Seán Ó Fearghaíl (Kildare South, Fianna Fail)
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I am grateful for the selection of this important issue for discussion. Deputy Connaughton raised a point earlier which was graciously accepted by the Minister of State and which is important to put on the record. This Topical Issue debate has become an important part of the minimalist Dáil reform we have seen. The Whips and members of the Committee on Procedure and Privileges have expressed concern in recent times that Ministers do not appear to deal with the issues. I agree this is an exceptional week - the Cabinet benches have become like the deck of the Mary Celeste as the week has gone on - and that it is appropriate for Ministers to be out of the country this week. However, I hope what we have seen happen in recent weeks does not become a trend.

We learned yesterday that Dublin's Tallaght Hospital has a backlog of approximately 6,000 reports on X-rays and other scans, reports that have yet to be provided to doctors who referred patients for checks. The problem relates to delays in typing these radiological reports.

These cases involve X-rays, CT scans, MRI scans and ultrasound scans that have been read by specialists. The results have been dictated onto tapes but they have not been circulated to the referring medical practitioners. The excellent CEO of the hospital, Eilish Hardiman, has said that no risk to patient safety arises from these delays. She has said that when the standard turnaround time is taken into account, the current delay in typing up reports is two or three weeks. We discovered yesterday that an internal memo circulated in the hospital's radiology department warned that the backlog might put patients at continued medical risk as a result of the failure to transmit findings to the referring doctors. Furthermore, the memo claims that this problem was highlighted to senior hospital management up to four months ago, but attempts to tackle the backlog did not succeed.

As we know, this is sadly not the first time there has been a controversy regarding X-rays at Tallaght Hospital. An independent report was produced after it was discovered in 2009 that 57,000 X-rays had not been read and thousands of referral letters had not been opened. Following the publication of the report, we were assured that problems of this nature would not recur. It appears fairly evident to me that difficulties are arising at the hospital as a result of chronic staff shortages. When health service issues are debated, the importance of front-line staff is often mentioned because it cannot be questioned. However, derisory comments are often made about those who work in the administrative and clerical departments of our hospitals. This controversy should remind us how important it is to provide the necessary level of support staff, including administrators and clerical assistants. This appears to be a difficulty at present. I hope the Minister, Deputy Reilly, having waxed lyrical on previous crises in this hospital, will turn his attention to this crisis with a view to finding a resolution as a matter of considerable urgency.

Seán Sherlock (Cork East, Labour)
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I thank the Deputy for raising the issue of the typing and issuing of transcripts of X-ray reports. I am responding on behalf of the Minister for Health. It is important to assure people attending the radiology unit at Tallaght Hospital that there is no risk to patient safety. Urgent and prioritised reports in the emergency department and the paediatric radiology unit are produced within 24 hours. Tallaght Hospital has in place a documented clinical governance process for radiologists, the doctors who examine x-rays. Urgent cases and cases in need of time-sensitive clinical decisions are flagged in advance by clinicians for immediate reporting. Critical or urgent findings are immediately brought to the attention of the referring doctors and the clerical staff who transcribe and send the report immediately.

An average of 15,000 reports are typed at Tallaght Hospital each month. Standard non-urgent reports are usually produced within two or three weeks. The number of reports that need to be typed has increased due to initiatives to improve access to imaging. More patients are receiving radiography examinations in Tallaght because of higher productivity and better facilities. For example, a second CT scanner was opened in December 2012. An initiative with Naas General Hospital reduced the MRI waiting list by 16% in 16 weeks. Some 6,000 examinations, or 3.5% of the annual total of 172,000, are currently untyped. Some 3,000 of these untyped reports relate to patients who attended routine outpatient imaging. They have been reported through an initiative with additional consultant resources. The remaining untyped examinations date from 12 February last to the current day. As the standard turnaround time for routine reports is two to three weeks, these tapes are currently delayed by a further two or three weeks.

The radiology department, the diagnostic directorate and the executive team are taking a number of steps to address this issue. Additional clerical support is being provided in the radiology unit to assist with the typing of tapes. It is intended that the backlog will be cleared in approximately five weeks. The hospital has initiated demand management protocols within national guidelines to avoid the need for reports on specific images such as orthopaedics. An integrated voice recognition system that was piloted last year will be introduced from early April. This will eliminate the need to type transcripts for approximately 65% of the radiology workload. It is expected that voice recognition for all reporting in Tallaght will be fully implemented by the first quarter of 2014 as part of the roll-out of the national integrated medical imaging system. This will eliminate the need to transcribe radiology reports.

Seán Ó Fearghaíl (Kildare South, Fianna Fail)
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I welcome much of the positive content in the Minister of State's reply. I reiterate that an internal memo in the radiology department has pointed to the possibility of some medical risk. We are all committed to ensuring medical risk is reduced in all circumstances. I am sure the Minister of State shares that commitment. Aside from the issue of medical risk, it must be pointed out that delays of two, three, four or five weeks also place considerable pressure on patients awaiting the results of MRI scans or X-rays. This problem has many repercussions from a human point of view. It is symptomatic of the larger staffing problem in Tallaght Hospital, particularly in the accident and emergency department. My attention was brought to this matter at the weekend when I met a friend who works as a nurse in the hospital. I ask the Minister of State to highlight this issue with his colleagues at Minister of State level and with the Minister for Health. The accident and emergency department in Tallaght Hospital is facing inordinate staffing pressure. Nursing staff, in particular, are working up to 80 hours a week because they are under intense pressure to work extraordinary levels of overtime to ensure the necessary services are provided. This issue must be of concern to everyone in this House. I am sure it is of concern to management personnel at the hospital, whom I salute for doing their best in difficult circumstances. I hope the Minister of State will take up this matter with the Minister for Health.

Seán Sherlock (Cork East, Labour)
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I will do so. I acknowledge everything that has been said.