Seán Haughey (Dublin Bay North, Fianna Fail)
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6. To ask the Minister for Health when the upward trend in waiting list and waiting times will be reversed; and if he will make a statement on the matter. [13802/16]

Simon Harris (Wicklow, Fine Gael)
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I look forward to working with Deputy Kelleher in his role as his party's spokesperson on health, a role he has carried out for a number of years.

Improving access for patients is a key objective for our public health service. The 2016 HSE service plan undertakes to maintain 2015 levels of service in respect of scheduled care and to continue to address waiting times as part of the regular performance and accountability process. The HSE seeks to ensure that those whose clinical needs are most urgent are prioritised accordingly, while managing the needs of those who have been waiting longest for routine treatment in chronological order. Currently, 94% of patients wait less than the maximum waiting time of 15 months for inpatient, day case or outpatient procedures, with over 60% of patients waiting less than six months for their required care.

A scheduled care governance group has been established within the HSE to co-ordinate key initiatives to reduce waiting times and the number of patients awaiting treatment. Actions overseen by this group include driving greater adherence to chronological scheduling, relocation of low complexity surgical procedures to smaller hospitals and administrative and clinical validation procedures to ensure that patients are available for treatment. All too often, I have heard stories of people who have passed away remaining on a waiting list and the difficulty this has caused for their family and for the accuracy of the list.

Each hospital group has been mandated to designate a key person to lead and support waiting list management improvements so as to advance towards compliance with maximum waiting times. The National Treatment Purchase Fund supports the management of inpatient, day case and outpatient waiting lists, by working with the HSE to assist hospitals in developing local demand and capacity planning and providing technical guidance materials to ensure the highest standard of data quality and practice.

My Department is currently engaging with the NTPF and the HSE on a focused plan for endoscopy waiting lists in 2016. The programme for Government and the supply and confidence arrangement with Fianna Fáil contain a commitment to reactivate the NTPF and to provide €15 million in 2017 to address waiting lists. My Department will engage with the NTPF and the HSE in this regard.

Billy Kelleher (Cork North Central, Fianna Fail)
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It is a sad indictment of the situation that over the past number of years we have seen an escalation in the number of people waiting for inpatient day case treatments, with 74,000 plus now awaiting treatment. The waiting list for outpatient appointments has risen to 407,000 people. Over the past number of years there has been a due diligence process in place for assessing waiting numbers, so the lists are reasonably accurate. The previous Minister for Health set a target of 15 months, a less ambitious one than the Minister prior to him. Therefore, it is backwards we are going in terms of the adjudication of our success or failure in terms of our ambition. This issue must be addressed.

I understand the Minister has had a meeting in regard to the winter readiness programme and I acknowledge that at least the Department is preparing in time. One of the solutions to winter readiness is the cancellation of elective surgeries and scheduled treatments, but I do not believe this can be seen as a long-term sustainable solution to overcrowding in our emergency departments. The NTPF is in place and I hope it is used wisely and efficiently. However, the issue of the 407,000 people on the waiting list is a sad indictment on everybody, because these people are unsure of what is wrong with them until they get a proper diagnosis.

Simon Harris (Wicklow, Fine Gael)
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The Deputy has made a fair point in regard to the 15 month target. As I said earlier, some 94% of patients are being seen within that 15 month target and 60% of patients are being seen within the six month period. However, we must continue to try to do better.

What we see here is a direct result of a period of difficult economic decisions, through the time Fine Gael was in government and during the time Fianna Fáil was in government before that. We are now in a different place, where we can now begin to reinvest in the health service, increase health budgets and increase the resources being made available to tackle the issues outlined. I am not afraid to admit it if I hear a good idea from somewhere else and I accept the NTPF was a model championed by the Deputy's party. I believe it has a role to play here and that it needs to be reactivated. We should all strive for investment in the public health service, but there is also a role for the NTPF in the effort to reduce waiting lists. I want to start a programme for endoscopy with the NTPF this year, to put at least €15 million into the NTPF for 2017 and to have discussion in this House about how best to target that in terms of the most difficult and acute types of treatment needed.

In regard to the winter initiative, the Deputy is correct that we must be very careful that the consequence of preparing for the emergency department situation does not distract from the waiting list situation. The best way to ensure that is to increase resources for the health service and increase recruitment and retention of front line staff.

Billy Kelleher (Cork North Central, Fianna Fail)
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As an aside, access to diagnostics is an important issue, particularly the issue of direct referrals by GPs into diagnostics. The reason we have such a build up of people on waiting lists currently is due to the inability to access diagnostics. We do not seem to be sweating the assets of public diagnostic services, which work on a five day week.

We should be imaginative and creative to change the rostering programme in order to make radiography and other diagnostic services available seven days per week. We should utilise the huge capital investment that has gone into this in recent years to ensure we have greater capacity in diagnostics in the public health system. It is a key area.

Simon Harris (Wicklow, Fine Gael)
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The Deputy is correct. I recently met some of the representatives of radiographers and I am aware that the latter are willing to do more within the public health service. We are exploring with the HSE the additional tasks they want to take on, which will lessen the burden on other parts of our health service. Where health service professionals put their hands up and say they are willing to do more and play a role, it is very important that the HSE responds positively.

We must ensure that diagnostics are available within the community where it is possible to do so in order that we might keep people out of acute hospitals. Sometimes we clap ourselves on the back too much for building a primary care centre when the real question we must ask is what is in the primary care centre. It cannot just be a fancy GP centre that has diagnostic equipment. There is a commitment in the programme for Government to look at how we can incentivise health care professionals to provide diagnostic equipment within the community so that primary care centres can provide real primary care.