Enda Kenny (Mayo, Fine Gael)

Deputy Martin has raised a range of issues which are clearly of concern to the Government. Those issues relate to the structure of the health service and also to the way in which services are delivered to patients, either those in hospital or those who are unfortunate enough to be on waiting lists. I listened to a radio interview this morning with a paediatric professional from Our Lady's Children's Hospital, Crumlin. The individual in question made a very reasonable case and pointed out that what has happened in respect of adult waiting lists began in a small way and then just grew to unacceptable proportions. He made a very reasonable point to the effect that we should consider and deal with waiting lists relating to children. He also highlighted the fact that it is easier to deal with short-term illnesses, be they respiratory infections or whatever, that children contract than it is to deal with those which affect adults. The point he made is one which the special delivery unit and the Minister for Health will be anxious to examine. The proposition the individual in question put forward in the context of attempting to deal with this matter before it grows in the same way that the problem relating to adult waiting lists did should be given due consideration.

As Deputy Martin is aware, paediatric hospitals work together and take a unified approach. Children are obliged to await admission in personal cubicles or isolation rooms in circumstances where beds are not yet available. Those children who are admitted have access to the full range of specialist care when they are in emergency departments. I understand that the three Dublin hospitals work very closely together in order that children can, where necessary, be admitted very quickly. The hospitals have a single approach to bed capacity and a joint escalation plan is also in place. I also understand that the HSE's regional director of operations and its clinical director, Dr. Costigan, is covering the three hospitals and is arranging to meet representatives of the Irish Association of Emergency Medicine as soon as possible. The HSE has already started the roll-out of national paediatric clinical programmes under the lead of Professor Nicholson.

Deputy Martin referred to medical cards. I understand that matters in this regard have been alleviated to an extent in that medical cards will continue to be valid until people's applications have been dealt with, one way or the other. I have asked Deputies to highlight individual cases and I intend to visit the medical card section. The process relating to medical cards should not be operating in the way it is at present. I must stress, however, that in many cases the information submitted may not be clear or may be insufficient. The personnel who work in the medical card section are more than anxious to have the process streamlined in order that they can operate in a professional and very efficient manner. I hope we will be able to reach that point quite quickly.

The special delivery unit established by the Minister for Health is specifically focused on ensuring competency and reducing waiting lists and trolley times. It is also focused on dealing with cases where people have been waiting for over 12 months. I read reports in some newspapers in respect of people waiting four years for procedures relating to varicose veins and two years for orthopaedic assessment. I do not have evidence of this. Like the Minister, I would welcome details regarding the cases that are being highlighted in order that action might be taken in respect of them.

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