Louise O'Reilly (Dublin Fingal, Sinn Fein)
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41. To ask the Minister for Health the number of elective surgeries cancelled in each month to January 2017 inclusive; and if he will make a statement on the matter. [4549/17]

Louise O'Reilly (Dublin Fingal, Sinn Fein)
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My question is fairly self-explanatory. I do not need 30 seconds to introduce it.

Simon Harris (Wicklow, Fine Gael)
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I thank Deputy O'Reilly for giving me a chance to find the question and I thank the Leas-Cheann Comhairle for making sure we are all awake.

I thank Deputy O'Reilly for her question and fully acknowledge the distress and inconvenience for patients and their families when elective procedures are cancelled. Cancellation of elective procedures can occur for a variety of exceptional reasons, including because a bed or the clinical team is not available, the patient is unable to attend or because the patient may not be fit for surgery at the time.

Based on data provided by the National Treatment Purchase Fund, NTPF, collated from reports by hospitals, approximately 3,400 elective procedures, on average, are cancelled per month. In 2016 there were typically approximately 53,000 admissions to acute hospitals on a day case and inpatient basis per month.

Public hospitals need to plan, taking account of seasonal pressures and this is an area in which we need to get much better. The national emergency department escalation framework which was agreed with a number of representative bodies and management sets out procedures to be followed in hospitals during periods of high demand for emergency care to ensure that safe care is provided to all patients. The HSE intends to undertake a review of the escalation framework in the coming months to ensure its effectiveness. As the Deputy will know, part of that escalation framework is agreement that elective procedures will be cancelled.

Reducing waiting times for the longest waiting patients is one of this Government's key priorities. In December 2016, I granted approval to the NTPF to dedicate €5 million to a day case waiting list initiative with the aim of ensuring that no patient will be waiting more than 18 months for a day case procedure by 30 June 2017. In addition, the NTPF will be working closely with my Department and the HSE to agree an approach to the remaining 2017 allocation, as well as planning the approach for the significant increase in the allocation to address longest waiting times in 2018.

The HSE is also currently developing a 2017 waiting list action plan for inpatient and day case procedures and for outpatient appointments to ensure that no patient is waiting more than 15 months by the end of October for any such procedure or appointment.

I include a tabular statement setting out details of the number of elective surgeries cancelled from January 2016 to January 2017, broken down by month.

Louise O'Reilly (Dublin Fingal, Sinn Fein)
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I am sure the Minister is as aware as I am that the full capacity protocol was initiated in one particular hospital on over 80% of the days in question, with 50% being the average across our hospitals. One of the things that happens when the full capacity protocol is activated is that elective procedures are cancelled. One of the other things that happens is that the people who have had their elective surgery cancelled when the previous full capacity protocol was initiated find themselves entering the hospital by the only door open to them, namely the door of the accident and emergency department. We are caught in a cyclical trap. We have elective procedures being cancelled and the people involved have to wait and wait, often in chronic pain. One would have to feel for the bed managers because very often it falls to them to make the phone calls telling people that they will not be coming to hospital for their operations.

Traditionally, surgical day wards were used as a safety valve but that has now become more of a permanent arrangement. I do not see any plan to reduce these waiting lists.

Simon Harris (Wicklow, Fine Gael)
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There is a plan to reduce the waiting lists. I have outlined that plan and have also outlined the very specific target of getting the waiting times back to no longer than 15 months for outpatient, inpatient or day case appointments by the end of October. That is about as specific as I can be. The aim then is to enhance the target times further into 2018, recognising that we have €50 million allocated for waiting list initiatives in 2018 on top of the €20 million for this year. This will not all be done through the NTPF. It will involve the HSE developing its own waiting list plan - we have seen the progress it made in that regard last year - and the NTPF implementing its plan too.

As Deputy O'Reilly outlined, we have a system-wide escalation framework in place which has been agreed. The framework is aimed at making sure that when our acute hospitals experience overcrowding in their emergency departments appropriate measures are put in place. It is designed to support our hospital groups and community healthcare organisations, CHOs, in developing integrated escalation plans so that capacity and patient throughput is appropriately managed at a time of excess demand and the most acutely ill patients are seen. I take the point that it is an indication of the lack of adequate capacity. Indeed, it is the reason we need a bed capacity review, more beds and more staff within our health service. Bed capacity and recruitment are two key issues for the Department this year.

Louise O'Reilly (Dublin Fingal, Sinn Fein)
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The Minister could put the bed capacity review to music and sing it at this stage. We have not seen it yet but the Minister talks about it all of the time.

Simon Harris (Wicklow, Fine Gael)
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It is not done yet.

Louise O'Reilly (Dublin Fingal, Sinn Fein)
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The NTPF is just another sticking plaster in the Government's box of Band-Aid. It is not going to work. It has been proven not to work. I am not asking the Minister to take my word for it; Dr. Sara Burke will tell the Minister that it does not work and does not have any long-term impact. It only works in the short term. It might get the Minister a headline or two but that is about it.

It is regrettable that there is no plan to deal with this issue. There is nothing that will give people comfort while they are waiting. I spoke to a gentleman in Westmeath on Monday night who is waiting to have a hip replacement operation. I could see the pain etched into that man's face. His operation had been cancelled and he was given another date for April. He told me, however, that he has absolutely no faith that he will have his operation in April. The man can hardly walk. He is only one example of the hundreds of thousands of people right across the State who waiting for care.

Simon Harris (Wicklow, Fine Gael)
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There are far too many people waiting far too long for a procedure in Ireland. We all agree on that but what are we going to do about it? Just because Deputy O'Reilly keeps saying that I do not have a plan does not actually make it true. I have a plan. I have outlined that plan. It is funded to the tune of €20 million in 2017, with a further €50 million of funding for 2018. The Deputy might disagree with the plan or might not agree with the modality of it but I do have a plan. The Deputy can keep saying that I do not have a plan to reduce waiting list times. If she says it often enough it might even stick but it is not actually true. The plan is quite specific and it is going to reduce the length of time that people like the gentleman to whom Deputy O'Reilly referred are waiting in the Irish health service. Waiting times have become far too long in the health service. I concede that this is due to a lack of ring fenced, targeted investment in waiting list initiatives over a sustained period of time.

On the bed capacity review, the Deputy has not seen it because it is still underway. We will have a very clear ask, by the time of the mid-term capital review, in terms of how many additional beds we need in the health service. It is not as simple as-----

Louise O'Reilly (Dublin Fingal, Sinn Fein)
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What are the terms of reference of the review?

Simon Harris (Wicklow, Fine Gael)
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I intend to brief members of the Oireachtas Committee on Health, including Deputy O'Reilly, on the review in the coming weeks and I would welcome her input.

Pat Gallagher (Donegal, Fianna Fail)
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I am sorry to interrupt but I am trying to accommodate as many Deputies as possible. We will now move to Question No. 37. Deputy O'Reilly has been nominated to take other questions and I will get back to her. Deputy Thomas Byrne is next.