Thursday, 1 December 2016
Hospital Waiting Lists
The Government is committed to improving waiting times for patients. It is the waiting time rather than the headline figure that is the Deputy's focus, and it is an important point. While recognising that the demand for acute hospital services has increased the important issue for patients is how long they wait.
The latest National Treatment Purchase Fund, NTPF, inpatient and day case waiting list figures indicate that the total number of people on the waiting list for Tallaght Hospital is 4,415 and 92% of these, or 4,053 people, are waiting less than 18 months for their inpatient or day case appointment. The HSE has advised that most of the patients waiting over 18 months are orthopaedic and ENT patients and the hospital is working with the HSE to ensure that the majority of these patients will have their procedures scheduled or completed by year end.
In August, I asked the HSE to develop a waiting list action plan for 2016 to reduce by year end the number of patients waiting over 18 months on the inpatient and day case waiting list. Since then, approximately 6,500 patients have been removed nationally from the waiting list. Additional funding of €11.25 million has been allocated under the winter initiative to support patient treatment under this action plan. This has seen some people's procedures outsourced to other facilities when there is no capacity within a certain hospital.
Budget 2017 provides for the treatment of our longest-waiting patients. A sum of €20 million is being allocated to the NTPF in 2017, rising to €55 million in 2018. I met the chair and CEO of the NTPF last Tuesday and I have granted approval to its proposal which outlines the use of a first tranche of funding, in the region of €5 million, for an initiative focusing on day case procedures. I will shortly ask the HSE to develop a waiting list action plan for 2017 working collaboratively with the NTPF to address inpatient, day case and outpatient waiting times, including at Tallaght Hospital. We finally have ring-fenced funding for waiting list initiatives. Such funding was lacking in recent years.
I am grateful for the Minister's reply. We are in real danger of getting lost in statistics, but I welcome the figures and particularly the announcement concerning the National Treatment Purchase Fund. The Minister will accept that there were 4,415 were on the inpatient day case list for Tallaght Hospital in October. He will also accept that it was an increase of 1,732 or a whopping almost 65% - there is another statistic - in two and a half years. It is unacceptably high. Of these, over 350 have been waiting for more than 18 months and 612 are waiting a year to 18 months. Let us stop with the statistics for a moment, because the Minister will pile on the narrative in terms of the money and how many millions or thousands of euro he is putting into it and obviously the Opposition spokespeople will focus on the numbers. However, if we take it to an individual level, what does the Minister say to somebody who has been waiting 18 months, and is still waiting, for a treatment? In particular, will he make some type of connection between their wait and the role of the National Treatment Purchase Fund?
I would tell them that it is utterly unacceptable. That is the reason I believe the House is united in its view, and it is my view, that every cent we target on waiting lists must be focused on the longest waiters. Thankfully we are now spending specific money on waiting lists, be it the €20 million for the NTPF in 2017, the further €55 million earmarked for 2018 or the €11 million on the HSE waiting list action plan. These are statistics but they represent real money. There will always be waiting lists in every health service. The issue is when somebody is waiting for an unacceptably long period. The reason I was quoting statistics was that while the question referred to people waiting over 18 months I believed there was an onus on me to point out that 92% of people on the list in Tallaght are waiting less than 18 months. The 8% is 362 patients, to make that real. That is a long wait for people. The HSE has advised me that the majority of those patients are in the orthopaedic or ear, nose and throat, ENT, areas. The hospital is working with the HSE to ensure that the majority of these patients will have their procedures scheduled or completed before the year ends, so that number should drop significantly in Tallaght. The hospital is also in the process of recruiting additional orthopaedic and ENT consultants. These are tangible benefits that should help the Deputy's constituents who are waiting a long time.
The additional recruitment is welcome news. The Minister's party was not a great champion of the NTPF but there appears to be an acceptance that it has a role, particularly in the short to medium term. Will the Minister comment on a statement made by Mr. Tony O'Brien at a meeting of the Committee on the Future of Healthcare yesterday? He spoke of a 5% to 6% increase in presentations to emergency departments year on year and the impact this is having on the acute hospital system and, in particular, on the bed capacity currently available to carry out elective work. He appeared to be implying that we will be coping with emergency intake as opposed to standard intake into the near future. What is the Minister's view?
I see merit in the NTPF, regardless of past political debates. I acknowledge that the Deputy's party established it. If I was to be objective, in the past perhaps the NTPF cherry-picked patients somewhat, and the point the Deputy and I would agree on is that this time it must target those waiting the longest. That has to be the difference.
With regard to the increase in attendances and the impact it is having on bed capacity and the like, the attendances at emergency departments have increased by approximately 5% so far this year to date. It is a very significant extra capacity for our health service to develop. In other countries a number of those people would not be seen in an emergency department because services would be provided within the community.
That is why I genuinely believe the answer to this lies in a new general practitioner, GP, contract. It will be hard fought and not easily won. We are operating off a contract that is 44 years old and we will begin the engagement before the end of this year between GPs, the HSE and the Department of Health on what a new, modern fit-for-purpose GP contract would look like. The more people that we can treat in the community the fewer people will need to go the acute hospitals. That will free up the beds for the people who need to be in the acute hospitals. That is not a criticism of people attending emergency departments, as sometimes they have nowhere else to go, but we need to do more in the area of primary care.
I answered Deputy Kelleher's earlier question about the bed capacity review, which will give us an accurate view of what we need to do in regard to future bed capacity. It needs to examine bed capacity not only in the acute hospitals but across the health service and that will be done in time for the Government's mid-term capital review, which will take place in the middle of next year, so that we know what the ask of health is at that stage.