Dáil debates

Thursday, 16 April 2015

10:10 am

Photo of Billy KelleherBilly Kelleher (Cork North Central, Fianna Fail)
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8. To ask the Minister for Health the waiting time targets for scheduled inpatient and day case treatment and outpatient consultant appointments; and if he will make a statement on the matter. [14650/15]

Photo of Billy KelleherBilly Kelleher (Cork North Central, Fianna Fail)
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Will the Minister make a statement on current waiting time targets for scheduled inpatient day case treatments and outpatient consultant appointments? Will he also clarify, once and for all, the issue of HSE health statistics and whether there is a certain massaging of figures? Are they all being published, as indicated in December 2014, when concerns were expressed that some people waiting for diagnostics were not being counted in hospitals?

Photo of Leo VaradkarLeo Varadkar (Minister, Department of Transport, Tourism and Sport; Dublin West, Fine Gael)
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Improving waiting lists for scheduled care is a key priority for me and the Government. Taking into account current pressures on acute hospital services, I have put in place a target that by mid-year nobody will wait more than 18 months for inpatient or day case treatment or an outpatient appointment, with a further reduction to a waiting time of no more than 15 months by year end. The existing targets are that no adult should have to wait longer than eight months and that no child should have to wait longer than 20 weeks for inpatient or day case treatment and that no patient should have to wait longer than 12 months for an outpatient appointment. However, these targets have not been met for many years. In order to bring about an improvement, I am starting with the longest waiters to reduce progressively the period beyond which nobody will wait. This is a realistic approach to achieving a much needed improvement, even while recognising that waiting times are considerably longer than international standards.

The HSE is working on an implementation plan to achieve these targets. This will involve both productivity improvements and rigorous waiting list management. Further increasing day surgery rates for specific procedures will be important in improving elective access within available capacity. Priority will be given to adherence to the guidelines on the scheduling of patients for surgery, including chronological scheduling, which will be monitored by the HSE throughout the year.

I do not believe there is any massaging of figures. If anything, I expect that there is quite a lot of double-counting on waiting lists and quite a number of people who have been referred to three consultants for the same thing or who have already received treatment privately but still appear on a waiting list.

If anything, the numbers are probably higher than the figures suggests.

One area that is not counted is the number of people waiting for diagnostics. Deputy Kelleher is correct in that sense. This is because the figures were not accurate. However, once the figures are accurate the HSE will start publishing them again.

10:20 am

Photo of Billy KelleherBilly Kelleher (Cork North Central, Fianna Fail)
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The Minister said that a row over statistics misses the point, but every statistic represents a person. There are 405,000 people waiting for outpatient appointments. That is a statistic, but it is an alarming statistic because there are 405,000 people involved. Clearly, the measures that the Minister is now outlining to achieve targets represents an admission that the targets set by the Government were not achievable and are not being achieved. Rather than addressing the problem the Minister is effectively moving the targets. As I said previously, it would be like Johnny Sexton kicking the ball wide from a penalty kick all the time while saying that the goalposts were in the wrong place. It is a farcical position. This is detailed spin at its best.

The Minister is setting new targets. He is setting targets that are way behind the targets in place previously. In other words, he is camouflaging the fact that the numbers of people waiting are going up. Not only that, the Minister has decided to shift the targets, for example, from nine to 18 months for some people. This is a complete admission of failure. Yet the Minister always applauds himself for the fact that he is being brave to set targets. The targets are in the wrong direction.

Photo of Leo VaradkarLeo Varadkar (Minister, Department of Transport, Tourism and Sport; Dublin West, Fine Gael)
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The figure of 400,000 people waiting for outpatient appointments probably involves a good deal of double counting. It includes people waiting to see a number of consultants for the same condition. Deputies should bear in mind that it also includes routine appointments and people who are waiting one week or perhaps two or three weeks for appointments. It is not that everyone in that figure is waiting six months, eight months, 12 months or anything like that. The numbers waiting 12 months for outpatient appointments is currently at approximately 77,000, which is a high level but it is certainly not the 400,000 figure that Deputy Kelleher is using.

The reality is that the targets that were set were not met and have not been met. I am trying to set realistic targets that can be met. Deputy Kelleher should bear in mind that Fianna Fáil, as a party, is led by a former Minister for Health who promised to abolish all waiting lists entirely within two years at a time when there was no limitation on spending, but he was unable to do it.

Photo of Billy KelleherBilly Kelleher (Cork North Central, Fianna Fail)
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The Minister promised to get rid of the HSE.

Photo of Leo VaradkarLeo Varadkar (Minister, Department of Transport, Tourism and Sport; Dublin West, Fine Gael)
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Inevitably in health any time we provide a new service, it generates a new waiting list. That is one of the paradoxes of health care. What we are trying to do is set minimum targets and minimum acceptable limits. Even they are going to be difficult to reach.

Photo of Billy KelleherBilly Kelleher (Cork North Central, Fianna Fail)
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This gets more disturbing as the Minister tries to explain it. Basically, the Minister is saying that the 405,000 figure is not a realistic figure in the first place and there may be double counting in it. However, there was double counting in the previous figure of 330,000. At the time we were told it would never climb any higher, that the issue could be addressed easily and that we were being alarmist in raising the matter as a challenge in the health services. The figure is now at 405,000 people. The Minister has decided to set targets that will alleviate the pressure on him and the HSE to deliver on in a timely fashion. That is what the Minister has done. He has gone from nine to 18 months. As sure as night follows day the Minister will be applauding himself and will say that the health service has nearly reached its target of 18 months, although the original target set was nine months.

The Minister should bear in mind that among outpatients, some 9,569 are waiting more than two years for an appointment. A total of 2,712 are waiting more than three years. That is where we are. I listened to all the glib talk of my party leader being a previous Minister for Health. Nevertheless, it is four years since the Government has been in office. Something needs to be done about this because it is creating serious pressure on individuals throughout the country.

Photo of Leo VaradkarLeo Varadkar (Minister, Department of Transport, Tourism and Sport; Dublin West, Fine Gael)
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I reiterate the fact that the figure of 400,000 includes people who are waiting for routine appointments for a few weeks. I am focusing on waiting times. When we talk to individual patients they talk about how long they have been waiting, not whether they are placed 1,647 on the list. They want to talk about how long they are waiting. That is why the target should be about waiting times. That is what I am focusing on.

Deputy Kelleher referred to people who are waiting over two years for an outpatient appointment. If I can get my plan through and if it is properly operational by the HSE, then all those people will be called for appointments in the next couple of months. It will be interesting to see how many of them have already had the appointment or have already seen a different consultant. We will see how many of those extremely long waiters recorded in our statistics, for example, those waiting over two years, have really been waiting over two years. That will become evident quite soon.