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

I thank the Deputy for the opportunity to outline the concerted actions being taken to reduce waiting times, nationally and in University Hospital Waterford. I recognise fully that too many patients are waiting too long for treatments and that this needs to change but reducing wait times is not that simple. If it was simple, it would have been done by now. As the Deputy will be aware, it is not long ago that his own party leader promised in office to abolish waiting times altogether, but that was not done.

However, I can assure the House that reducing waiting times is a key priority for this Government and much work is underway. Structural change in the organisation of our hospital sector, which is currently underway, will improve quality and access. Hospital groups will help us to better manage patient flow and patient demand. The reality is, however, that the major changes underway will take some time to implement and further time to show results. In the meantime, we must address the significant pressures on hospitals, including pressures on waiting times for inpatient and day-case treatments and for outpatient appointments. The HSE has specific measures in place to manage waiting lists more efficiently. These include the national waiting list protocol, the national clinical programme guidelines, prioritising day-of-surgery admission over inpatient surgery and the validating of inpatient waiting lists. Regarding this last measure, many waiting list entries are duplicates or relate to people who have since gone private.

I want to drive improvements in waiting times and ensure that we make maximum use of all available resources. Taking into account current pressures on acute hospitals, I have set a maximum permissible waiting time such that by the end of this month, nobody should wait more than 18 months for treatment or an outpatient appointment. By year end, that outer limit will be 15 months. This will be achieved in all but a small number of specialties in which there is a shortage of adequately trained staff which we cannot resolve. The HSE is focused on delivering this objective through maximising capacity across hospital groups. However, there are key limiting factors, primarily theatre nursing staff and consultant numbers in particular specialties. Consequently, some outsourcing to private hospitals is required, which is being managed through a public tendering process.

For my own part, I believe that new pathways to improve patient flow, such as medical assessment and local injury units, urgent care centres and non-hospital settings, can and must be used to provide a range of care to support the efficient use of hospital resources. There is significant potential to further improve hospital performance and efficiency. We must achieve the highest levels of efficiency ahead of providing new resources. The Irish hospital redesign programme is working with clinical programmes to support local change and innovation and raise national standards through internationally recognised redesign and improvement methods. I welcome this initiative. It is now advanced in Tallaght and Limerick is next on the list. At national level, the HSE's acute hospitals division is responsible for and manages hospital performance. Weekly meetings are held with the hospital groups to review performance against agreed clearance plans for treatment waiting lists and for outpatient appointments.

University Hospital Waterford is contributing to the South/South West Hospitals Group plan to reduce waiting times through additional outpatient clinics in all specialties. I am also advised that evening or weekend clinics are being held for ENT, orthopaedics, general surgery, vascular, neurology and urology. In terms of staffing, two consultant urologists have taken up posts this year and a temporary part time ENT consultant will begin at the end of June. Two much-needed consultant dermatologists are also expected to start in 2015 and a replacement consultant orthopaedic surgeon post is awaiting approval. My Department will continue to work with the HSE and hospital groups to ensure an appropriate focus and drive to improve hospital waiting times, including that in Waterford.

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