Results 26,861-26,880 of 34,872 for speaker:Seán Fleming

Public Accounts Committee: Special Report No. 83 of the Comptroller and Auditor General: Managing Elective Day Surgery (6 Nov 2014)

Seán Fleming: With regard to figure 2.4 - elective surgery rates for target procedures in specialist hospitals, 2012 - on page 20, I can understand why paediatric day surgery rates are somewhat lower, especially in light of the need for extreme care to be taken. I presume paediatric procedures are carried out in the main hospitals. The rate for paediatric day cases stands at 75%, which is the lowest in...

Public Accounts Committee: Special Report No. 83 of the Comptroller and Auditor General: Managing Elective Day Surgery (6 Nov 2014)

Seán Fleming: Figure 3.1 relates to the day surgery patient pathway and it is stated that post-discharge treatment is 50% nurse led. Should the figure in this regard be higher? I am concerned that people were not given details regarding the accident and emergency departments they should attend if they required aftercare. It appears that patients seem to be discharged on a somewhat perfunctory basis. It...

Public Accounts Committee: Special Report No. 83 of the Comptroller and Auditor General: Managing Elective Day Surgery (6 Nov 2014)

Seán Fleming: Are consultants obliged to return after a couple of hours and discharge patients?

Public Accounts Committee: Special Report No. 83 of the Comptroller and Auditor General: Managing Elective Day Surgery (6 Nov 2014)

Seán Fleming: Of the 49,000 emergency procedures dealt with through accident and emergency departments, how many would be day cases? If there is an emergency involved, would they by definition be classed as inpatient cases? We are really only considering elective procedures on a day surgery and inpatient basis, but there were 49,000 other emergency procedures in respect of which we have not received the...

Public Accounts Committee: Special Report No. 83 of the Comptroller and Auditor General: Managing Elective Day Surgery (6 Nov 2014)

Seán Fleming: I wish our guests the best of luck with that. I visited the accident and emergency department in Naas yesterday and I could hardly gain physical entry as a result of the line of trolleys on both sides of the corridor. This is a very difficult matter with which to deal but deal with it we must. There is no doubt that some emergency procedures could be done on a day case basis if the...

Public Accounts Committee: Special Report No. 83 of the Comptroller and Auditor General: Managing Elective Day Surgery (6 Nov 2014)

Seán Fleming: We are being told that the day case rate was 60% in 2010, 63% the following year, 65% in 2012, 67% last year and 77% today. I do not accept for one moment that the medical cases presenting in hospitals have become so much less complex that we can go from a day case rate of 60% four years ago to 77% now. That represents a phenomenal number of patients being dealt with on a day surgery basis...

Public Accounts Committee: Special Report No. 83 of the Comptroller and Auditor General: Managing Elective Day Surgery (6 Nov 2014)

Seán Fleming: To clarify, is Professor Keane saying that we do not, in 2014, have a system of unique identifiers for patients?

Public Accounts Committee: Special Report No. 83 of the Comptroller and Auditor General: Managing Elective Day Surgery (6 Nov 2014)

Seán Fleming: Irish Water seems to have no problems in this regard when it comes to charging for water, but the HSE has not figured it out yet. Did the delegates never hear of PPS numbers? I am shocked to discover there is no system of patient ID numbers. I am thinking of a case, for example, where an elderly person is treated in Portlaoise, returns to his or her nursing home and is readmitted to Naas...

Public Accounts Committee: Special Report No. 83 of the Comptroller and Auditor General: Managing Elective Day Surgery (6 Nov 2014)

Seán Fleming: We will have to make a recommendation in this regard, Chairman, because the situation is unacceptable in 2014. Public service cards, complete with photographic ID, are being issued to people for use in their dealings with social welfare offices and Revenue. We are being told today that the HSE is not part of that system and, for some reason, patients cannot use the public service cards that...

