Michael Healy-Rae (Kerry, Independent)
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I thank the Office of the Ceann Comhairle for selecting this issue. I appreciate it very much.

A top consultant turned whistleblower at University Hospital Kerry has told the newspaper Kerry's Eyethat the lives of public patients are now at serious risk because of vital scans being delayed. Consultant radiologist Dr. Martin Schranz has said public patients with potentially life-threatening illnesses are facing serious health risks because of delays in assigning them a patient number that will allow them to have a scan at the hospital. He said that when a patient is referred to the hospital for a scan, he or she has to be assigned a number by the clerical staff in the hospital before he or she can be scanned. He said he knows of five patients whose treatments have been delayed in the past five years.

The latest case was in the past five months and involved a cancer patient who was awaiting a scan so he could be operated on in Cork. By the time he had the scan, which was weeks later because he was waiting for the number, he formed a complication, which may or may not have existed beforehand. That is where the delay has occurred. Dr. Schranz said a GP can ring and say he is worried about a patient and that he has only one option, that is, to send the patient to the emergency department. The consultant says he cannot scan the patient because he does not have a number. It could take a couple of weeks or up to three months. He said one never knows when one can get that number. If the patients pay, they get the number the same day but those who cannot afford it do not get the scan. One does not know who is serious and who is not.

The consultant claims GPs are worried enough to ring him but that his back is against the wall. What can he say to the patient? Does he say he cannot scan the patient unless he or she pays, or does he apologise and say he or she must go to the emergency department and wait six or seven hours just to get the scan? Dr. Schranz says this has been going on since the manual system at the hospital was digitalised four years ago. It can take months to get a number, if one gets a number at all, but the average waiting time is about four weeks.

It is a simple matter but it means patients who could have cancer, appendicitis or another urgent or semi-urgent condition are not scanned for weeks or months. Dr. Schranz filled up incident forms that the hospital should take seriously and investigate but he has heard nothing back. He says the delays are seriously impeding him from doing his job. That is not right for patients and it is not right for general practitioners, GPs, who are very frustrated. Dr. Schranz said that a colleague of his in the emergency department cannot understand why their department is being bogged down with these patients. Most of these matters turn out to be normal but potentially they could result in life or death situations.

I will put three questions first to the Minister of State. First, has he or the Department ever been made aware of the issues raised by Dr. Schranz at University Hospital Kerry, UHK? If so, when were they made aware and what action was taken? Second, does the Minister of State accept the claims made by Dr. Schranz and the concerns raised about the delays regarding scans at University Hospital Kerry? Third, is he aware that UHK, through its public relations, PR, consultants, Heneghan PR, categorically stated in writing that the hospital does not accept what Dr. Martin Schranz is stating and has no knowledge of the incidents he alleges? I have a number of other questions that I will ask after the Minister of State has replied.

Finian McGrath (Dublin Bay North, Independent)
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I thank Deputy Michael Healy-Rae for raising the issue of timely access to services at University Hospital Kerry and for giving me an opportunity to update the House on the position. I am taking the matter on behalf of the Minister for Health, who apologises that he could not be here.

The Minister acknowledges that, in general, waiting times are often unacceptably long and he is conscious of the burden that places on patients and their families. However, it is important to note that in regard to the prioritisation used when scheduling patients for appointments, the Health Service Executive, HSE, has adopted a national waiting list management policy, which sets out the processes hospitals are to implement to manage waiting lists. This policy was developed to ensure that all administrative, managerial and clinical staff follow an agreed national minimum standard for the management and administration of waiting lists for scheduled care.

I understand Deputy Healy-Rae has specific concerns about delays in the radiology department in University Hospital Kerry. It is important to note that all staff in our hospitals are aware of the strict protocols relating to patient safety incidents. All safety incidents, both clinical and non-clinical, must be notified through the process outlined in the HSE’s safety incident management policy. I would like to assure the Deputy that the Minister for Health has been advised by the HSE that the hospital has not received any safety incident forms relating to ultrasound scan delays in University Hospital Kerry.

The Minister has been further advised that management in UHK has been working with radiologists in the hospital to develop a pathway to assign patients for scans in a manner that is consistent with HSE protocols relating to fair and equitable access to treatment for public and private patients based on patient acuity. A transparent, fair and equitable pathway has also been developed for GP referrals for ultrasound scans which are non-urgent and routine, and for urgent cases which are dealt with through the emergency department or acute medical assessment unit, AMU, if required.

The Deputy may also wish to note that, following a recommendation in Sláintecare, the Minister has established an independent review group, chaired by Dr. Donal de Buitléir, to examine the impact of separating private practice from the public hospital system. The group has been asked to conclude its work and report to the Minister in September 2018.

In regard to the radiology department in University Hospital Kerry, I wish to conclude by reassuring the Deputy that the HSE has confirmed that the management at the hospital has not received any safety incident forms relating to ultrasound scan delays and that it is satisfied that patients are assigned for scans in a manner consistent with HSE protocols on fair and equitable access to treatment.

Michael Healy-Rae (Kerry, Independent)
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Can the Minister of State explain why the hospital or the HSE have denied all knowledge of the issues raised by Dr. Schranz when correspondence seen by Kerry's Eyenewspaper clearly shows that the hospital management was made aware of them in writing on numerous occasions as far back as August 2015? Can he assure hundreds of public patients, including cancer patients, that the scan delays issue raised by Dr. Schranz has not resulted in missed diagnosis or delayed treatment that has adversely affected an existing diagnosis? Can he assure patients that their health and welfare is not compromised because of the issues raised by Dr. Schranz? Can he confirm that, regarding the radiology department at UHK, private patients are being block-booked for scans assigned to protect public patient slots? Is this the first time the Minister has become aware of the issues raised by Dr. Schranz? What does he propose to do about it?

Having said all that, it is only right to acknowledge the work that has been carried out by management on the public-private issue I have raised in recent months about which I have concerns. My overall concern is that the HSE does not allow University Hospital Kerry to be downgraded by stealth, in other words, by not allocating adequate resources to the hospital. I do not want to see our hospital in Tralee, in County Kerry, downgraded and left to be nothing more than a glorified community hospital. I do not want that. The people of Kerry deserve better. We deserve to have a properly run and adequately resourced hospital. We have great people working in the hospital, including management, doctors and nurses who are diligent in their duty. I want them to be given adequate resources to run an excellent hospital.

Finian McGrath (Dublin Bay North, Independent)
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I acknowledge Deputy Michael Healy-Rae's support for the staff and the management at University Hospital Kerry. I will bring the concerns he raised to the Minister, Deputy Harris, as well as the particular points he raised in respect of Dr. Schranz.

In regard to investment in the health services, they will not be downgraded by stealth; there is no question of that. We have invested a great deal of money in the health services. We will deal with these issues as part of the reform agenda because we accept that we need to reform and invest in health services.

On the particular questions asked, it is important that we accept the following three points, which are very important. First, the UHK operations manager has engaged directly with the consultant radiologist about his concerns. Second, UHK has advised that it has developed a clear pathway for GP referrals for ultrasound scans which is transparent, fair, equitable and consistent with HSE protocols relating to fair and equitable access for public and private patients. Third, the UHK management has advised that the hospital has not received any safety incident forms regarding the ultrasound scan delays in the hospital. It also advises that none of its other radiologists have raised any concerns in that regard. That is important.

I will bring the other issues raised by Deputy Michael Healy-Rae to the Minister, Deputy Simon Harris. We will follow up on them and revert to the Deputy with a more detailed response.