James Reilly (Dublin North, Fine Gael)

I welcome the opportunity to speak about the issue of colonoscopy waiting times. As has been widely reported, the most recent waiting list figures provided by the National Treatment Purchase Fund to the Irish Cancer Society show 2,418 people are waiting longer than three months for colonoscopy tests. I have no hesitation in saying that both the numbers waiting and the longer waiting times are unacceptable.

That is the reason the HSE has put in place a specific waiting list initiative to address this issue.

It is important to point out that colonoscopy tests are carried out to monitor a range of other conditions besides cancer, including bowel disorders such as Crohn's disease and inflammatory bowel disease. I would like to clarify that while more than 50,000 colonoscopies a year are carried out in our public hospital system, the vast majority of patients are diagnosed as not having cancer. In 2009, the HSE provided hospitals with national guidelines on managing colonoscopies. This included a definition to prioritise patients referred for colonoscopy services into two groups, urgent and non-urgent.

The target timeframe within which urgent cases must be seen is four weeks. I accept, as Deputy Higgins said, that there is no exact science in terms of identifying all urgent and non-urgent cases. The symptoms which make a situation urgent are well known and these should receive priority. That is the way it has to be. However, I do not accept this number of people should be on a waiting list for a colonoscopy, urgent or non-urgent. I will deal in a moment with how we are going to address that. The target timeframe within which urgent cases must be seen is four weeks.

Data on waiting times for urgent colonoscopies has been collected. The monthly performance reports from the HSE show that the vast majority of people requiring an urgent colonoscopy receive the procedure within the 28 day target. In the month of June, 98.1% of patients waiting for an urgent colonoscopy had the procedure within the 28 day target. Nationally, five patients were outside the 28 day target. This is a slight improvement on the May figure, when the rate was 97.8%, with 20 people outside the 28 day target. It is important to stress that the NTPF waiting list referred to by the Deputy does notinclude urgent cases which are assessed and deemed by a doctor as being at risk from cancer.

With regard to HSE waiting lists initiatives for routine colonoscopies, the figures from the NTPF show that more than 1,600 people are waiting three to six months and a total of 2,418 are waiting up to 12 months and longer for the procedure. As I mentioned earlier, the HSE has put in place a specific waiting list initiative which will see at least an additional 3,000 endoscopies, namely, colonoscopies and upper GI endoscopies, take place by the end of the year in hospitals where there are waiting lists. The aim of this initiative is to increase access to routine colonoscopies for patients. A second phase of this initiative will bring the total additional number of endoscopies to be undertaken to 7,000.

The initiative involves providing funding to around 20 hospitals which will allow additional procedures to be undertaken within a strict timeframe during 2011 in order to address current problems. It may involve referral of patients to a different HSE hospital in line with the NTPF approach. This approach has a number of benefits, including increased access for patients, reductions in waiting lists for hospitals and assisting candidate screening colonoscopy units in their preparation for participating in the national colorectal screening programme which is scheduled to commence in 2012.

HSE monthly performance data show that practically all of those referred for urgent colonoscopy are being seen with a 28-day time frame. In addition, in regard to waiting times for non-urgent colonoscopy, I welcome the HSE's specific targeted initiative to address these and to ensure that those referred are seen in a timely manner.

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