Jim O'Callaghan (Dublin Bay South, Fianna Fail)
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19. To ask the Minister for Health the targets in place for reducing outpatient waiting times in St. Vincent’s University Hospital in 2017. [12113/17]

Jim O'Callaghan (Dublin Bay South, Fianna Fail)
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St. Vincent's University Hospital is in Elm Park in my constituency. I want to ask the Minister about the outpatient waiting lists there, which have exploded recently. What is the Minister's plan to deal with the waiting lists? Are there targets in place to ensure we get the waiting lists down to manageable proportions?

Simon Harris (Wicklow, Fine Gael)
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I thank Deputy O'Callaghan for this important question on outpatient times in St. Vincent's University Hospital specifically. I am absolutely committed to reducing waiting times for patients, both for patients waiting for inpatient or day case procedures and for outpatient appointments. During 2016, there has been evidence of a considerable increase in demand for health services as our population grows and ages. In order to reduce the numbers of long-waiting patients, the HSE is developing waiting list action plans in the area of inpatient, day case, scoliosis and outpatient services, which is the issue the Deputy has raised. Draft waiting list action plans for outpatients, inpatient, day case and scoliosis are with my Department, and it is reviewing these plans. Engagement is ongoing with the HSE and I expect to be able to publish them in the coming weeks.

In November 2016, the HSE launched the Strategy for the Design of Integrated Outpatient Services 2016-2020. The strategy seeks to improve waiting times for outpatient services in the long term by restructuring referral pathways and utilising technology to improve service delivery. The HSE has significantly progressed the development of a draft outpatient waiting list action plan. In the plan, the HSE will identify proposals to reduce the number of patients waiting long periods of time for outpatient appointments across all hospitals, including St. Vincent's University Hospital. A number of initiatives are in place in St. Vincent's hospital to address waiting times, including the introduction of virtual clinics and pooling of referrals, which means people are not referred to a specific consultant. The target is that no patient will wait longer than 15 months by the end of October. While it is still too long, it would constitute significant progress on current waiting times. I expect to make known the details of the outpatient waiting list action plan in the coming weeks.

Jim O'Callaghan (Dublin Bay South, Fianna Fail)
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It is important to put on the record of the Dáil the waiting lists for outpatients in St. Vincent's hospital. In January 2016, there was a total of 15,612 people on the outpatient waiting list. By January 2017, it had increased to 17,526. What is most significant about the figures is the increase in the amount of time and the number of people who have been waiting for 18 months or more. In January 2016, 19 patients on the outpatient waiting list had been waiting 18 months or longer. By January 2017, the figure had exploded to 491 people. Although the Minister has been in office for only ten months, his party has been in power for six years. The explosion in those figures, particularly for people who have been there longer than 18 months, needs to be explained and we need a plan in respect of it.

Simon Harris (Wicklow, Fine Gael)
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My office contacted St. Vincent's University Hospital specifically to ask what measures it will put in place to target the very specific outpatient waiting list to which the Deputy has referred. I have been informed that it is putting in place specialty-specific meetings with the specialties concerned to identify the issues. The "did not attend", DNA, rate is a serious issue in our health service and St. Vincent's hospital has established a task force to focus on reducing the DNA rate. Last year, 450,000 people did not attend scheduled hospital appointments and this has a significant burden in terms of time and cost on the Irish health service. It is anticipated that through the reduction in the number of DNAs and compliance with the one-strike national policy, the number of patients awaiting first appointment will be reduced.

The hospital has introduced a number of virtual clinics which have been a great success and have allowed specialties to increase the number of new appointments per clinic. This has assisted in reducing the new to review ratio within specialties. St. Vincent's hospital is leading in this way. The hospital has introduced urgent and routine new appointments in outpatient department clinic profiles, the pooling of referrals across a number of consultants, a project to review the discharge process and validation completed on a biannual basis to ensure the outpatient appointment list is valid. I will send the Deputy further details of these initiatives.

Jim O'Callaghan (Dublin Bay South, Fianna Fail)
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The fact that people are not attending hospital appointments does not explain the extraordinary figures, for instance in respect of cardiology, where 233 cardiology appointments have been outstanding for more than a year. It does not explain the situation regarding plastic surgery where 456 people have been waiting to be dealt with by plastic surgeons, which is an increase of 265 on last year. There are significant delays in respect of people seeking ear, nose and throat, ENT, treatment. The Minister's predecessor, Deputy Varadkar, had set a target of July 2015 for nobody to be waiting more than 18 months. We need the Minister to recognise that the Government's strategy simply is not working. We need to know what plan has been put in place regarding the usage of the National Treatment Purchase Fund, NTPF, or other mechanisms to ensure people do not find themselves in this inhuman position of waiting longer than 18 months for treatment.

Simon Harris (Wicklow, Fine Gael)
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The DNA rate has a bearing. While it is not the only factor, consultants have a certain number of appointments available and when a person does not turn up for an appointment, the slot is wasted. Given that there were 450,000 such incidences, there is an onus on me to expect the health service to put in place methods to ensure patients are reminded of appointments and, ultimately, wait less time, which makes them more likely to remember the appointment.

The NTPF has a role. Fianna Fáil pursued it during the confidence and supply discussions. We have it back up and running after years of it not having any specific budget for dedicated waiting list initiatives. We have a budget of €20 million for the NTPF this year, rising to €55 million next year.

4 o’clock

It is one the few areas of the health budget in respect of which we got a commitment during the Estimates process, and not just for the level of funding for 2017 but also for the level of funding for 2018, so we can plan for the future. The pooling of consultant appointments and the utilisation of the hospital groups is essential. If a consultant at St. Vincent's Hospital cannot see a patient, but the consultant up the road can, then we need to have a situation where the consultant does not own the patient and the patient should be directed to whichever consultant can see them quickly. I will send further details specifically on St. Vincent's Hospital to the Deputy.