David Cullinane (Waterford, Sinn Fein)
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58. To ask the Minister for Health when the waiting list plan will be published; and if he will make a statement on the matter. [7839/22]

David Cullinane (Waterford, Sinn Fein)
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I think we all accept that waiting lists are dangerously high. At the weekend, figures from the National Treatment Purchase Fund, NTPF, showed almost 900,000 people are on some form of health waiting list. More than 600,000 people are waiting for a hospital appointment, of whom 165,000, including 25,000 children, have been waiting longer than 18 months to see a hospital consultant. We are moving in the wrong direction. I ask the Minister to outline his strategy to tackle, once and for all, these dangerously high wait times.

Stephen Donnelly (Wicklow, Fianna Fail)
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I thank the Deputy for his question. He has raised one of the greatest challenges in the health service. It is a top priority for me and the Government. Before the Government was formed and Covid arrived, waiting lists were far too high across the board. They are still too high and very significant action is required. The 2022 waiting list action plan, which I will bring to the Government shortly, builds on the successes of the plan in the fourth quarter of 2021, which ran from September until December.

That 2021 plan was developed by my Department, the HSE and the National Treatment Purchase Fund to mitigate the impact of the pandemic and cyberattack on scheduled care and stabilise the resulting growth in waiting lists. Understandably, many more people are coming forward for care.

I am pleased to say that the actions under the plan for last year delivered immediate extra activity, resulting in a 6% reduction in waiting lists last year. Considering the pressure the system was under last year, it is welcome that we were able to reduce the lists at the same time. Obviously, we must go much further. More than 40,000 additional men, women and children treated under the action plan last year no longer have to wait for care.

The short-term plan also incorporated reform actions that will continue to be progressed as part of the 2022 waiting list action plan. This includes revised waiting list management protocols, improved data collection and information and further work towards improving patient pathways of care. Some 37 priority scheduled care pathways across 16 specialties are on track for implementation in 2022. These will ensure the availability of more timely access to care for people in settings closer to their communities and homes.

David Cullinane (Waterford, Sinn Fein)
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The problem is that all sorts of promises have been made in the past to deal with waiting lists. When the HSE was established and in 2005, the Taoiseach at the time stated he would eliminate waiting lists. In 2015, the Tánaiste, as the then Minister for Health, said that by the summer of 2015 under his watch no patient would wait longer than 18 months. In 2017, the then Minister for Health, Deputy Simon Harris, said he would halve the time people were waiting for more than 18 months. What has happened? The waiting list has gone in the wrong direction. There are now 165,000 people waiting over 18 months. The number has quadrupled since the then Minister made that statement. That is the reality and it is not all due to Covid.

I received a call earlier today from Ms Phil Ní Sheaghdha of the Irish Nurses and Midwives Organisation, INMO. She is very concerned about what is happening in our hospitals. The number of patients on trolleys is at a critical level in Waterford, Galway, Cork and Limerick. She is calling for the emergency department task force to be convened immediately and for the Minister to take the reins and intervene by putting all options on the table, including leveraging private capacity if necessary. We must understand the scale of what is happening in the hospitals. Ms Ní Sheaghdha's call to me was urgent. She is very concerned because her members across the State are telling her that this is a real crisis.

Stephen Donnelly (Wicklow, Fianna Fail)
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Phil Ní Sheaghdha and I spoke yesterday about many of these issues. I will visit Limerick on Thursday when I will go directly to the hospital and meet the hospital group. The Deputy is right in identifying the ongoing pressures there in spite of investment, increased resources and a new emergency department. The pressure is still not acceptable in Limerick or in Galway and other hospitals.

I agree with the Deputy's core point on waiting lists. I made similar contributions in this House from where the Deputy is sitting. Waiting lists have not been acceptable for too long. The question is what we are doing about it. I have allocated €350 million this year specifically for waiting lists. Obviously, it will take much more money to build the permanent capacity in the public system because we need a public health service that can deal with total demand for the country. We want a single-tier system. At the same time, we must get help for all of the men, women and children who are waiting. That is what the €350 million plan is for. I look forward to publishing it shortly and discussing it in detail with the Deputy and other Members.

David Cullinane (Waterford, Sinn Fein)
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The Minister has to understand what causes the problem with waiting lists. It is the same thing that causes the problem in our emergency departments. We do not have enough admission beds in hospitals. Two years ago, in budget 2021, the Minister committed to bring 1,147 additional in-patient acute beds into the system. Some 400 of those have not yet been delivered. Hospitals do not have the beds to admit patients in the numbers they need. That creates problems in our emergency departments. We do not have the enhanced community care that we were promised along with integrated care and step-down beds in communities. This causes late discharges as hospitals cannot discharge people into the community as they do not have the beds. That is a second problem. The third problem is GP capacity, which we will deal with later.

For the first time, we are beginning to see people waiting for access to a GP. Will we get to a point where we have waiting lists to see a GP? People are waiting not just days but sometimes weeks for appointments. These are the problems. When people are unable to access a GP in hours or out of hours they have no choice but to attend our emergency departments. When we have emergency departments overflowing it is a symptom of everything going wrong at the same time. The Minister should convene a meeting of the task force, get the stakeholders together and put all the options on the table, including leveraging capacity in the private sector, because this is so urgent.

Stephen Donnelly (Wicklow, Fianna Fail)
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I largely agree with the Deputy. I had a high-level meeting with the HSE on exactly this matter in the past few days. There are still some issues related to Covid. One point the HSE raised with me was that about half the nursing homes have Covid outbreaks. We have a protocol in place whereby one must wait 28 days, two full cycles of Covid, before anyone can be discharged. As the Deputy rightly said, there are pressures on discharges. We funded an extra 2.7 million home care hours for last year, which have been carried forward into this year. However, the issue at the moment is not funding but making sure there are people who can deliver the services.

The Deputy is absolutely correct about discharges, more community beds and how we need the nursing homes to be free of Covid in order that people can be discharged. Then there is the issue of home care packages. The Minister of State, Deputy Butler, has done huge work on reducing waiting lists for those looking for home care packages. As the Deputy says, this is end to end, from prevention, GPs, community services and frailty intervention and community intervention teams to the availability of multiple pathways in emergency departments, diagnostics, including acute diagnostics and GP access to diagnostics, acute beds and discharge options.