Tuesday, 29 May 2018
Ceisteanna - Questions - Priority Questions
Hospital Waiting Lists
I thank the Deputy for his question.
Reducing waiting times for patients for hospital operations and procedures is a key priority for the Government. Cataract surgery is among the most common surgical procedures carried out in the ophthalmology specialty. Through the work of the National Treatment Purchase Fund, NTPF, and the HSE, the overall number of patients waiting for cataract surgery has fallen by 22% since July 2017, while the number of patients waiting for more than 12 months has declined by 71% in the same period. This is one of the areas where we are making significant progress as a result of the investment made through the NTPF.
For 2018, under the inpatient-day case action plan, all clinically suitable patients waiting for more than nine months for a cataract procedure will be offered treatment this year, with 5,000 additional NTPF funded procedures planned in public and private hospitals. Last year funding was allocated to provide additional capacity at the Royal Victoria Eye and Ear Hospital and a cataract theatre is now operational there. This year, in line with the action plan, the HSE is planning to open a dedicated cataract theatre in Nenagh hospital in July. This will also benefit patients from Deputy Brassil's constituency.
In primary care the HSE published the primary care eye services review group's report in June 2017. The report sets out the way forward for a significant amount of eye services to be provided in a primary care setting. The recommendations made in the report are to be implemented on a phased basis. To support implementation of the report, funding of €1 million was allocated this year to establish new primary care eye support teams in south and west Dublin and further develop the primary care eye team in north Dublin to help to alleviate waiting lists. We are making progress in this area, but we need to continue to make progress. There were 10,304 people waiting for cataract procedures in April 2017. In April 2018 that number had dropped to 7,818. We are, therefore, seeing the benefits of the investment to reduce cataract surgery waiting lists. The opening of the cataract operating theatre in Nenagh hospital in July will make a real difference. It will provide a service for patients from counties Limerick, Laois, Kerry, Clare, Offaly, Kilkenny and Tipperary. We have begun the roll-out of the new primary care eye support teams, but, clearly, we need to see them being spread throughout the State. I look forward to seeing the impact of the new €1 million investment.
There is an issue in the Cork-Kerry region which has the longest waiting list in the country for cataract operations, at up to 60 months from the time of referral to the carrying out of the operation. One can often wait up to 24 or 36 months before even being seen. People with such difficulties attend my clinic on a weekly basis. It is the Minister's colleague, the Minister of State, Deputy Jim Daly, who has to deal with the social aspects that result from, for example, a person who was once able to drive to the local town now being unable to do so, with all of the related isolation issues. This matter needs to be tackled. Given all of the reports and offerings, for example, from the National Treatment Purchase Fund and the Association of Optometrists Ireland, there is a potential solution, but elements are falling between the stools. In a recent reply to a parliamentary question it was pointed out to me that the primary care eye service review group's report offered interesting and progressive solutions, but I am told that no extra funding has been provided to implement the report in my area.
I agree with the Deputy that we need to do more about this issue, but I will give some figures, given the considerable commentary on the matter in recent months. We are making significant progress. In the 12-month period between April 2017 and April 2018, the total number fell from 10,304 patients waiting to 7,818, a decrease of more than 20%. On the length of time people have to wait, 744 were waiting for 18 months or longer, but that figure has decreased to 326. There were 950 waiting for 15 to 18 months, but that figure is down to 175. There were 1,297 waiting for 12 to 15 months, but that figure is down to 295. There were 1,468 people waiting for nine to 12 months, but that figure is down to 893. I am giving a commitment that, through our work and investment, we will ensure that by the end of the year no one will have to wait for a cataract procedure for longer than nine months.
The Deputy is right, in that we could do more on two fronts. First, we must ensure we are using all of the capacity within the acute hospital setting. That is why I am eager to do more in Nenagh. Second, we have started to roll out the primary care eye service review, albeit in the locations I mentioned, but I want to see it spread throughout the country.
I will concentrate on the Association of Optometrists Ireland. In my day we used to call them opticians. There are 352 registered optometrists who are willing to get involved and provide much needed community backup for an overloaded system. We recently heard a presentation by the association in Buswells Hotel. It is more than willing to get involved, particularly in screening for young people. Squints and lazy eye syndrome are easily dealt with. If they are, such cases do not go on to clog up the system further down the line. However, there is resistance somewhere in the system to allowing optometrists to get involved in solving the problem associated with public waiting list. The Minister needs to use his good offices to get to the bottom of the matter and stop it. There is enough work for everyone in the system. When a body is willing to get involved and help, we should facilitate it.
I will take the Deputy up on his offer. I do not want anyone to work in a silo. There is enough work to go around. Given the ageing demographic profile, demand for ophthalmological services will only increase. The report of the primary care eye service review group is a good body of work, with people working in the community and acute hospital settings coming together to draw up what was effectively a model of care. We have started to roll it out, albeit only in south, west and north Dublin, with the development of new primary care eye teams. I want to see the project rolled out. It will be my next challenge to deliver in the area of ophthalmology.
We have seen significant progress being made in dealing with inpatient day case cataract waiting lists. People were waiting for far too long and we will see more progress this year. The investment in the new Nenagh clinic will see activity ramped up as we increase staff numbers there. The clinic will see up to ten cases a week for the first 12 weeks and 30 cases a week for the remaining 12 weeks. In 2018 the service will carry out up to 500 cataract procedures. From next year, it could carry out 2,500 additional cataract procedures per annum. The level of activity proposed in Nenagh will not just meet demand in the mid-west, it will also provide additional capacity to support patients from counties Limerick, Laois, Kerry, Clare, Offaly, Kilkenny and Tipperary. There is much more we can do in dealing with this matter and I look forward to making progress on it.