Tony Killeen (Clare, Fianna Fail)

I am responding on behalf of my colleague, Deputy Mary Harney, the Minister for Health and Children. While it would be inappropriate for me to comment on a particular case, the HSE has advised the Minister that the patient to whom the Deputy is referring in this instance attends Tallaght hospital. The patient is awaiting surgery under the care of one of their orthopaedic surgeons. Decisions on the clinical care of patients including appropriate surgery and the preferred timescales for such surgery are for the clinicians involved to make.

The HSE has written to the Deputy in regard to the waiting list of the surgeon involved in this case. The hospital has sourced another consultant to provide treatment for patients awaiting day surgery under this particular orthopaedic surgeon's care. The hospital intends to ensure that the day case list will be cleared by the end of the year. Tallaght hospital provides a trauma and elective orthopaedic service for a large catchment area with approximately 500,000 people. Some 70% of inpatients referred for elective orthopaedic surgery are referred from the hospital's outpatient clinics. A further 15% are referred from Naas General Hospital's outpatient clinics and another 15% from St. James's Hospital clinics. Tallaght has two theatres and 22 beds for the provision of the elective service.

In April 2010, the hospital's executive team approved a bed ring-fencing and waiting list initiative proposed by the hospital's peri-operative directorate. Since then, the number of patients waiting more than 12 months has been reduced by almost 70%. In addition, the number of patients waiting between six and 12 months has been reduced by 41%. The waiting list initiative includes a focus on improved efficiencies within the use of elective orthopaedic theatre and inpatient beds. There has been an increase in theatre utilisation of up to 49% and a similar increase in elective orthopaedic admissions. At present, almost one third of all surgery in the orthopaedic department is carried out on the day of admission. The length of stay of patients has been reduced by 8%. This initiative, along with other steps being taken by the hospital, will contribute to an increase in activity, a reduction in waiting times for treatment and improved outcomes for patients.

The recently published Tallaght hospital review, the Hayes report, identified difficulties in regard to orthopaedic services at Tallaght hospital and has made a number of recommendations in this regard. The HSE and the board of Tallaght hospital have undertaken to implement all the recommendations of the report. The Minister met Dr. Hayes on 8 November to discuss the implications of his report. She met the chairman of Tallaght hospital on 9 November and has also had discussions with the CEO of the HSE about the report. The main focus of these discussions is on what initiatives are needed both in the hospital and in the wider health system to provide sustained improvements in the services for patients. The Health Service Executive has assured the Minister that patients referred for treatment will be prioritised on the basis of clinical need.

The priority list is regularly updated. It is important that there be a co-ordinated approach to the management and treatment of patients in order that patients who require treatment can receive it as quickly as possible in the appropriate health care setting. The Minister has asked the Health Service Executive to address the issue as a matter of priority.

Bheinn sásta labhairt le mo chomhghleacaithe faoin mholadh atá déanta ag an Teachta go laghdófaí an tuarastal atá ar fáil do dhaoine laistigh den Teach go dtí leath den méid atá ann anois.

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