Máire Hoctor (Tipperary North, Fianna Fail)

I am pleased to reply on behalf of my colleague, Deputy Harney, Minister for Health and Children. I thank Senator Keaveney and the Seanad for giving me the opportunity to address this important matter.

The National Treatment Purchase Fund was established to tackle the issue of excessive waiting times for hospital treatment for public patients. The fund has been very successful in fulfilling this remit and arranged treatment for some 135,000 patients to date. It is on target to arrange treatment for a total of 37,000 patients in 2008. On average, public patients are waiting 2.9 months for their operation, down from two to five years before the NTPF was established.

Notwithstanding this success, there remain a number of hospitals in which there are significant numbers of patients waiting for more than 12 months for treatment. The Minister has asked the NTPF and the HSE, working together, to give this issue particular attention. As a result of the efforts made by both organisations during 2008, the total number of persons waiting over 12 months has been reduced by 60%, from 4,594 in October 2007 to 1,846 in November this year.

It is important to ensure waiting lists reflect the numbers in a position to avail of treatment when it is offered to them. This includes offers of treatment via the NTPF, given that this is a statutory body which is provided with significant funding to facilitate treatment of public patients. The Minister has, therefore, asked the HSE to ensure there is consistent and active management of waiting lists. The NTPF, working with representatives of both the HSE and voluntary hospitals, has drawn up the national guidelines for management of inpatient and day case waiting list data which provide a basis for a consistent approach.

At this point, the problem of particularly long waiting times for patients is largely confined to a small number of hospitals. Five hospitals — Letterkenny General Hospital, Sligo General Hospital, Temple Street Hospital, Limerick Regional Hospital and Cork University Hospital — account for some 60% of those waiting over 12 months for surgery. While substantial reductions have been achieved, the latest returns from the two hospitals in the north west, Sligo General Hospital and Letterkenny General Hospital, show that there are still 337 and 316 patients, respectively, waiting over 12 months for surgery.

In line with the requirement to focus particularly on those who have been waiting for excessive periods, the NTPF has asked the HSE and the hospitals concerned to accord priority to facilitating the treatment of these patients. The Minister supports this approach. The fund has the resources to arrange treatment for these patients and wishes to see the hospitals concerned referring their longest waiting patients in order that treatment can be arranged for them. Treatment is free of charge and in most cases can be arranged within weeks. It makes sense to ensure there is a concentration on this group ahead of persons who have not been waiting as long for treatment. The fund also arranges treatment for patients waiting for under 12 months in these hospitals.

In 2008 to date, 974 Letterkenny General Hospital patients have been referred and treated under the NTPF, 260 in the last two weeks. This is progress, but it has to be said the NTPF could have treated substantially more patients had more referrals been made.

I emphasise a recent initiative by the Minister. In approving the HSE's service plan for 2009, the Minister indicated her particular concern about patients having to wait a long time for hospital treatment. She said the HSE needed to give consideration, where necessary, to directing co-operation with the NTPF, including through the imposition of financial penalties for hospitals failing to refer patients who could benefit from NTPF-funded treatment. A long delay in treatment for public patients, when treatment is actually available, cannot be excused. If it takes financial penalties on hospitals to drive home this point, so be it, but we hope this would not be necessary. The Minister looks forward to continued effective co-operation between the NTPF, the HSE and individual hospitals in order that the unnecessary and unacceptable situation where people are waiting for 12 months and more for surgery will be eliminated.