Leo Varadkar (Dublin West, Fine Gael) | Oireachtas source

Long ago when I was involved in clinical practice, I used to take great pleasure in writing such letters to politicians, including to the former Taoiseach, one Bertie Ahern. I am pleased to see the practice has not been discontinued. I thank the Deputy for raising the issue and for giving me an opportunity to outline to the House the current position on it.

Cappagh National Orthopaedic Hospital is a major elective orthopaedic facility which provides a national secondary and tertiary referral service for orthopaedic care for adults and children, including the national bone tumour surgical service. There has been a significant increase, 40%, in the number of referrals to Cappagh hospital this year. The level of increase has not been observed at other sites and the factors for the increase in referrals are being investigated.

I had the opportunity to meet representatives of Cappagh hospital yesterday, including the CEO, the chairman, the medical secretary and the medical director, and hear from them first-hand about the challenges faced by the hospital this year. The cumulative effect of a reduced orthopaedic revenue allocation, the cessation of National Treatment Purchase Fund, NTPF, funding and a reduction in private insurance income in 2014 has limited the surgical capability.

Cappagh hospital has a total of seven operating theatres. However, while there are sufficient consultant staff available to provide services to meet demand requirements, not all theatres have been in use in 2014. As the Deputy outlined, between two and four theatres have been in use. This is a factor of both the need to manage activity levels within the financial capability and the availability of suitably qualified theatre nursing staff.

In terms of access, urgent patients continue to be prioritised and Cappagh hospital has advised that owing to strict chronological booking policies, all patients attending the hospital are being offered dates for surgery based on their waiting time for surgery having due regard to clinical categorisation.

The HSE has been in active engagement with Cappagh hospital this year regarding its finances and to examine and agree options for optimising the available theatre resources and to ensure patients have timely access. The HSE recently facilitated €800,000 in additional funding to enable Cappagh hospital to treat 102 patients from the waiting list in Cavan General Hospital. This will also facilitate treatment for some additional Cappagh hospital patients. Funding has also been provided this year for 43 active rehabilitation beds at Cappagh and I understand this initiative has worked very well.

I have also been advised that, while challenges remain in relation to inpatient access targets, day case and outpatient 2014 target levels will be achieved this year. For 2015, I understand the HSE will continue to engage with the hospital regarding its budget and to explore mechanisms to ensure optimal use of resources, including theatre capacity, at the hospital within the overall resources available to the acute sector.

The Deputy will also be aware that Cappagh hospital is part of the Ireland East hospital group, which includes the Mater; St. Vincent's University Hospital; Midland Regional Hospital, Mullingar; St. Luke's Hospital, Kilkenny; Wexford General Hospital; National Maternity Hospital, Holles Street; Our Lady's Hospital, Navan; St Columcille's Hospital; St Michael's Hospital, Dún Laoghaire; and the Royal Victoria Eye and Ear Hospital.

I am confident there will be a structured integration of Cappagh hospital into the Ireland East hospital group in 2015 and that this will provide opportunities and support for Cappagh hospital in managing demand and delivering high quality, safe patient care in a cost-effective manner.

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