Seán Haughey (Dublin North Central, Fianna Fail)

I thank Deputy Clune for raising this matter, to which I will respond on behalf of my colleague, the Minister for Health and Children, Deputy Mary Harney.

It was estimated in 2007 that 43% of special care adults required either intravenous sedation or general anaesthetics for completion of their care. Where general anaesthesia is provided, access to resources such as anaesthetists and theatre space is necessary. Some patients, especially adult patients, who are seriously medically compromised require supporting hospital services. In the HSE south area, Cork University Hospital, CUH, has been the principal provider of such services. In Waterford and Wexford, local hospitals provide these services, with only the most complex cases referred to Cork University Hospital.

The service in Cork University Hospital was suspended in 2007 for safety reasons and reactivated in September 2009. There is currently a waiting list for this service of 113 patients. The current facility only has the capacity to meet the needs of the most urgent cases.

Since August, the HSE has been working on a plan to prioritise and target vulnerable groups and those with intellectual disabilities. A pilot initiative has been established in the HSE south area for children and adults with intellectual disabilities who require dental services. It is expected that the outcome of this initiative will lead to a reduction of up to 50% in the current waiting lists for general anaesthetic. The initiative takes a multifaceted approach. I will outline the initial steps, the first of which is the reprioritisation of waiting lists. An audit is near completion which will provide information regarding the complexity of care that patients require. Following this, a clinical assessment will be carried out on patients. Early results indicate that the majority of patients have moderate to mild medical complexity. This means their dental care may be carried out in a district hospital setting.

The second step is to take a two phased approach to treatment. This will involve providing more urgent as well as less complex care. This will mean stabilising the patients to ensure they can enter a preventative programme while awaiting treatment for any remaining oral health needs. This is to begin in January 2011.

The third step is the training and up-skilling of dental staff. Training dental staff in relative analgesia and intravenous sedation will enable those patients who can be treated by other means to be removed from the general anaesthetic waiting list. The training of staff will begin in spring 2011. The HSE is also exploring the opportunities for the realignment of services in the south in order that access to other general anaesthetic facilities outside of Cork University Hospital will be available to less medically compromised patients. The impact will be immediate since patients with less complex medical histories will be removed from the Cork University Hospital waiting list.

The capacity of other hospitals is currently being determined with a view to treating patients with the least complex medical needs. This will support the two phased approach. As a result, in six to nine months this approach will be used to treat approximately 40% of patients on the current general anaesthetic waiting list.

I thank the Deputy again for raising this matter on the Adjournment.

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