James Reilly (Dublin North, Fine Gael) | Oireachtas source

We had a good debate in the other House yesterday and this area was touched on. I will rehearse some of the issues which were mentioned with regard to outpatient statistics. A total of 360,000 may seem an extraordinary figure and a daunting prospect but it should be put in context. Approximately 200,000 patients are treated in outpatient departments every month. Some of the issues are disturbing and unacceptable. There needs to be a change in practices and I have already spoken to the acting chief executive officer of the HSE. I refer to the practice of calling 35 people to attend at the same appointment time. This is to suit the system rather than to suit the client - the patient. In my view, this shows tremendous disdain and disrespect for citizens that their time is of no consequence. I wonder if we were to compute the cost in time lost from work for people, the figures could be quite staggering. I want appointments to be arranged in a more structured way that is respectful of people. Equally, this is a two-way street. I see no reason all hospitals cannot institute a system which is used in some hospitals, a system for texting the people on the list a couple of days before the appointment date to ascertain if they will be attending. If a person does not attend, having confirmed the appointment, I am prepared to discuss the prospect - even in the House - of a €20 charge for the next appointment.

The situation can be improved by ensuring that the right person is seen by the right professional. A survey carried out in England was also done in Cork - in Deputy Kelleher's constituency. The physiotherapists screened the orthopaedic referrals from general practitioners and they found that in nearly 50% of cases the physiotherapist was able to deal with the complaint. In fairness to GPs, that could mean a couple of things. It is also the case with regard to psychiatry. The GPs cannot access the service of a physiotherapist for their public patients and the only way to access the service is by sending the patient to the orthopaedic clinic, which seems a very fruitless waste of everyone's time, including the patient's time. Similarly, a depressed person may require counselling but this is not available for a GP's public patients so they are referred to the psychiatric clinic. This is very inconvenient for patients and very costly for the system.

There are many actions we intend to take to address this problem. While I am deeply unhappy with the level, for the first time now - as I said in the Seanad yesterday - we are now driving with headlights and we can see where we are going. We can see the size of the problem and we can start to address it. I will undertake to the House and to my colleague opposite that we will keep everyone informed as to progress. We will not be afraid to talk about this. We will make a target and I will expect to meet it. I will expect Deputy Kelleher to castigate me if I do not meet it but it is better to have a target which is open and transparent so that everyone can aspire to it as opposed to not knowing what is the problem and therefore not know how to deal with it.

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