James Reilly (Dublin North, Fine Gael)
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Question 32: To ask the Minister for Health and Children the hospitals that are cutting back on services ahead of Christmas 2009 to balance the books; the nature of those services; and if she will make a statement on the matter. [45896/09]

Mary Harney (Dublin Mid West, Independent)
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Overall clinical activity in our acute hospitals is ahead of target by 3.4% and this pattern is likely to continue until the end of the year. When inpatient and day cases are combined, acute hospitals have treated 33,000 more patients to date in 2009 than during the same period in 2008. Outpatient activity is also 3% ahead of target.

Hospitals must deliver their services within budget and they are working intensively to ensure that they do so in 2009. However, the HSE has indicated hospitals will meet the full level of service promised in the service plan for 2009 and, in a number of cases, that they will exceed this target. Hospitals always scale back elective work towards the end of the year, especially in December. This reflects the preference of most patients not to be in hospital during the holiday period. The traditionally quieter time for elective work also gives hospitals an opportunity for refurbishment of wards, deep-cleaning and maintenance, while not disrupting services to patients. However, emergency and acute services such as the accident and emergency department, critical care, acute surgery, acute medicine, dialysis and obstetrics remain fully operational.

My priority is to ensure that all patients receive a quality service without delay. I am pleased that average waiting times published last week by the National Treatment Purchase Fund show a reduction in the average waiting time to just 2.4 months for all procedures. This contrasts with a situation where patients had to wait for between two and five years in some specialties a number of years ago. The number of acute inpatient beds open at any time will depend on varying circumstances, but the HSE has delivered on the service promised in its service plan for 2009 and average waiting times for elective procedures have fallen demonstrably. Hospitals are managing their budgets and levels of service well in this difficult economic situation.

James Reilly (Dublin North, Fine Gael)
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I hope the Minister is safe from the frog counting exercise, as she seems to have one in her throat. The question was very straightforward; it asked for details on hospitals cutting back services ahead of Christmas to balance the books and the nature of those services. The Minister made a statement on the matter, but she did not tell us the services that will be cut or the hospitals affected.

The National Treatment Purchase Fund, NTPF, figures of 2.4 months are much massaged. At present, to get on the NTPF waiting list in Tallaght, one must be waiting for a year, and to get on an orthopaedic waiting list in Tallaght, one must wait two and half years to see an orthopaedic surgeon. The Minister can massage the figures whatever way she wants but people are not fooled because they know how long they must wait for a service.

Yesterday, when I was in Tallaght, I walked through the accident and emergency unit. Every corridor was full of trolleys. I know that last week in Beaumont Hospital almost 50 people were waiting on trolleys. If the Minister does not mind, I would like her to give us a direct answer on what hospitals and services are being affected.

Mary Harney (Dublin Mid West, Independent)
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When Deputy Reilly was in Tallaght yesterday, I do not know whether he met the incoming chief executive officer designate, Professor Conlon. If he did, I am sure Professor Conlon made him aware of his plans, particularly, but not exclusively, with regard to orthopaedics. Tallaght Hospital has 11 orthopaedic surgeons, which is a large number by any standard for any hospital. The waiting times to see one of them are unacceptably high and I have discussed this matter with Professor Conlon. I have confidence that he will deal with the issue.

I do not accept what the Deputy stated about the National Treatment Purchase Fund. It has published figures for the first time in recent years and we have verifiable and accurate figures on waiting times which show that only 477 people wait more than 12 months for a procedure. As far as I am concerned, that is 477 too many, but it has reduced and the number was 27,000 at one point. One must acknowledge that there has been major success.

James Reilly (Dublin North, Fine Gael)
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They are massaging the figures.

Mary Harney (Dublin Mid West, Independent)
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They are not massaging the figures. They are accurate verifiable figures and I invite the Deputy to meet representatives of the National Treatment Purchase Fund or invite representatives to come before the Oireachtas Joint Committee on Health and Children to discuss the significant progress that has been made. At a meeting with the NTPF last week, I discussed whether a person should remain on a waiting list if he or she refuses an appointment for no good reason. That happens in many instances.

With regard to hospital activity, the key issue is that services are up on the service plan provision for 2009. I agree there are pressure points and major financial pressures, but we cannot give more money to any of the hospitals and they have to live within their budgets. This means hospitals must take whatever steps are necessary to live within that budget.

James Reilly (Dublin North, Fine Gael)
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I accept that hospitals must live within their budgets but I reiterate what I stated. An employee of the Houses was told she would have to be on the waiting list at Tallaght hospital for one year before the NTPF would accept her. That is a fact. Another man, who is 53 and has a painful knee, is awaiting an orthopaedic outpatient appointment but cannot get one for two and a half years. That is another irrefutable fact. I will not go through all of the anecdotes but it is very disconcerting that the Minister-----

Brendan Howlin (Wexford, Labour)
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A question, Deputy.

James Reilly (Dublin North, Fine Gael)
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The obvious question is how can the Minister tell us that patients are not being affected detrimentally when this is the reality.

Mary Harney (Dublin Mid West, Independent)
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I invite the Deputy to read the OECD publication today which shows the significant improvements we have made in Ireland in health, life expectancy and cancer treatment. It is an independent analysis which shows that, over the past decade, life expectancy has increased faster in Ireland than in any other EU country. Some of the cases the Deputy discussed had already been brought to my attention, which is why I discussed the matter with Professor Conlon. It is not acceptable when there are 11 orthopaedic surgeons in one hospital that someone must wait two and a half years for an outpatient appointment. It is not acceptable to me, to Professor Conlon or to the board of the hospital and the matter will be dealt with.