Stephen Donnelly (Wicklow, Fianna Fail)
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No, it is not. What is now happening in a small number of cases is the GPs can only refer into say urology - they cannot refer to a consultant - and the hospital manages the workload within the hospital, which is how it should happen. I asked the HSE on Monday how quickly we can bring in what is exactly the Deputy's proposal as a national policy. There are some individual specialties where the advice is that one might want to have the ability to refer to consultant A or B because they have a very specific skill set. However for general dermatology, urology, orthopaedics or any of this stuff my clear view is to say a GP should only be able to refer into a hospital and the hospital must load-balance, and I have asked the HSE to implement this. For example, I do not know whether we will discuss this today but on scoliosis, one of the people involved who is a brilliant surgeon said to me that one of the single greatest determinants of how long a child will wait is which surgeon their GP happened to refer them to. That is totally unacceptable so we want that removed and I want to go further than that. That is step one.

Step two then has to be, what about one hospital versus another hospital? If the urology waiting list in St. Vincent's hospital is a lot lower than the urology waiting list in wherever, then we should load-balance there as well and move patients across. The national treatment purchase fund, NTPF, is doing a little bit of load-balancing but not on a systemic level.