Catherine Murphy (Kildare North, Independent)
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I have submitted this Topical Issue seven or eight times before now, so I am pleased that it was selected for today's debate. Like Deputy Shortall, I had hoped that the relevant Minister would have been here. Nonetheless, I hope that the points I wish to make will be brought to the attention of the Minister for Health.

I will cite the example of one child because there is a disproportionately young population in my constituency, as the Acting Chairman, Deputy Wall, will know. It may not be that the same situation pertains throughout the country. It may well be different elsewhere, but my experience is that parents seeking an ear, nose and throat specialist for their children are experiencing considerable delays.

The example concerns a child who is about to enter secondary school in September this year. She is routinely on antibiotics and painkillers because of a chronic problem with tonsils and her sleep has been badly affected. Because her tonsils are enlarged there is a major restriction in her airways which is contributing to sleeplessness. She has lost weight and is very pale. I have met the youngster and it is appalling to talk to a 12 year old about such health problems. It is pretty grim to reach that stage.

In September 2012, this child was referred by the family's GP to an ear, nose and throat consultant in Tallaght Hospital, but was told that it would be 18 months before she would get an appointment. Her GP was then asked to refer her to another hospital and, in January 2013, she was referred to Crumlin Hospital. The latter hospital replied stating:

Thank you for your referral to the ENT department. Currently, the outpatients' waiting time is over two years for routine ENT appointments. [That is not for the operation but for a routine appointment]. Accordingly, we are not in a position to accept your referral at this time. We suggest that you consider referring the patient to an alternative service.

Other parents have spoken to me about raising loans and trying to get treatment done privately because they find the delay unacceptable. Someone else told me that the size of the tonsils was impacting on a child's ability to form words and is, consequently, in a queue for speech therapy that they may not need.

I raised this matter in March by way of a parliamentary question. I have highlighted the case of one child but a lot more children are affected. I also raised the overuse of antibiotics. If tonsillitis is left untreated it can lead to serious complications, including heart problems in the most extreme circumstances. I am hoping to hear not only that there will be a move to reduce the delays for routine appointments, but also for the procedures to be carried out. It is unacceptable to see children awaiting fairly minor procedures to give them a better quality of life. I have experienced this problem in a number of hospitals, including Crumlin and Tallaght, which suggests that there is a serious difficulty with waiting lists for this particular discipline. I hope the Minister of State will provide me with some comfort in his response.

Dinny McGinley (Donegal South West, Fine Gael)
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I am answering this matter on behalf of the Minister who is unavoidably absent. I thank the Deputy for raising the issue of waiting lists for ear, nose and throat specialist consultations.

As the Deputy is aware, improving access to outpatient services is a key priority for the Government. Tackling outpatient waiting lists is the next priority for the special delivery unit established by the Minister for Health in 2011 to unblock access to our acute hospitals.

In 2012, building on work already undertaken by the Health Service Executive and the National Treatment Purchase Fund a national project was initiated to compile, for the first time, an outpatient waiting list database based on patient-level information from individual hospitals.

For the first time, clear data on the OPD waiting list is now being reported. The waiting list for outpatients is updated monthly and is available on www.ntpt.ie. The data show numbers waiting over the various time bands for a first appointment at a consultant-led clinic. In a further enhancement of the reporting, future updates will, for the first time, include numbers reported by specialty, including ENT, in addition to the breakdown by hospital. However, that data is not yet available.

The outpatient waiting list number currently reported, as of 28 March 2013, is 384,632 - slightly lower than the January figure. The data also show that more than half of people on the list are waiting less than six months and almost 75% are waiting less than 12 months.

For 2013, a maximum waiting time target has been set of 12 months for a first-time outpatient appointment and this is reflected in the HSE service plan. This will apply to all patients, including those waiting for ear, nose and throat consultations.

The collation and analysis of outpatient waiting time data in a standardised format, allow resources to be targeted towards those patients who are waiting longest and ensure that they are seen and assessed. Currently, the focus is on hospitals continuing the validation of waiting lists. All hospitals have been engaged in this process which is anticipated to be complete by mid-May 2013. At that point, the SDU will have a better view of the profile of long waiters in terms of their numbers, geographical and specialty distribution.

In parallel with reducing the numbers of longest waiters, an outpatient reform programme is under way with the special delivery unit, the HSE outpatient reform team and the HSE clinical programmes. This overarching programme is examining the structure and operation of outpatient clinics to ensure the right patient is seen and assessed by the right health professional at the right time. Implementation of this programme will ensure a sustainable low-wait environment for outpatient services and prevent the build-up of long waiters. As stated in the strategic framework document, Future Health, one of the key goals of hospital reform is to deliver more responsive and equitable access to vital services for all patients and a key action is the reduction of waiting times. The Government is determined to deliver on this goal.

Catherine Murphy (Kildare North, Independent)
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I would like to meet the person who replied in that way. I will not give that reply to the parents of that 12-year-old child or a few others who have approached me about their children because, to be perfectly honest, this is an academic response. I seek a strategic response and do not simply wish to raise the issue of a single child. I have been approached by several parents whose children are seeking ear, nose and throat, ENT, appointments and I used one child to portray the predominant picture. The Minister of State informed me that a certain number are waiting less than six months and 75% are waiting less than 12 months. However, I read out a letter to him and informed him this child has been told by Our Lady's Children's Hospital, Crumlin, to go somewhere else because it has a two-year waiting list for an ENT appointment. There is no point in telling me about the special delivery unit or the National Treatment Purchase Fund because, essentially, this child cannot even be seen in order to get onto a list. Can the Minister of State express my dissatisfaction to the Minister with regard to this response, which really does not address the issue at all with regard to ENT? There is a crisis here for youngsters who cannot get even an appointment and cannot get a fairly minor procedure that would give them a better quality of life, such as having their tonsils removed. I have to hand a letter from Crumlin hospital stating the child cannot get even an appointment because there is a two-year waiting list and telling the general practitioner to find another hospital that might put the child on its list. This simply is not acceptable and that response is just Civil Service-speak, because it does not match the reality of the topic on which I have asked this question. I am deeply unhappy with the response. I will forward to the Minister for Health the letter that was sent to the parent because it outlines very well the deficiency.

Dinny McGinley (Donegal South West, Fine Gael)
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I appreciate the Deputy's concern for her constituent and any Member would be concerned for such a case. In this case, I ask the Deputy to furnish the details of the case to the Minister in order that it can be investigated. However, I can only go on the information that has been collected and presented to me, which indicates that more than half the people now are on waiting lists for less than six months and that almost 75% are waiting for less than 12 months. I do not suggest there is not an exception to the case and if what the Deputy has outlined is accurate, there may be an exception to the case. Were she to furnish the details, I certainly would have the matter investigated, no problem.

Catherine Murphy (Kildare North, Independent)
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I raised this as a general issue. While I used that child as a specific example, this is a general issue. She has been turned down and cannot be seen for two years but she is not the only one on the waiting list. I will provide the information to the Minister of State.

Dinny McGinley (Donegal South West, Fine Gael)
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If the Deputy gives me the details, I will see what can be done.