Seán Ó Fearghaíl (Kildare South, Fianna Fail)
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10. To ask the Minister for Health the reason for the increase, from August to September 2015, in the number of adult outpatients waiting longer than 18 months for an appointment in Naas General Hospital in County Kildare and in Tallaght Hospital in Dublin 24; and if he will make a statement on the matter. [36656/15]

Seán Ó Fearghaíl (Kildare South, Fianna Fail)
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This is a simple and straightforward question, focusing on the statistics available from the Minister's office which indicate that, in Tallaght Hospital and Naas General Hospital, the number of people waiting for outpatient appointments for more than 18 months increased quite dramatically between August and September of this year. The Minister worked for a while in Kildare so he will be appreciative of the importance of both these hospitals to the more than 200,000 people living in the county. We wonder why this problem is occurring and what the Minister is doing about it.

Leo Varadkar (Dublin West, Fine Gael)
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Improving timely access to care is a key priority for the Government which is why, in January, I put in place maximum permissible waiting times of 18 months by the end of June and 15 months by year-end for routine appointments. In June, the HSE reported a performance against the 18-month maximum waiting time for outpatients of 92%. In September, there was a slight increase in the number of patients waiting over 18 months for an outpatient appointment in both Naas and Tallaght hospitals. However, the overall number of patients on outpatient waiting lists in both hospitals actually fell during this period. Less than 1% of the total number of patients on the outpatient waiting lists in these two hospitals are waiting over 18 months, while almost 90% are waiting less than 12 months in Naas and 75% are waiting less than 12 months in Tallaght.

I want to assure the Deputy that the Dublin Midlands Hospital Group is actively engaging with the hospitals to support them in addressing capacity issues in specific specialties. Concerted efforts have been made to reduce outpatient waiting times nationally by facilitating additional clinics outside conventional working hours and outsourcing where capacity is limited. As an example of the volume of work which is ongoing at present, over 58,000 outpatient appointments are being provided in the next six weeks. Approximately 4,620 outpatient appointments are being provided by mid-November, specifically for those waiting 15 months and over. During that same period, almost 20,250 patients from the waiting lists will undergo an inpatient or day-case procedure or scope.

Seán Ó Fearghaíl (Kildare South, Fianna Fail)
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It is difficult to be reassured by the Minister's response. According to the statistics from August, 1,001 patients had been waiting for 18 months or longer in Tallaght. By September, that number had risen to 1,215, an increase of 21%. In August in Naas, just 12 people had been waiting for 18 months or longer. By September, that number had risen to 41, an increase of 241%. Why is this happening on the Minister's watch? In particular, why are there problems with urology, orthopaedics and dermatology in Tallaght hospital? Is it a staffing issue? Have we an inadequate number of specialists in place to deal with demand at these hospitals? Has the Minister identified where the problem lies and what will he do about it?

Leo Varadkar (Dublin West, Fine Gael)
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What has happened at Naas is similar to what has happened in other hospitals, in that there was a waiting list initiative to ensure that no one was waiting for longer than 18 months for a routine appointment. That initiative was delivered successfully in almost all hospitals across the State by July. By August and September, though, people had breached the 18-month period again. That is why additional finance has been provided to undertake the initiative again and to target in particular people who have been waiting for longer than 15 months for routine appointments.

I am not involved in the day-to-day management of Tallaght hospital. It is a statutory hospital with its own board and CEO. It is short a number of specialists and is experiencing difficulties with space for clinics and with capacity in general.

Seán Ó Fearghaíl (Kildare South, Fianna Fail)
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We know that the Minister is not personally responsible for the management of Tallaght hospital, but the situation there is a disgrace. Only University Hospital Galway had more people waiting in September and nearly one in ten people on the national list of those who have been waiting for 18 months or longer is in Tallaght. It is fine to comment on and identify these matters, but what the public wants is something to be done about them.

When discussing health, Deputies and politicians more generally often refer to millions of euro being spent, numbers of patients on waiting lists and percentages. The reality is that we are referring to human beings who, in many instances, are enduring suffering, pain and loss of participation in society and work because of these delays, which must be addressed as a matter of urgency.

Leo Varadkar (Dublin West, Fine Gael)
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The increase in the number of outpatients waiting for longer than 18 months at Tallaght is largely due to capacity pressures in certain specialties relating mainly to medical manpower pressures as a result of consultant retirements, maternity and sick leave and the inability to recruit locums into those positions. However, it should be noted that, overall, the 18-month target is being achieved and exceeded by the majority of medical and surgical specialties in the hospital. On 30 January, 4,082 people were waiting for 18 months or longer. By the end of September, this figure had decreased to 1,407. Continued efforts are being made to reduce that to zero by the end of the year.

Michael Kitt (Galway East, Fianna Fail)
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I will allow Deputy Lawlor to ask a brief supplementary question.

Anthony Lawlor (Kildare North, Fine Gael)
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It may assist Deputy Ó Fearghaíl. We are still awaiting the tendering process for the endoscopy unit at Naas General Hospital. Perhaps the Minister might write to me to let me know when that will start. The unit would help to reduce waiting lists at Tallaght as well as at Naas. Maybe we can get the tender documents out and the building work started as quickly as possible.

Will the Nursing and Midwifery Board of Ireland get more staff? That would ease staffing pressures, particularly at Naas General Hospital.

Leo Varadkar (Dublin West, Fine Gael)
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I do not have an update on the new phase of development of the endoscopy unit at Naas, but suffice it to say that the unit is included in the capital plan and we are keen to get it started and have works under way sooner rather than later.

Billy Kelleher (Cork North Central, Fianna Fail)
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Before the election anyway.

Leo Varadkar (Dublin West, Fine Gael)
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This is a matter on which I will follow up. The Deputy has a particular interest in it and has raised it with me many times.

Regarding the Nursing and Midwifery Board of Ireland, nine additional staff have been provided to accelerate the application process and a new call centre has been established, allowing staff to concentrate on processing the applications instead of having to take calls. The call centre seems to be working well. There has been a doubling in the number of nurses applying to register this year, which may surprise people who constantly hear the contrary narrative. The number of nurses seeking to register - those who are newly graduated, from overseas or returning to Ireland - has increased by 122%, which has put the board under a great deal of pressure.