fact that we are failing at the front-of-house stage. In terms of the National Treatment Purchase Fund and the purchase of treatments, I cannot comment on this year but it was brought to my attention in previous years that orthopaedic teams in hospitals were unable to carry out procedures because they had run out of implants. If that is the case, is it possible for the NTPF to purchase the implants for hip or knee replacements? It is a shame to have highly specialised teams unable to carry out procedures due to a lack of implants.

I have one other point. I do not wish to delay the Minister because I am aware he has enough on his plate today. He referred to the cross-border directive and the treatment abroad scheme. The failure of Government policy is evident in what is going through the printing presses of the Oireachtas in the sense that every Deputy, mainly Government ones but Opposition Deputies as well, is highlighting the cross-border directive and the treatment abroad scheme. People should know their entitlements and rights as EU citizens and Irish citizens. A number of years ago we had some consultants who refused to advertise the National Treatment Purchase Fund in their clinics.

While the scheme is good, it is an indication of failure that we now have a situation where bus loads of people leave west Cork and travel to Belfast for cataract operations. Deputies now feel compelled to take their constituents to Belfast for procedures because they have waited extraordinary long periods for them here. On numerous occasions in the Dáil I have mentioned the case of a 90 year old man who lives in my constituency. He has waited years for a cataract operation and he has been told that he must wait another three or four years. The Minister can analyse all of the success he likes. Everybody likes to put a gloss on things and I will not take away from any of his achievements. The idea that the waiting list system has improved dramatically is not the case. The problem is at the front of house. That we have yet to assess and address the issue of outpatients having to wait between one and three years for appointments when we know that they should receive treatment is the new scandal.

I thank the Minister for the delivery of the HPV vaccination programme. The committee had tried to make traction in terms of the matter but his intervention was positive and very timely.