John Moloney (Laois-Offaly, Fianna Fail)

I am replying this Adjournment matter on behalf of the Minister for Health and Children. The division of trauma and orthopaedics at CUH is responsible for providing trauma and elective orthopaedic services in Cork. Trauma services are delivered in CUH, while elective orthopaedic services are currently provided at St. Mary's Orthopaedic Hospital. Currently, there are five permanent consultant orthopaedic surgeons engaged in the trauma and elective service, with two locum consultants engaged in the trauma service only.

At present, just over 300 are people waiting for elective orthopaedic treatment in the CUH, the majority of whom are waiting for less than three months. The HSE estimates that 97% of elective orthopaedic cases are treated within six months. For most of the remaining patients, there are specific individual reasons why surgery has not been completed. The HSE indicates that approximately 3,500 people are on the waiting list for orthopaedic outpatient appointments in CUH. Work is in progress to validate the waiting list to establish whether all of the people concerned still require an appointment.

The HSE is working to reduce orthopaedic waiting lists and a recent initiative is the establishment of a physiotherapist-led assessment clinic to triage patients waiting longest to be seen. Evidence shows that many patients on outpatient waiting lists can have their needs addressed by a physiotherapist working in a team led by a consultant orthopaedic surgeon. The HSE is optimistic this initiative will result in an appreciable reduction in the number of patients still awaiting treatment and in the waiting period involved. The HSE is also making arrangements with the National Treatment Purchase Fund for orthopaedic outpatient appointments to be offered by the fund to approximately 400 people who have been waiting longest to be seen at the CUH.

The business plan of the HSE south for 2010 prioritises the reconfiguration of acute hospital services in the region. This plan involves the creation of a single acute hospital system across the region, to achieve the best possible health outcomes for the people of Cork and Kerry. As part of this process, the HSE will reorganise some services across the six acute hospitals in the region. While complex care will tend to be centralised, the roles of local hospitals in the areas of day surgery, diagnostics and outpatient care will be expanded.

In May 2010, the HSE announced its intention to relocate orthopaedic services, including elective inpatient, rehabilitation trauma and day surgery, from St. Mary's Orthopaedic Hospital to the South Infirmary Victoria University Hospital, Cork. This change, which is planned to take place in 2011, will result in all orthopaedic services being provided in an acute hospital setting, with related specialties, including rheumatology, on site. Patients from Cork, Kerry and the wider Munster area will benefit from improved treatment and surgery for conditions including spinal and skeletal injuries and deformities, in addition to rehabilitation for damaged joints and muscles. The redeveloped facility will have three dedicated orthopaedic theatres, compared to two in St. Mary's Orthopaedic Hospital. It is also intended, following the move, to recommence orthopaedic surgery for children, for which HSE south patients must currently attend Our Lady's Children's Hospital in Crumlin. Trauma and emergency orthopaedic surgery will continue to be delivered in CUH, as is the current practice.

The HSE is working to develop national quality and clinical care standards across a range of hospital services and specialties and to improve the performance of outpatient services generally. The measures I have outlined represent a structured approach to improving access to orthopaedic services in the Cork area and to the longer-term organisation of services in this key specialty on a safe and sustainable basis.

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