Mary Butler (Waterford, Fianna Fail) | Oireachtas source

I thank Deputies for the opportunity to speak to some of the key issues and to address some of the points made in the course of this debate. The 2022 waiting list action plan is delivering targeted investment of €350 million to get many more people treated as quickly as possible. At the same time, we are reforming and investing in our public health service to eradicate the gap between demand and permanent capacity. As the Minister, Deputy Stephen Donnelly, said earlier, we are not trying to reset to where we were before the pandemic, when our waiting lists were unacceptably high. We want to improve and transform access to elective care.

I am particularly pleased the plan provides for a dedicated €5.5 million to significantly reduce the number of children and young people under 18 waiting to avail of these vital services. This will build on the €4 million initiative that I launched last August to tackle these challenging waiting lists, which has since enabled more than 1,600 young people to avail of the primary care psychology service and access necessary supports.

The additional investment will enhance the capacity of primary care psychology services, placing them on a more sustainable footing over the longer term. This investment will allow recruitment of additional psychologists, psychology assistants and counsellors to provide supports to those who need them most, as early as possible. I have set a target of a further 3,300 children and young people to be seen by the service and removed from the waiting list as these new staff come onboard during 2022. I was also very pleased to secure the allocation under the plan of a further €1.3 million for counselling in primary care and €9.1 million to support priority community areas, including child and adolescent mental health services, autism and other areas.

All of the 45 actions outlined in our waiting list action plan will make a huge difference. We plan to bring the number of patients on active waiting lists to its lowest point in five years. We will also introduce maximum waiting time targets to ensure that many people who have already been waiting too long will finally receive their hospital procedure or initial assessment by the end of the year. We had 75,000 patients on active inpatient and day case waiting lists at the end of 2021. We aim to have treated all, or almost all, of those patients by the end of 2022.

While our targets are ambitious, we need to be honest about what is achievable in the coming months. Our waiting list crisis has been building up for very many years and there are no instant fixes. Our waiting lists are unacceptable but we will overcome this challenge too, and deliver immediate and long-lasting improvements for our healthcare professionals and patients of the future.

I am aware of the concerns raised around recruitment but we must be ambitious, and I will not apologise for that. We have funded the recruitment of 10,000 staff this year but it is a challenging recruitment environment. As the HSE chief executive outlined recently, it will be doing everything it can to achieve that. He also outlined that the HSE had 675 net recruits in January of this year, which is a good start. To ensure ambitious recruitment targets are being achieved to the greatest extent possible in 2022, the HSE has adopted various measures. This includes expanding international recruitment frameworks with specified targeted recruitment approaches; broadening domestic recruitment markets by working with the Department of Enterprise, Trade and Employment, education bodies and training boards; and improving the efficiency of the recruitment process by greater use of technology.

All units within our Department are now responsible for driving universal healthcare and Sláintecare reform while individual members of the Department’s management board at deputy secretary and assistant secretary level are directly pushing the Sláintecare Implementation Strategy and Action Plan 2021-2023. They are in turn reporting progress to the programme board.

I would like to highlight some other progress made in 2021 that is continuing at pace. In December last year, the Government approved our national elective ambulatory care strategy which will change the way in which scheduled procedures, surgeries, scans and outpatient services can be better arranged to ensure greater capacity in the future and help to address waiting lists. The development of scheduled procedure or outpatient capacity will be provided through dedicated, stand-alone elective hospitals in Cork, Galway and Dublin. These elective hospitals will provide coverage for 60% to 70% of the overall population, catering for up to 940,000 procedures annually, including 180,000 in Cork and 175,000 in Galway.

These new facilities will be of a size and scale to implement an elective care programme that will tackle waiting lists on a national basis. This means that the new facilities will be designed to maximise their capacity and in doing so will operate to cover as wide a catchment area as possible, extending beyond existing and future health areas. Subject to approval processes under the public spending code, detailed plans for these could be brought to Government before the end of June.

We are continuing to invest in new care pathways, new technologies and new ways of working. Our National Ambulance Service provides a good example. It successfully continued the development and implementation of alternative care pathways in 2021 with the aim of hospital avoidance and an improved use of healthcare resources. The total number of patients treated by these alternative care pathways was over 18,000 with 44% treated at home or in the community.

There has also been significant investment in enhancing community care and capacity to affect the shift from a hospital-centric model of care to delivering more care in the community. Approximately 20.46 million hours of home support were delivered in 2021 with over 55,000 people in receipt of the service by end December. This is about 2.9 million, or 17%, more hours compared with 2020 with increased funding maintained for 2022. I accept this is not without challenges around putting care services in place but we will continue to do our absolute best to encourage more healthcare workers into the sector.

The GP chronic disease management programme recently received a prestigious United Nations award for developing a structured illness and preventive care programme in general practice. Over 85% of GPs are registered with the programme which delivered close to 220,000 consultations in 2021. The GP direct access to diagnostics scheme resulted in over 138,000 radiology tests being accessed by GPs in the community with another 17,000 undertaken in January 2022 alone.

We have very many challenges in respect of access to healthcare. Sometimes, I fear we lose sight of some of the very real progress that is being made. This can be demoralising for staff. The last two years have seen record increases in staffing and bed numbers. This was no mean feat during a pandemic. The last two years have been very difficult for those working in healthcare. No group of workers has felt the burden of the pandemic more than our health and social care professionals. In spite of enormous challenges, our healthcare workers responded with determination and distinction. Our waiting lists are a challenge, and a big one, but we will overcome this challenge too and make long-lasting improvements for our healthcare workers and patients of the future.

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