Bernard Durkan (Kildare North, Fine Gael) | Oireachtas source

I wish to make a few comments. First, we must acknowledge the success of using the National Treatment Purchase Fund to cut waiting lists for various procedures, as there has been a considerable drop in the number of people on them. For example, in the case of inpatient or day case procedures the number fell by 20,000 up to November 2019. That is a major achievement. There are still two tranches of 20,000 each to go to bring the figure down to zero, which should be our aim. Do we have the commitment and procedures in place to continue on that line and to reduce the waiting lists to the necessary and desirable extent? It is no use to say it is at a tolerable level now. We must continue with it down to the wire, as it were.

My second question arises from Deputy O'Reilly's comments on the replacement of consultants. If a consultant is due to retire, presumably notice is given by the consultant in advance. Why not adopt a procedure whereby whatever reappointment procedures are required are put in place instantly? I realise there is an argument that sometimes they are not approved or they could be on a list waiting for approval, but why not appoint them temporarily? We must get away from the nonsense of this weighted procedure that is so laborious. There are procurement procedures that must be complied with, but there should be no gaps in the provision of service. It must be a seamless provision. There can be no gaps in the entitlement of the public to have a continuous health service. That should be borne in mind.

The Minister will be aware that we occasionally come across glitches, as occurred in our local hospital. I am loath to be parochial but everybody else does it. Even you, Chairman, have been known to do it from time to time. There is a rise in political testosterone, on both sides, during the approach to general elections and one must make allowances for that, but that should not distract us from the issue of making a simple intervention that can be very cost effective. The Minister has seen the issues in our hospital. Some of them are ongoing and some are periodic. I am aware that provision is being made at present, but I wish to raise two matters. First, we need to know whether there are vacant spaces in our hospitals, particularly where patients are in corridors and awaiting treatment and where ambulances are waiting outside the hospital to deliver their patients and cannot do so for obvious reasons. We must carry out an audit of the spaces that are available or that can be converted as a matter of urgency. It is not rocket science. It is very simple.

We must also examine the cost. In most cases the question to ask is: "Why are all the waiting spaces, the emergency department and the corridors full?" We must find out what is causing the problem. Is it because there are no doctors or an insufficient number of doctors available? Is it because an insufficient number of beds are available or insufficient space where beds or trolleys can be put? Incidentally, there is no reason that a trolley cannot be put in a ward while awaiting transition instead of having patients in the front row at the entrance to the hospital, which is bad for hospital morale and bad and dangerous for patients. It is bad for the morale of the staff and that is dangerous because there will eventually be stress, which causes other problems, and health and safety issues. Could an urgent audit be carried out to ascertain the amount of spaces that can be supervised and in which beds or trolleys can be placed, rather than having them in corridors where patients, visitors and staff have to bump into each other? I have seen cases where blood samples are being taken, people are being fed, patients are being visited, people are getting seriously ill and so forth in those circumstances. It is absolutely unacceptable that this should be happening. There is no reason for it to happen if there is covered space in the grounds. If not, it is quite simple to get temporary accommodation that would meet that requirement. It is not expensive. We must look at the things we can do quickly to make it safer, better and more comfortable for patients.

On the issue of child mental health, we have all encountered situations where there are acute cases of autism and behavioural problems. The patients are in obvious difficulty and their parents are at their wits' end trying to find something that meets their requirements. I believe it is possible to provide an adequate service. It is necessary to do so. One of the things that is urgently required is a number of mental health programmes in-house where the child can be put on a programme that is corrective and has the required amount of supervision over a specified period of time, which is readily recognised. Could that be done as a matter of urgency? The mental health sector has always been regarded as the Cinderella, but at some stage we need to recognise that there is a growing problem in that area. There is no necessity for it. Two parents called to see me last weekend. They are desperate to find a way to solve the problem for their child. The child has a profound disability and sudden, unexpected behavioural breakdowns. In those circumstances, we should provide the service that is necessary. It is not massively costly. It is simple, but we must provide the programme.

I have come to the last issue.