Matt Shanahan (Waterford, Independent) | Oireachtas source

I note the Minister's announcement that he is proposing a task force to deal with waiting lists and that he has put in a funding request for a budget allocation of hundreds of millions of euro to pay for this multi-year plan. That is wonderful news. Again, we can find emergency money to outsource waiting lists, yet we cannot find the money to support expansion within our own hospital settings.

I will speak about the regional hospital of the south east, University Hospital Waterford, UHW, a model 4 hospital that is servicing a catchment of approximately 520,000 people. It is a hospital that continues to be the least resourced model 4 in the entire country. To put that in context, UHW, with its catchment of 520,000 potential patients, receives €194 million in annual funding. University Hospital Limerick, by contrast, has a catchment of 400,000 and receives annual budgets of €266 million. That is a €72 million budget deficit compared to a hospital providing exactly the same services and to a smaller number of patients. What is that additional €72 million paying for in Limerick? A portion of it is certainly paying for the additional 865 whole-time equivalent employee positions the hospital enjoys over the hospital employee number allocated to the south east and Waterford. I often hear Deputies in the House describing the funding deficits at University Hospital Limerick and if there are such deficits, and I am sure there are, what does that say about the treatment of the main regional hospital of the south east?

The Minister has long been aware of the extensive waiting lists that have been a feature of UHW's treatment landscape, record waiting lists nationally in cardiology, ophthalmology, endoscopy, elective trauma and colorectal surgery. The list goes on. In fact, national media reported last year that UHW waiting lists were ranked the third worst in the country. What has been the response of the Department of Health in the interim? Did it decide to revisit the budget issues or examine the efficiency metrics in terms of procedures completed per euro spent in this hospital, which ranks among the best in the country? Did the Government decide to provide additional funding and approve whole-time equivalent positions to consultant staffing, specialists in general nursing, radiography and lab technicians to build on the capital efficiency of this hospital? The answer is "No". The Minister did not do that and nor did the Department, the HSE or the South/South West Hospital Group. Instead, money was found from the National Treatment Purchase Fund, NTPF, to begin targeting south-east patients for treatment options in Cork and Dublin private hospitals. Most galling of all was the loss of the significant rescue provided to the cardiac service during the pandemic, where UPMC installed a new laboratory that gave a massive service to our hospital system. No sooner did the resumption of procedures happen in UHW than an NTPF contract was drawn up which bypassed the UPMC facility in favour of sending vulnerable cardiac patients more than 80 and 120 miles, respectively, to Dublin or Cork to have cardiac diagnostic procedures completed. Less than half the people selected on the list took up that option. That clearly shows medical management are totally out of touch with the needs of people to have these procedures in their own regional hospital where they regularly attend.

The issue of waiting lists has always been a component of poor capacity, staffing and recruitment issues, available theatre and diagnostic space, and the ability of patients to attend appointments. Many of these factors are solvable by increased health resourcing. This is the status that private hospital consultants must reach to remain commercially viable and that is why they, as opposed to public health systems, can offer a solution to low level elective procedures.

Many of the patients the new initiatives will target will just move from one waiting list to another. Having received one procedure,their care plan and management will likely still fall back on the regional hospital they attend. Money will not solve the waiting list problems but will only dampen down them for a number of months. The Minister's recent talk of looking at new elective hospitals in Cork, Dublin and Galway tells me that he is deciding to continue to give to those who already have much more and in so doing, he will continue to embed health inequity and waiting lists within our public health system.

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