Richard Bruton (Dublin Bay North, Fine Gael) | Oireachtas source

I thank the Leas-Cheann Comhairle for the opportunity to raise this issue. It is going to become very important and it is absolutely critical that a coherent plan to address it is put in place. Just as much thought should be put into that plan as went into the Covid crisis. The truth is that the health service will face a backlog of treatment and people seeking treatment at a time when hospital staff are stressed out after a very difficult period. It is really important that the management goes into how this can be dealt with in a fair way.

The data speak for themselves. Inpatient numbers stand at 80,000. Surprisingly, that is only up 10,000 or 14%. Many people may have thought that, with two years of disruption, it would have increased by more. The number of outpatients is 630,000, an increase of 82,000, or 15%, compared with two years ago, before Covid struck. The numbers have got worse but are not as bad as people might think. However, if one looks beneath the numbers to see how many have been waiting more than a year, that is where the real rub comes. The number waiting more than a year for inpatient treatment is 24,000, comprising nearly one third of all those waiting. That number has more than doubled in the past two years. A similar picture is presented in the context of outpatients, with 284,000 waiting more than 12 months, an increase of 70%. They comprise very close to half of all those on those lists. There is no doubt that a new wave of people will soon have the confidence to go back and schedule treatments and appointments.

Overall, these numbers are manageable. Every year, 3 million outpatients are seen and, against that background, a figure of 600,000 is manageable. More than 1 million patients are discharged from hospitals and, in that context, a figure of 80,000 seems manageable. We know, however, that there will be a very mixed picture of various people, some of whose conditions will have deteriorated significantly. A risk-based approach to this will be needed. What planning is going into that?

We will need innovation in the way this is approached. For example, it would be good to have GP-supported reviews looking at critical indicators that would be presented to the lead consultants and their teams such that a review of the condition of various patients could effectively be done remotely. Remote consultation should be extended. It became a pattern when it was a necessity during the Covid crisis, but, as the saying goes, necessity is the mother of invention and we should make sure that remote consultations become embedded. They can be very effective in the context of some disciplines in circumstances where a procedure is not necessary and a face-to-face consultation is not always needed. Some of that face-to-face element could be carried out in GP surgeries and there could be more of a team approach to attacking this issue.

I would like to see the role of the National Treatment Purchase Fund, NTPF, integrated into such a plan. There is no doubt that during Covid it has not been using resources to the level it did previously, so it may have reserve budget. It would be very good to see it integrating into the approach.

I am calling for a planned, strategic approach to this issue, one which considers fairness and how to use the resources available in the way that is most efficient and innovative in order to avoid a build-up of people who feel the urgency of their cases has been overlooked by those managing the process.

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