Louise O'Reilly (Dublin Fingal, Sinn Fein) | Oireachtas source

I would like to refresh the Minister's memory by going back to August 2016 and another Fine Gael five-point plan, a five-point plan to tackle waiting lists. One might have thought the Minister would have learned his lesson as regards five-point plans but apparently not. One of the points in the plan was to make sure waiting lists were accurate and that there would be a clinical validation of waiting lists. After this week's revelations, nothing could be clearer than the fact that the waiting lists, as presented to us, are far from accurate. Was hiding these 49,000 people on waiting lists part of the Minister's clinical validation? Was the change in the classification used by the NTPF early this year part of this clinical validation? Can the Minister share with us the reason the protocol used by the NTPF from 2014 to 2017 was abruptly changed earlier this year, with no fanfare and no launch but a radical departure in how the to-come-in, TCI, patients are defined? I sincerely hope this change was not prompted by panic at the realisation that the waiting list figures reflected very badly on this Minister and his plans, five-point or whatever, to reduce waiting times.

The NTPF issued a statement after the "RTE Investigates" programme to the effect that, "in line with international best practices published waiting list data excludes patients classified as pre-admit and preplanned procedures". The preplanned procedures in this case are the TCIs. What is disturbing about this statement is that the protocol used by the NTPF, dated 2014 and in use up until a few weeks ago, provided for the publication of the TCI figures. International best practice does not change overnight and it certainly does not change to suit the agenda of a Government running scared from its own abysmal failures.

I am deeply disturbed about this. As the protocol dated 2014 has disappeared from the NTPF website, was it discredited? What international best practice caused the change? I sincerely hope this change in protocol was not decided on simply to put off any awkward questions. It seems to me that this protocol, and the reference to international best practice, magically appeared just as the figures waiting for treatment magically disappeared. This is not good enough and the Minister has to explain this fundamental shift in policy. Was it directed by his office? Was it directed by the HSE? Did the NTPF take it upon themselves? That is some classy validation process the Minister has going on there and we saw it effects on Monday night.

Rather than focusing on taking people off the lists who the Minister thinks should not be on them, he should ensure that the body into which he is pumping millions is transparent in its data collection and conforms to international best practice. Indeed, the Taoiseach made an important point on Tuesday during Leaders' Questions, when he said:

The list system is nothing new. It has been in place since 2002 and the counting of the list has always been the same. It is nothing new under this or any previous Minister in the 15 years since it was established.

10 o’clock

What he did not say is that there has been a fundamental change in what is published. This makes the scandal worse. The Government is still recording the figures. It is just being very creative with those it publishes so as to make its five-point plan look like it is working. Let us look at the reality behind the smokescreen. When we strip away the smoke and mirrors, we see that the numbers waiting longer than 18 months for inpatient day cases trebled between from 459 on 31 December 2015 to 1,738 on 30 December 2016. Every one of these figures is a real person.

The Minister has said he is ashamed they have been left waiting, and he should be. However, he should be more ashamed at his public congratulations of the HSE, which he was very quick to throw under a bus when it suited him. He should be ashamed at the manner in which the figures were manipulated. Yet Fianna Fáil retains its enthusiasm to pump vital public funds into this body, which has proven itself incapable of being honest with the data. Are we really back to a situation like that of the banks, investing public funds into something that is so out of touch with international best practice?

Deputy Billy Kelleher said the advent of new politics means things have to be done differently. However, it does not mean we pretend we have forgotten what Fianna Fáil did in government. We cannot forget that Fianna Fáil is very much a major part of the NTPF's past. It does not stop there. There have been initiatives before the Government's five-point plan. In 1993, under Deputy Brendan Howlin, the coalition Government established the waiting list initiative. In 2002, the NTPF was established. In 2011, then Deputy James Reilly oversaw the establishment of the special delivery unit, supposedly to reduce waiting times. What do all these have in common? Each one failed, as the Government's five-point plan has failed.

We need to get to the nub of the issue that perpetuates the waiting list and trolley crisis, namely, capacity, or the lack thereof, in our public system. Over a decade of pouring hundreds of millions of euro into the NTPF is proof that it does not address the underlying causes of the long waits for public patients in the first place. This week's revelations show that the waiting time for public patients, as articulated by the NTPF, have not been accurate. The Minister would be better off investing public funds in a new system, the digital solutions that are required to modernise our health service, than relying on the NTPF which has demonstrated that it cannot count or publish the figures accurately. Investment in developing capacity in the public health system would be much more beneficial in the long run.

Sinn Féin has proposed a new system of integrated hospital waiting list management, whereby people can move from one hospital to another to reduce waiting times. I very much look forward to meeting the Minister and considering our Comhliosta plan. However, I have to say it is regrettable that I have written to the Minister three times since August to ask for a meeting to discuss it. Now, following all the hoopla, we will have the meeting and it is to be welcomed. The Minister does not seem to be very interested in solutions. He seems to be very interested in spin, which is very regrettable.

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