Mr. Paul Reid:

I will address a few points if I can. We can do nothing other than fully agree that the waiting lists are unacceptable and that we have to manage our way through. However, we have to start the process. We certainly have been impacted over the past while.

On the emergency approaches, I did not respond to one of the Deputy’s earlier questions. He is correct that one approach is to increase theatre utilisation. There are good examples of hospital groups that have put in place change-management processes that account for the whole flow across the hospital. It is not just a matter of addressing the use of theatre but also of increasing the flow throughout the hospital, which increases theatre utilisation. Working with the services, Dr. Henry is finalising a plan with us that will start to address, across a range of hospitals, theatre utilisation, good practice, good processes and how we can replicate these across the system. I apologise to the Deputy as I meant to respond to him earlier.

On emergency-plan approaches, the action list the Minister launched for waiting lists involves a process overseen by me in the HSE weekly, and jointly with the Department fortnightly. It is integrated into the service in terms of the allocation of funds and expected delivery on foot of any incremental funds got for measured delivery against the targets for reducing waiting lists. A new governance structure and oversight system are in place to do what is required.

The Deputy is correct that we have a very significant legacy in the acute hospital network, for sure. On his question in respect of the capital plan, the plan is a real one. We have a €1 billion capital plan. Our capital plan is significantly consumed by some of the major strategic projects that the Deputy will be familiar with, especially those that have featured over recent years, including the children’s hospital, the national forensic mental hospital in Portrane, and the additional 120 units for the National Rehabilitation Hospital. These represent a very significant absorption of capital but we have a range of initiatives to start addressing some of the real legacy infrastructure issues. For example, Galway hospital has significant infrastructural challenges but so too do many other hospitals. We have a limited capital envelope, it is significantly absorbed by some the major projects, and we are trying to utilise it on a multi-annual basis.