Dáil debates

Wednesday, 23 September 2015

Hospital Waiting Lists: Motion (Resumed) [Private Members]

 

7:45 pm

Photo of Jimmy DeenihanJimmy Deenihan (Kerry North-West Limerick, Fine Gael) | Oireachtas source

Last night my colleague, the Minister, Deputy Varadkar, updated the House on the range of measures being undertaken to address long waiting times and access issues in acute hospitals. He spoke of the almost 40,000 additional outpatient clinic appointments that have been provided to patients in 2015, of the 290 additional consultants who have been appointed since the Government took office, of how there now is the highest ever number of non-consultant hospital doctors, with 5,500 employed at present, as well as of the 122% increase in applications for nursing and midwifery registration this year. It was heartening last night to hear from both sides of the House the acknowledgement of the incredible hard work and dedication of those nurses, doctors, managers and allied health professionals. They are at the front line, interacting with patients and working to deliver a high-quality and safe service, often under major pressure. They combine the clinical expertise and the human interaction that are at the core of any health service. The Government must ensure that people are seen and treated in a timely fashion, whether in an emergency department or for scheduled care, that is, in a clinic or for elective surgery.

The priority being placed on this goal by the Government is shown clearly in the more than €140 million in additional funding that has been provided this year, of which €51 million has been provided to the HSE to focus on reducing long waiting times by optimising internal capacity and using targeted initiatives where necessary. This ensured that by June, waiting times had fallen below the maximum permissible waiting time of 18 months set by the Minister for 99.6% of inpatient and day case treatments, as well as 92% of outpatient appointments. It will also ensure that progress is maintained and that the HSE can continue to reduce waiting times to a maximum of 15 months by the end of the year. The additional funding of €74 million to alleviate the problem of delayed discharges has led to a steady reduction in the number of patients who are in hospital because there is a delay in putting in place arrangements for their personal care needs. From a high of 830 last December, the latest report indicates a current number of 584. The waiting time for the nursing home support scheme funding has been reduced from 11 weeks at the beginning of the year to between two and four weeks at present. These are major improvements, as I am sure Deputy Kelleher will acknowledge. The winter period will increase pressure on hospitals and they will need to gear up for it. That is why the Government is providing €17 million this year to open 300 additional beds and undertake other specific plans to improve patient flow. It also was evident from last night's debate that there is general agreement on the need to build up primary care and community services. Developments such as community intervention teams and the provision of care in patients' homes in order that they can avoid hospital admission or be discharged at the earliest opportunity are key, as is the provision of minor surgery by general practitioners, for which €500,000 has been provided by the Government in 2015.

Beyond the immediate issues, for long-term sustainability, full year-round demand and capacity planning must be established. It is crucial that this be supported by integrated working between hospitals and social and primary care services. In tandem, the national clinical programmes directorate of the HSE, which has successfully developed models of care for a wide range of medical conditions in collaboration with health professionals and patient representatives, is now turning its focus to integrated care programmes. These will provide the health service, for the first time, with the capability of designing clinically led, multidisciplinary, cross-sectoral, integrated models of care for older people, children, maternal health and chronic disease, as well as improving the flow of patients through the hospitals.

Emergency department overcrowding is not a new problem; nor are long waiting times. They certainly are not unique to Ireland. Moreover, they did not start when the present Government came to office. I recall speaking several times about waiting lists while on the opposite side of the House, so they always have been there. Now that the economy is recovering, we can afford to deal with some of these problems, and this year the Government has prioritised funding for them. I wish to conclude by assuring Members that the Government is making every effort to ensure sustainable improvements.

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