Jan O'Sullivan (Limerick City, Labour) | Oireachtas source

We in the Labour Party are extremely concerned that the public has been misled about the true extent of those waiting for procedures in hospitals throughout the country. Having seen the programme on RTE, we saw the real-life situation for so many people who are on waiting lists. There is a need for an independent review to determine whether any deception in the compilation of waiting lists has taken place, or if there has been a deliberate attempt to mislead people regarding the official figures. The Minister must commission an independent review of how waiting lists are being compiled and audit the accuracy of the data being presented. An internal NTPF process is not good enough. For 14 years, the public and successive Governments, it appears, have had the wrong figures. People have lost faith in the accuracy of the figures and whether they can trust the health system when it reports how many people are awaiting procedures.

The practices the "RTE Investigates" programme uncovered, with people being placed on waiting lists at the wrong date and written to to confirm their ongoing need for a procedure shows how confidence in the waiting list system is at rock bottom for patients and the public. The "Living on the List" programme is a watershed moment for our health system and we must restore confidence in how figures are compiled. The only way to do it is with an independent review. This is separate from the actions needed to expand capacity in our health service and permanently reduce waiting lists. New hospitals are part of it.

On Tuesday evening, the Minister announced that the NTPF will audit practices in individual hospitals and that it will carry out a review of international best practice on waiting list data publication models. The Minister specifically said the NTPF, at the Minister's request, will audit the practices in each of the hospitals highlighted by the individual cases featured in the programme and will report to the Minister. The NTPF has informed the Minister that the way it classifies its waiting list has been the same since its inception in 2002 and follows international best practice. However, it has already commenced a review of international best practice on waiting list data publication models. It would be better if the Minister brought in an international expert to examine how the NTPF, the HSE and individual hospitals are compiling their figures and the systems in place for managing waiting lists. People are concerned that there is a lack of accountability in our health system and an independent review that would probe all aspects of the system is needed.

What "Living on the List" uncovered on Monday was traumatic and very upsetting. Anyone who saw the programme would have found it very upsetting for the individuals whom we saw struggling with pain every day, particularly the children. I was especially affected by the children who were curled up in pain on the couch at home unable to go to school. We should not tolerate it. In a country as well-off as ours, nobody should have to live with the uncertainty of knowing when they will be treated, and everything should be done to address the distress caused to families across Ireland.

The revelation of secret pre-admit and preplanned waiting lists have added further to the uncertainty as to what is happening in our hospitals and how many people are waiting to be treated. That is why we reiterate the need for an independent review of how waiting lists are compiled. It is about confidence, independence and ensuring the people can trust the information that will come from the independent review. Continually outsourcing problems to the private health service through the NTPF should not be used to let the HSE, the Department and the Minister off the hook. Increased funding for the NTPF alone may provide some short-term reduction in waiting lists, but it will not address the capacity problems in our hospitals nor will it improve the processes. While the extra €20 million extra allocated this year, rising to €55 million in 2018, will provide some relief, it is not a proper solution to the capacity issues in our health service.

Figures I have seen regarding the NTPF suggest that it is not cost-effective because, effectively, one is paying for treatment that should be done in a public hospital. We would be in favour of a single-tier public hospital system which treats people fairly. The fact that a person can get a cataract procedure done privately in several weeks but that he or she would be obliged to wait months if he or she goes public needs to be addressed. I accept that the Committee on the Future of Healthcare is getting on with its work but there is a need for a long-term strategy where people will be treated on the basis of need, not on the basis of the money in their pockets and where they will not have to wait months - even years - for treatment simply because they do not have the money to avail of private health care. That is a situation over which none of us can stand. We need to get to the bottom of this and implement a long-term financial plan. I wish the Committee on the Future of Healthcare well and hope it will give us solid proposals to which we can all sign up. That is the only way we are going to get a long-term solution to the kind of problems to which we are continually returning with the health service.

I welcome the fact that the HSE will present an action plan for scoliosis to the Minister by the end of February. I also welcome that the Minister made an announcement on this to the effect that the new theatre in Crumlin hospital will opened in April and that an orthopaedic post there will be filled by June. The cases that got to me on the recent "RTE Investigates" programme were of the young girls waiting for operations. The young girl from Limerick, particularly after seeing the X-ray of the curvature of her spine, should have had her operation, as should have the other young girl with a pin in her back. We must ensure this does not happen to the many other children who are on that list. The delay until June in respect of filling the orthopaedic post is long, particularly when one considers that this extra facility was provided a year ago. If one concrete action comes out of the RTE programme, it is that we should set a six-month deadline and fast-track treatment for the 200 and more children on the scoliosis waiting list. If we could do that, it would at least give the public some confidence we can solve these problems.

Alongside this, the emerging news of the €1 billion extra cost in respect of the national children's hospital must be explained. This adds further to the mounting financial crisis emerging in the health service. This is an issue which the Labour Party has highlighted in the past week. I am concerned that the costs coming down the line in the health service will distract from the need to help sick people. Resources must be better targeted. The contract for the children's hospital has been awarded at a cost of over 50% of the expected bill and an extra €200 million is going to be required to kit out the facility. It was reported on Tuesday that the €750 million of expected savings over the next several years from generic biological drugs will not materialise because brand name drugs continue to be prescribed. The HSE faces a bill for over €350 million in respect of the issue relating to consultants' contracts. On Sunday, it was revealed that transport could not be guaranteed for children awaiting liver and heart transplants. As Deputy O'Reilly said earlier, pay talks are set to get under way soon, not just for nurses but also for GPs and consultants.

Adding up all these figures shows that there are serious financial storms ahead for our health service which the Minister must address. He needs to explain why, in the space of two years, the projected cost of the children's hospital has increased by almost €350 million to €1 billion. This will have serious effects on other capital projects, including the national maternity hospital and new emergency departments.

The new emergency department in Limerick is due to open in May. However, we have been told that recruitment, kitting out and deep cleaning may cause delays. From the reply to a parliamentary question I submitted, I understand that an additional €1.4 million was allocated to facilitate the opening of the new emergency department this year. I tabled a further question regarding how much it would actually cost to open the emergency department in Limerick in May. However, that question was referred to the HSE and I have not yet received a reply to it. My concern is that the €1.4 million may not be enough to open the new emergency department in May. That department most certainly needs to be opened.

There is no funding for the national maternity strategy, which involves maternity hospitals in Dublin, Limerick and Cork. Answers are needed in respect of when the Minister knew about the increased costs for the children's hospital and what planning has been done to address that matter. It is incredible that the Department and the HSE are accepting cost increases of over 50% when the rate of inflation is practically zero. I hope the Committee on the Future of Health Care will offer real solutions because we certainly need them.

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