Paul Kehoe (Wexford, Fine Gael) | Oireachtas source

I thank Deputy Ó Fearghaíl for raising this issue. I am replying on behalf of my colleague, Deputy Varadkar, who sends his apologies for being unable to be in the House this afternoon. He is otherwise engaged on Government business.

Under the Future Health plan, significant structural changes are envisaged for the acute hospital sector, with the formation of hospital groups and the reconfiguration of services to improve both quality and access. These major structural changes will take some time to implement and there remain significant operating pressures on acute hospitals, including waiting lists for inpatient and day case treatments and outpatient appointments. Reducing these waiting lists is a key priority for Government. Taking into account current pressures on acute hospital services, the Minister has put in place a target that by mid-year nobody will wait more than 18 months for treatment or an outpatient appointment; by year-end, that target will be revised to a wait time of no more than 15 months. When these targets were announced in February, there were 4,996 patients to be treated by the end of June 2015. As of 1 May, there are 3,508 patients requiring treatment by the end of June 2015 if the 18 month target is to be achieved, a reduction of almost 1,500.

It is acknowledged that the volume of the outpatient waiting list is far greater, principally due to consultant shortages in particular specialties and resource pressures on a small number of hospitals. The HSE has put in place specific measures to manage waiting lists more efficiently, including observation of the national waiting list protocol, adherence to relevant HSE national clinical programme guidelines, prioritising day-of-surgery admission where clinically appropriate and validation of inpatient waiting lists to establish and maintain a precise current position regarding the volume of people awaiting care. The monthly publication of hospital and speciality level waiting list information on the National Treatment Purchase Fund website is a welcome development, as is the HSE service plan commitment to the publication of waiting lists at consultant and speciality level.

I am advised that the acute hospitals division is meeting weekly with the hospital groups to review performance against agreed clearance plans for all treatment waiting lists. A similar process is in place for outpatient appointments, with the assistance in particular of the national clinical programmes for orthopaedics, rheumatology and surgery. New pathways of care to improve patient flow through hospitals, such as medical assessment units, local injury units and urgent care centres, as well as care provision in non-hospital settings, can and must be used to provide a spectrum of care which supports the efficient use of hospital resources.

Waiting list performance will be assessed within the revised accountability framework for the HSE, which requires formal performance management for hospitals to include access, quality, outcomes and financial performance. The work of the special delivery unit indicates that there is still significant potential to improve performance in hospitals. The hospital redesign programme is working with the national clinical programmes to support local change and innovation and raise national standards through the use of internationally recognised redesign and improvement methodologies.

Based on the emergency department task force's action plan and in view of experience to date, the Government is providing additional funds of €74 million, in addition to the €25 million provided in 2014, to address delayed discharges and support initiatives which improve timeliness for admissions from emergency departments and waiting lists. The Department of Health will continue to work with the HSE to ensure that all issues relating to hospital waiting lists are resolved.

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