Public Accounts Committee: Special Report No. 83 of the Comptroller and Auditor General: Managing Elective Day Surgery (6 Nov 2014)

Seán Fleming: I am even more shocked to hear that a Bill is being introduced to deal with this issue. Legislation is not required. Every one of the 1.2 million people who went through the door of a hospital last year has a PPS number. We do not need to waste time drafting legislation to identify them. It would amount to another PPARS if we were to use resources to design a system that is already...

Public Accounts Committee: Special Report No. 83 of the Comptroller and Auditor General: Managing Elective Day Surgery (6 Nov 2014)

Seán Fleming: I apologise for going off on a tangent with this issue. We must look at the direction in which we will be moving if we are obliged to track the records of the people with whom we are dealing. Appendix A tracks the 24 procedures but there is no list provided as to the number of people covered by those procedures. Will somebody forward the relevant information in this regard to the...

Public Accounts Committee: Special Report No. 83 of the Comptroller and Auditor General: Managing Elective Day Surgery (6 Nov 2014)

Seán Fleming: That is fine. Paragraph 1.2 of the HSE's briefing note reads: "There are currently 2,102 day case places nationally. Of these, 1,530 are public, 293 private and the remainder are non-designated". I will not hone in on the last point. The 293 cases represent 14% of day case places. I hope Dr. O'Connell is following me.

Public Accounts Committee: Special Report No. 83 of the Comptroller and Auditor General: Managing Elective Day Surgery (6 Nov 2014)

Seán Fleming: Of the 61,000 inpatient cases, what percentage are private? The HSE claims it has the exact numbers in respect of day case places, but what is the comparison between public and private inpatient places?

Public Accounts Committee: Special Report No. 83 of the Comptroller and Auditor General: Managing Elective Day Surgery (6 Nov 2014)

Seán Fleming: That is interesting.

Public Accounts Committee: Special Report No. 83 of the Comptroller and Auditor General: Managing Elective Day Surgery (6 Nov 2014)

Seán Fleming: That was my hunch. Some 14% of people who opt for day surgery are private patients, but the comparable percentage opting for inpatient treatments is much higher. Does this have anything to do with the operation of the private health industry? If someone needs a day case procedure, he or she may need to pay for it and reclaim the cost from a private health insurer at a later date. If...

Public Accounts Committee: Special Report No. 83 of the Comptroller and Auditor General: Managing Elective Day Surgery (6 Nov 2014)

Seán Fleming: Am I right? That was my instinct about how Irish society and hospitals worked and the HSE's figures verify it. What can we do about this situation?

Public Accounts Committee: Special Report No. 83 of the Comptroller and Auditor General: Managing Elective Day Surgery (6 Nov 2014)

Seán Fleming: Does Dr. O'Connell take my point? It was a valid, if not empirically proven, observation, but even the HSE's figures demonstrate that more private patients want to be kept in overnight. That approach might suit the surgeon, but it certainly suits the client, as the bills go straight to the VHI, Laya or another insurer. Convenience is a factor. I have not seen particular information in...

Public Accounts Committee: Special Report No. 83 of the Comptroller and Auditor General: Managing Elective Day Surgery (6 Nov 2014)

Seán Fleming: Will the HSE provide it? The Comptroller and Auditor General's report runs to 50 pages, but it is the first one I have seen that does not contain a single euro symbol. We are the Committee of Public Accounts. We might discuss health, outcomes and so forth, but this is a discussion of numbers, percentages of targets, percentages of the 24 procedures, percentages of pre-operative assessments...

Public Accounts Committee: Special Report No. 83 of the Comptroller and Auditor General: Managing Elective Day Surgery (6 Nov 2014)

Seán Fleming: To follow the report. I am gently saying that I would like to see a few money-----

Public Accounts Committee: Special Report No. 83 of the Comptroller and Auditor General: Managing Elective Day Surgery (6 Nov 2014)

Seán Fleming: Like the consultant, I will not. However, nothing I have read so far gives any indication of the savings to be achieved by the HSE's targets. If the HSE reached a 75% target - I am pleased to hear that it has reached 77% on average this year - how much would it save? I cannot find even a single sentence on this issue. Does the HSE know? Is it a financial target or a procedures, numbers...