Simon Harris (Wicklow, Fine Gael) | Oireachtas source

I will start with the Deputy's final question. The plan this year, for the first time in many years, is to have fewer patients waiting for an outpatient appointment by the end of the year than at the start of the year. I accept that is not a radical advance but it will be the first year in a number of years that we will end the year with fewer patients waiting for an outpatient appointment than at the beginning of the year.

We have talked about there being more people than ever on waiting lists. It is important to acknowledge that outpatient waiting lists were not kept and published until 2011 or 2012 so that is a new departure, which is good. Every year, the health service sees about 3.3 million outpatients so this number of people will go to an outpatients clinic this year. Only about 1 million of them will be first appointments, which means about 2.3 million will be repeat appointments. One of the challenges for us is to reduce the number of return appointments to the hospital that are needed. This means the patient will see the consultant, as necessary, but the ongoing management of the chronic condition will be done in the community. One of the big wins in the GP contract is that, over the lifetime of the agreement, 400,000 patients will be treated in the community who would have been treated in the hospital previously. The Deputy asked how we will fix this. We will do this by significantly reducing the number of people who must repeatedly return to the consultant by trying to have more of them seen in the community.

This is the first year for many years that we are using the NTPF to provide support for outpatients. We have asked, through the HSE, all hospital groups and hospitals how can we help them using a fund in the NTPF for outpatients. Until now, we have only used the NTPF for inpatient day cases.

I make this point because we must grapple with it. About 500,000 people missed their outpatient appointments last year. People do not miss appointments unless they have a good reason or the lists are inaccurate. We need to get under the bonnet and I have asked the HSE and NTPF to do some work on the matter through the central validation office. If 500,000 people or thereabouts were offered an outpatient appointment last year but did not turn up, what does that tell us about the waiting lists? We will do a number of things this year, primarily using the NTPF to provide extra support on outpatients for the first time in a number of years.

The strike definitely had an impact on the outpatient lists at the start of the year but it remains the plan that there will be fewer patients waiting at the end of the year than at the start of the year. We need to look at what we are measuring in terms of waiting if 500,000 people did not turn up for appointments last year.