Simon Harris (Wicklow, Fine Gael) | Oireachtas source

I thank the Deputy for his comment. I thank him and all politicians who are health spokespeople in this House for their leadership, which made a real difference.

In terms of scoliosis, I acknowledge that Deputy Kelleher has highlighted the issue of outpatients for some time. He is entirely correct that there is an issue with the outpatient waiting list. I should have said earlier that the scoliosis co-design team is considering a sustainable solution and will incorporate the issue of outpatients as well.

I disagree with the Deputy about one area. There has been no slowing down in outpatient appointments to accommodate more inpatient activity this year. I must say out of respect for the significant investment that has been made but, more importantly, the clinicians whom I have met that the volume of inpatient procedures they have carried out is dramatically up on last year. What we were trying to do this year was always somewhat different from what should be a sustainable service. It was more about throwing everything that we could to solve a significant backlog that had built up over many years and get the lists down to a much more appropriate place. What 2018 must be about, and I am happy to be held to account on this, is a sustainable service in Ireland that does not involve telling children and their parents that they need to go to Germany or France and instead involves us saying that effectively we here in the Republic of Ireland can provide enough orthopaedic procedures to look after all of our children who need various spinal procedures. We will get there during 2018. When I came to office, a brand new theatre in Crumlin was closed but that has been reopened. We have hired additional nurses. We will hire an additional consultant again and that process will start very shortly. By the end of this year every child waiting over four months will have either been treated or will have a date for treatment early in 2018. I want to clarify a point about the four month target today because I do not want it to be misrepresented, not by the Deputy but in any way. We must allow the clinicians rather than HSE managers or me to set an appropriate target. They have said to me that they want to see some children much more quickly than four months while they feel that for others it is better for various reasons to wait a little bit longer. We must empower the clinicians rather than impose an arbitrary deadline.

Deputy Kelleher is correct about the issue of orthopaedics and implants. To the very best of my knowledge, the NTPF has already resourced public hospitals to carry out more procedures. Sometimes the only thing that the public hospital might have been missing was the implants. They may have had the theatre time and the consultants. I am pretty certain that such work is being done and, yes, it can be done.

On the cross-border directive and the treatment abroad scheme, I agree with the Deputy that we do not want anybody to leave this jurisdiction to get health care, but under the European Union they can do so. We know that we are in a changing dynamic in terms of the North and the UK and the scheme at the moment.

Sometimes we can all highlight bad cases. It is absolutely appropriate that we highlight them. It is absolutely appropriate that the health service and I would be held account for them. It is also absolutely true that there are far too many bad cases. People on waiting lists who might be watching these proceedings or following the debate would be excused for presuming that everybody in this country must wait an extraordinarily long time. The NTPF's statistics, and not mine, show that over 50% of us will have an operation, procedure or inpatient day case in six months or less and over one third of us will have it in three months or less. The same statistics apply to outpatients. Over 50% of them will be treated in six months or less and over one third in three months or less. We need a rational debate where we say some elements are going well but some are going extremely badly and what are we doing to do about the situation. The Deputy gave cataract procedures as an example. I agree that people are waiting far too long for the procedure. Many more people waited far too long earlier this year and the number of people waiting far too long has significantly reduced. I want to see the long waits eradicated. I am sure we will have a chance to return to the topic again.