Michael Moynihan (Cork North West, Fianna Fail)
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7. To ask the Minister for Health the reason for the substantial increase between December 2015 and May 2016 in the number of outpatients waiting more than a year for a consultation in Cork University Hospital. [20984/16]

Michael Moynihan (Cork North West, Fianna Fail)
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I raise the question of the substantial increase in the number of outpatients awaiting a consultation in Cork University Hospital. Is the Minister aware of the explosion in waiting times for outpatients and what plans will he outline in that regard? I want to tease through what can be done to try to reduce those figures.

Simon Harris (Wicklow, Fine Gael)
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I thank the Deputy for introducing the question. I have been made aware by him that the number of patients waiting over a year for an outpatient appointment in Cork University Hospital has increased since the end of last year. However, these increases must be seen in the context of the overall increased demand for care and increased overall activity and productivity in our health system. In fact, it was brought to my attention only today that 13,500 more elective surgeries have been carried out in the Irish health system this year than was the case last year, so we are seeing increased demand, increased activity and more procedures. Nonetheless, it is a key challenge for us to ensure timely access to health services and I am assured by the hospital group that those patients whose clinical needs are most urgent are prioritised.

The Deputy will be aware that improving waiting times for scheduled care is a priority for the HSE, my Department and, indeed, for the whole of Government, as I outlined to the Deputy's colleague. A Programme for a Partnership Government recognises the need for a sustained commitment to improving waiting times, with a particular focus on those waiting longest. To that end, it commits to €15 million in funding for the NTPF for an initiative targeted at those waiting longest as part of a continued investment of €50 million per year to reduce waiting lists.

I believe the policy of effectively deactivating the NTPF was a mistake.

We are beginning to see the consequences of this in terms of not having a ready made vehicle that can intervene in some of the particularly difficult situations highlighted by Deputy Moynihan. This is why we need to get it back up and running and the Deputy's party and my party agree on this.

The HSE has established a scheduled care governance group to co-ordinate key initiatives to reduce waiting times and the number of patients awaiting treatment. The Department is engaging with the HSE on the development of an action plan, asking each hospital what more it can do to address waiting times, to be rolled out over the reminder of 2016. I am conscious of the fact that for the first time in years the director general of the HSE has stated he has enough funding to deliver the service plan in front of him. Hospitals will be instructed to develop and implement process improvement plans, focusing on improving chronological scheduling, clerical and administrative validation of waiting lists and the optimisation of existing capacity. I expect this targeted approach, as well as the additional funding we now have available, will be of help to CUH in addressing the current backlogs.

Michael Moynihan (Cork North West, Fianna Fail)
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The Minister is aware that last week serious life-saving surgery had to be cancelled as a result of the bed crisis at CUH. Everything is backed up. First consultations are backed up as are second consultations and when it comes to surgery, this is also backed up or stopped. Not only is this at Cork University Hospital but it is throughout the Cork region. In many instances, the waiting times for initial consultations have exploded. The Minister spoke about the head of the HSE stating there is enough funding. What is the Minister's thinking on getting to grips with the waiting lists for initial consultations? When a letter goes from a GP to a consultant seeking an appointment for whatever trauma or illness the patient has, what is the Department's direct plan of approach in conjunction with the HSE to ensure the patient is dealt with in a timely fashion?

Simon Harris (Wicklow, Fine Gael)
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I thank Deputy Moynihan who made me aware of the very difficult and serious case of somebody's surgery, which I have had investigated. The very honest answer to the question is that we have a health system which lost 12,000 staff during the years of economic recession in the country and we have put back 6,000 of 12,000 staff but we need not pat ourselves on the back because we need at least another 6,000 to get us back to where we were before the financial collapse. Continued investment in our public health service to ensure there is adequate capacity in terms of staffing numbers, consultant posts, as Deputy Moynihan's colleague mentioned, and front-line staff is absolutely the answer. This is in regard to the specific question about ensuring someone receives an initial consultation. If the person needs a procedure after this initial consultation, how do we make sure this can be done as quickly as possible? I do not think now should be the time for ideological debate. It needs to be a time for pragmatism. If we have a vehicle like the NTPF, which can assist and work alongside public hospitals, it can move along the backlog. I am absolutely committed to continuing to increase the number of front-line staff. This is why we are seeing some delays because we still need more front-line staff in our hospitals.

Michael Moynihan (Cork North West, Fianna Fail)
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The initial consultation is the subject of the question and any necessary follow-up treatment or surgery is as a consequence of this. Targets were set for waiting times by previous Ministers for Health. Are these targets somewhere in the clouds? Are they real or imaginary targets? Is the Minister for Health setting higher targets to try to clear the list? The initial answer to the question was about the seriousness of the referrals but many seriously ill people are awaiting referrals and initial consultations. The Minister should not be under any illusion that the most serious cases are getting to the front at the start because this is not the case.

Simon Harris (Wicklow, Fine Gael)
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According to NTPF data, 60% of patients wait for less than six months for the required outpatient appointment or inpatient day case procedure. At present, 91% of patients wait less than the maximum waiting time of 15 months for inpatient or day case procedures and 92% wait less than 15 months for outpatient appointments. We need to continue to do better but we need to not tie ourselves up in knots about targets. We need to recognise that particular hospitals have particular backlogs and examine what interventions can take place there on the ground with proper management. This is the idea of the action plan.

There is another piece to this, which is whether some of these procedures can take place outside of hospitals. An initiative we are carrying out is to ensure minor operations can be carried out by GPs in the primary care setting. At present, 24 GPs are participating in a programme which will see 10,000 minor operations redirected out of hospitals and back into primary care settings. Above and beyond this, there is also a diagnostic service, particularly with regard to ultrasounds, which is provided by GPs at ten sites nationally. There is a commitment in the programme for Government to support people in purchasing more diagnostic equipment to keep people out of hospitals and outpatient units in the first place and back in primary care.