Michael McGrath (Cork South Central, Fianna Fail)

I thank the Ceann Comhairle for selecting this important matter for the Adjournment debate, which concerns waiting times for people wishing to see an orthopaedic consultant in the Cork area. Having researched the matter, it is not unique to Cork but appears to be particularly acute there. Before a person is added to a waiting list for orthopaedic surgery, he or she must see an orthopaedic consultant. That is where the bottleneck exists. The outpatient waiting list for those waiting to see an orthopaedic consultant is 3,356, according to the latest figures from the HSE for Cork University Hospital, CUH. Only 248 people were on the waiting list for orthopaedic surgery. Even a cursory analysis shows the bottleneck in the system is the outpatient appointment system. Looking closer at the figures, some 1,500 of the 3,356 people are waiting for at least 12 months. It is a very long time for someone in need of a hip operation or knee replacement surgery. Of those people, almost 350 are waiting to see an orthopaedic consultant for two years or more. This is a real problem in Cork that must be grappled with as an urgent priority. I am aware the problem exists elsewhere as well.

What is the root cause of the problem? Is it the lack of orthopaedic consultants in Cork? Do consultants spend too much time on private patients rather than public patients? Are they not complying in full with the new consultant contract? A constituent contacted me and told me he will almost certainly need a hip replacement. He has been told by the CUH that it will be at least two years before he sees an orthopaedic consultant. It is only at that point that he can join the waiting list for surgery. The National Treatment Purchase Fund cannot help him because it deals only with those on waiting lists for surgery for at least three months. While there is an outpatient initiative in place, it does not help those waiting to see an orthopaedic consultant in Cork this year. If he has money and is able to go to a private hospital and pay for the procedure, he can get it done quickly. Otherwise, he must wait at least two years before he sees a consultant and joins the waiting list for surgery. There is not equality of access in respect of treatment for that man or thousands like him. We must address the issue of orthopaedics urgently.

I ask the Minister to consider extending the role of the National Treatment Purchase Fund to take on outpatient cases. From my work on the Committee of Public Accounts, it is clear the quality of the outpatient waiting list data is very poor. When representatives of the National Treatment Purchase Fund appeared before the Committee of Public Accounts some months ago, they gave evidence that when they probed the data it was of poor quality. Many people on the outpatient waiting list data provided by the hospitals were deceased. Many had treatment carried out elsewhere and others did not need the treatment anymore. In many cases, the contact information was out of date. There must be a national audit of waiting lists and waiting list data must be validated. Waiting lists will not be as long if we establish the true picture in that regard.

A recent article in the Sunday Business Post stated we have a ratio of one orthopaedic surgeon for 54,000 people, the lowest ratio in western Europe. Many countries have a ratio of one surgeon to 15,000 people. There is an issue in CUH but also other areas of the country. It is not fair or reasonable to expect someone who urgently needs to see a consultant and subsequently needs to have surgery carried out to wait at least two years before going on the waiting list for surgery. I hope the Minister of State can shed some light on the situation and give people in Cork hope that they will not be waiting so long to see a consultant and gain access to the surgery they so badly need.

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