James Bannon (Longford-Westmeath, Fine Gael)
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I thank the Ceann Comhairle for allowing me to raise this matter in regard to an urgently needed spinal procedure on behalf of a patient in my constituency of Longford Westmeath. The procedure is not available, due to under-resourcing of this sector in the hospital in question and the patient is suffering and deteriorating due to the excessive delay.

This case relates to a young person who has just started college and suffers from a spinal condition which is extremely debilitating. It is particularly difficult for a young girl to cope with a new academic routine while in extreme pain. There is also the physical appearance of such a condition, which gets harder and harder to disguise with clothing as the condition worsens.

According to the consultant in charge of her case, the capacity to provide surgery for patients is curtailed by the lack of resources directed towards this problem. In recent correspondence he says that he spent three years abroad training in this specialised area and is very conscious of the need for timely surgical treatment. He goes on to say that there are currently no dedicated resources for this kind of surgery. Unfortunately this means that patients suffer extreme pain and deterioration while they are waiting. He says that he and his colleagues have made multiple representations to the Department of Health and Children at all levels to try and improve this situation. Currently there are 102 patients awaiting spinal surgery on his list, with 35 of these for spinal fusion. I believe that the hospital has now sourced an additional consultant to perform day procedures, which should go some way to clearing the backlog, although day treatment is not applicable to the patient in question.

When cutbacks caused by Government mismanagement of the economy are set against the alleviation of pain, and the cutbacks win, then people suffer unduly. It is this Iack of consideration of the human element that is missing from our health services. The patient, who should be the prime focus of any health system, does not count.

The Minister recently admitted that 70% of the health budget goes into administrative salaries and just 30% is allotted for patient care. She then went on to say that the cutbacks in the forthcoming budget would be taken from that 30%. Then, to top off the disregard for the well-being of patients, a percentage of the health budget is returned unspent to the Exchequer each year. That is a farce.

I must ask the Minister to go back to the drawing board and work out who exactly is our health service for. As it stands, its primary function is to continue to pay for a top-heavy sector, with little money filtering down to the patient. The tales of horror, pain and sheer despair are mounting daily. This is morally and criminally wrong.

When patients in extreme pain and discomfort are given appointments with a waiting time of 18 months or more, the system is not meeting the needs of the sick and vulnerable. This is not acceptable, just as it is not acceptable to ask a young girl to wait for a year or more for essential surgery. What is particularly distressing is the hardening in attitudes towards the needs of patients, as civil servants take any measures necessary to make good the excesses of the Government, regardless of patient well-being.

When a country looks to its ill and vulnerable to make good its shortfall while the so-called elite continue to enjoy the good life, it is despicable. While he is apparently content to see patients die if necessary, I do not see the Taoiseach rushing to give up a half of his excessive salary. Why should the Taoiseach of a country in dire financial straits, for which he bears responsibility, be given the fourth highest salary of any prime minister or leader in the world? Is the IMF turning its attention to this necessary, indeed not negotiable, cutback?

In the meantime, while the fat cats are still lapping the cream, a young patient in my constituency of Longford Westmeath is suffering. I am asking the Minister to take this young patient out of pain and provide the surgery she so urgently needs.

Tony Killeen (Clare, Fianna Fail)
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I am responding on behalf of my colleague, Deputy Mary Harney, the Minister for Health and Children. While it would be inappropriate for me to comment on a particular case, the HSE has advised the Minister that the patient to whom the Deputy is referring in this instance attends Tallaght hospital. The patient is awaiting surgery under the care of one of their orthopaedic surgeons. Decisions on the clinical care of patients including appropriate surgery and the preferred timescales for such surgery are for the clinicians involved to make.

The HSE has written to the Deputy in regard to the waiting list of the surgeon involved in this case. The hospital has sourced another consultant to provide treatment for patients awaiting day surgery under this particular orthopaedic surgeon's care. The hospital intends to ensure that the day case list will be cleared by the end of the year. Tallaght hospital provides a trauma and elective orthopaedic service for a large catchment area with approximately 500,000 people. Some 70% of inpatients referred for elective orthopaedic surgery are referred from the hospital's outpatient clinics. A further 15% are referred from Naas General Hospital's outpatient clinics and another 15% from St. James's Hospital clinics. Tallaght has two theatres and 22 beds for the provision of the elective service.

In April 2010, the hospital's executive team approved a bed ring-fencing and waiting list initiative proposed by the hospital's peri-operative directorate. Since then, the number of patients waiting more than 12 months has been reduced by almost 70%. In addition, the number of patients waiting between six and 12 months has been reduced by 41%. The waiting list initiative includes a focus on improved efficiencies within the use of elective orthopaedic theatre and inpatient beds. There has been an increase in theatre utilisation of up to 49% and a similar increase in elective orthopaedic admissions. At present, almost one third of all surgery in the orthopaedic department is carried out on the day of admission. The length of stay of patients has been reduced by 8%. This initiative, along with other steps being taken by the hospital, will contribute to an increase in activity, a reduction in waiting times for treatment and improved outcomes for patients.

The recently published Tallaght hospital review, the Hayes report, identified difficulties in regard to orthopaedic services at Tallaght hospital and has made a number of recommendations in this regard. The HSE and the board of Tallaght hospital have undertaken to implement all the recommendations of the report. The Minister met Dr. Hayes on 8 November to discuss the implications of his report. She met the chairman of Tallaght hospital on 9 November and has also had discussions with the CEO of the HSE about the report. The main focus of these discussions is on what initiatives are needed both in the hospital and in the wider health system to provide sustained improvements in the services for patients. The Health Service Executive has assured the Minister that patients referred for treatment will be prioritised on the basis of clinical need.

The priority list is regularly updated. It is important that there be a co-ordinated approach to the management and treatment of patients in order that patients who require treatment can receive it as quickly as possible in the appropriate health care setting. The Minister has asked the Health Service Executive to address the issue as a matter of priority.

Bheinn sásta labhairt le mo chomhghleacaithe faoin mholadh atá déanta ag an Teachta go laghdófaí an tuarastal atá ar fáil do dhaoine laistigh den Teach go dtí leath den méid atá ann anois.