David Cullinane (Waterford, Sinn Fein)
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77. To ask the Minister for Health when he will publish a multiannual waiting list strategy; and if he will make a statement on the matter. [52299/22]

David Cullinane (Waterford, Sinn Fein)
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The Minister recently stated, presumably in response to a journalist, that if there were 2 million people on waiting lists, Sinn Féin would not be happy, which is obviously a political charge. At this point, 1.3 million people are on hospital waiting lists. That does not make me happy; in fact, it makes me angry and frustrated because, like him, I deal with patients every day who have concerns about how long they have been awaiting access to care. Approximately 900,000 people are on acute hospital waiting lists and a further 500,000 are awaiting a diagnostic scan or are on a community waiting list. What more can the Minister and the Government do to tackle the very long waiting lists?

Stephen Donnelly (Wicklow, Fianna Fail)
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Before I respond, I welcome to the Gallery the girls and boys from sixth class in the Harold School.

When I made that comment, I was not referring to Sinn Féin, although I stand to be corrected. We all focus on the total number of people on waiting lists but my point, which I imagine the Deputy will agree with, was that the number that matters is the number of people who have been waiting for too long. The example I gave was that if 2 million people had been referred for care but were waiting a matter of days, that would be a healthy, well-performing healthcare system. What we have to look at is the number of people who have been waiting for too long.

I might outline for the Deputy some numbers I received just last night. The focus of the waiting list action plan, in the first instance, is to provide care for patients who we all know are waiting too long. In the year to date, the outpatient waiting list - we are starting with those who have been waiting for more than 18 months - has fallen by 23% and is continuing to fall. Over the past four weeks, a further almost 7,000 patients were taken off the outpatient list. It is now at its lowest level this year, which I am sure the Deputy, like me, will welcome. In terms of inpatients who have been waiting for more than 12 months, the numbers so far this year have fallen by 14%. Obviously, we have a long way to go but that is very good to see, not least in the middle of a pandemic. The most impressive figure relates to those awaiting a scope for more than 12 months. That number has fallen this year by 74%.

Of course, a lot more needs to be done. The waiting list action plan for this year is year one of a multiyear approach to this. The National Treatment Purchase Fund, NTPF, has taken on a very ambitious programme of providing care for patients waiting for inpatient care for 15 high-volume procedures. Those who have been waiting for more than six months will have their care arranged. More than 80% of those patients have been contacted and have care authorised. I am delighted to say the NTPF is now looking at moving the wait time from six months to five and increasing the number of high-volume procedures from 15 to 20.

David Cullinane (Waterford, Sinn Fein)
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Of course, I welcome any reduction in the length of time people are awaiting care and I acknowledge the slight drop in that this year, but it is not just about people who are being treated. According to my latest figures, 60,000 patients were taken off the waiting lists through a process of validation. I do not disagree with that - it needs to be done because the waiting lists have to be fit for purpose - but they are not all people actually being treated. Some of it relates to the fact we are cleaning up the waiting lists, which does need to be done.

The Minister stated in an opinion piece published last February that he wanted to ensure people would not have to wait more than 12 months for any hospital procedure or 18 months for their first appointment by the end of this year. In my view, that is certainly not going to happen. A total of 120,000 people have still been waiting more than 18 months for their first outpatient appointment and 13,000 have been waiting longer than that. I have spoken to hospital managers and they need more beds in some hospitals.

They need more diagnostic capacity in public hospitals, not more outsourcing. They need more community beds and recovery beds in order that they can discharge patients and speed up that process. Crucially, they need more supports for people being cared for in the home and those with chronic conditions who are being cared for in the community. All of these measures are part of the solution.

Unless we have a long-term plan that beds in public investment rather than short-terms plans that are about outsourcing more and more, I do not believe we will actually get to a point where we really tackle the waiting lists. By the way, 1.3 million people waiting for care is far too many people.

Stephen Donnelly (Wicklow, Fianna Fail)
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I agree in terms of capacity. The hospitals, Community Care and the HSE all said we need record levels of investment and we need to add record levels of capacity, which is exactly what has happened. By the end of this year, compared to the start of Covid-19, there will be more than 1,000 extra hospital beds in the system. We will have funded approximately an extra 250,000 diagnostic scans and added more than 15,000 or 16,000 extra workers. We will have built an entire system of community care that did not exist 18 months ago.

The Deputy and I are agreed that record investment and record capacity is required in our public healthcare system. All of that is happening, which is why the waiting lists are now falling in spite of the massive challenges Covid-19 still presents to our healthcare professionals. I would be delighted to send Deputy Cullinane some of the lists of individual hospitals that are doing really well, including University Hospital Waterford in his own constituency. We just need to encourage them and keep going with the momentum.

David Cullinane (Waterford, Sinn Fein)
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University Hospital Waterford is one of the hospitals that has performed very well. I know that senior officials from the Department visited the hospital last week. There has not been a patient on a hospital trolley in 18 months, or maybe longer, in Waterford. We need to learn from best practice.

The reality is, however, that many of the beds that were promised still have not been delivered. Of course, while I welcome the additional 1,000 beds, 1,200 beds were funded. My understanding is that there are approximately 350 beds of the 1,047 that were committed in 2020. Then, there were additional beds in last year's national service plan. Approximately 350 beds have still not been delivered. It is expected that approximately 140 of those beds will not be delivered until the end of next year. These are beds for which the HSE was given funding.

Part of that goes back to the fact that we cannot recruit the staff quickly enough. Again, the Minister will acknowledge that 10,000 staff were to be recruited. There were approximately half of that last year. Hopefully, we can recruit more next year. All of that goes back to being able to plan and having the capacity needed to put into the hospitals in the first place. Without that, I am afraid that if we do not have a medium to long-term plan where we continue with the sustained investment we need, we will continue to see these long waiting times.

Stephen Donnelly (Wicklow, Fianna Fail)
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I agree with that, with one caveat, which is that we have a long-term plan. The Deputy will be aware that as part of the waiting list action plan, the chief clinical officer, Dr. Colm Henry, is leading out on 37 new models of care. The Deputy and I have discussed the need for record investment in capacity, which is happening. However, I think we are also probably in agreement about the need for modernisation of pathways for patients closer to the home and in the community. People should only be going into the hospitals when they need to be in there. We are also doing that.

The teams in the Deputy's constituency in Waterford deserve great credit. The latest figures as of yesterday are that the total outpatient list in University Hospital Waterford in the last 12 months has fallen 21%. That is a huge endorsement of the people in that hospital. Better still, the total number of patients waiting for outpatient clinics for more than a year and a half has, believe it or not, fallen by nearly 60% in the last 12 months. That is the kind of success we are beginning to see around the system. That is kind of success we need to spread and see happen in every hospital in the country.