James Reilly (Dublin North, Fine Gael) | Oireachtas source

The targets were only set this year and my promise to the people is that nobody will wait longer than a year by the end of this year. We are the first Government to measure the number of people on outpatient waiting lists. The total number is 386,000 people, but we see 200,000 people at our outpatient clinics every month and I believe we will be able to deal with this problem as we have dealt with the other problems. After the urgent and cancer patients are dealt with the longest waiters will be looked after. The true scandal for me is not the 386,000 people which no previous Government acknowledged or measured, but that more than 16,000 people have been waiting for longer than four years.

I thank the Senator for raising this matter and for the opportunity to update the House on the significant progress being made on outpatient waiting times as a result of the measures introduced by my Department, the special delivery unit and the National Treatment Purchase Fund. Access to acute hospital services is a priority for me and the Government. Hospitals have responded impressively to this challenge, in the face of considerable pressure.

This is due to the hard work done by clinical and managerial leaders in individual hospitals, coupled with comprehensive and coherent strategies and programmes enacted by the special delivery unit, working with the National Treatment Purchase Fund, the HSE, the hospitals, the men and women who work on the front-line of the health service and supported by clinical programmes.

With specific reference to outpatients, the National Outpatient Service Performance Improvement Programme 2012-2015 has commenced implementation. Current improvements include: validation of current outpatient lists; the standardisation of current referral management processes; and improved turnaround times for categorisation of referrals; the utilising of clinic capacity effectively through booking of pre-planned appointment slots; configuring specific clinic templates to address varying requirements of different specialties; improvements in the discharge planning process; reducing the do not attend rates by patients; and identifying, understanding and resolving long-standing organisational behaviours, culture and attitudes towards the provision of outpatient services. These measures are being implemented for waiting lists in all specialties.

Underpinning all of these work streams is the availability of patient level waiting time data in all hospitals providing an outpatient service. The data has been systematically collated by the NTPF and is publicly available on its website. As I said, the maximum waiting time target for 2013 of 12 months for a first-time outpatient appointment.

The SDU and the NTPF will shortly publish outpatient waiting times by specialty which will add further to the visibility and transparency of waiting times in our health system. It is hoped that the publication of data will commence by the end of this month. Already this work has identified orthopaedics, ENT and ophthalmology as the services which, nationally, are most at risk of not achieving access targets.

Ultimately, each hospital must systematically achieve maximum waiting time targets each year by matching capacity with demand, eliminating inefficiencies in the patient pathway, ensuring the strict chronological management of patients of equal clinical priority and implementing the recommendations of the clinical care programmes. Establishing hospital groups will further facilitate hospitals in addressing waiting lists. These Groups will see small and larger hospitals working together as teams, in conjunction with their academic partners, to enhance innovation and effectiveness in service development and delivery.

Waterford is a busy hospital. It is a cancer centre, hub for the southeast renal service, provider of invasive cardiology services and a regional trauma centre including an emergency department, ear, nose and throat and ophthalmology. Given the level of activity, it is no surprise that midway through the year work is ongoing to accurately measure and validate outpatient waiting lists and to match these to capacity, taking into account the clinical needs of patients.

With regard to the specialties that the Senator mentioned, these services are delivered not just in Waterford Regional Hospital but in a range of outreach hospital and community clinics in the southeast. I acknowledge that the numbers are high at 2,814 for dermatology, over 4,000 for ophthalmology, over 5,000 for orthopaedics and over 6,000 for ENT. However, these numbers are being proactively tackled by the hospital with the assistance of the HSE.

I am pleased to advise that a candidate is in clearance for the third new post of consultant dermatologist, following the appointment of the second new post on 1 March 2013. A candidate is also in clearance for the replacement post of consultant orthopaedic surgeon at the hospital, following a consultant resignation. Finally, one consultant ophthalmic surgeon replacement post will be advertised shortly and a second replacement post is also being processed.

All of these appointments will lead to significant improvements in their respective services, particularly in respect of waiting times. Coupled with management plans, revised governance arrangements and additional clinics or clinical reviews in specialties such as regional orthopaedics, regional ENT and opthalmology, l am assured that the hospital is making every effort to ensure the 12 month target is achieved by November 2013.