Leo Varadkar (Dublin West, Fine Gael) | Oireachtas source

The 20-week target remains. Hospitals must adhere to chronological scheduling and observation of guidelines drawn up by the national clinical programmes as well as improving efficiency in the management of referrals and reducing the number of unnecessary return appointments. Rather than the current situation whereby a consultant or his or her staff sees one new patient for every 2.6 repeat appointments, the HSE has set a target to achieve a ratio of one new appointment for every two reviews. That will free up thousands of appointment times for new patients without any additional resources being required. Similarly, with the assistance and guidance of the STU and the NTPF, poorly maintained waiting lists are gradually becoming a thing of the past. I refer to the old-fashioned waiting lists in boxes; that is charts in boxes rather than registers. Multiple referrals of individual patients by GPs are being tackled.

I expect all hospitals and clinicians to do everything they can to reduce waiting times within their own hospitals and specialties and not to allow overall patient waiting times to build up so that patients become urgent cases where this can be avoided. A new referral system which can speed up and streamline the referral cycle is being piloted and specifications for e-referral systems incorporating protocols and standards from the STU and clinical programmes are in development. This will allow the quality of referrals to improve. These are short-term targets which do not detract from the achievement in the medium term and, where it is possible this year, the retention of the Government's original waiting targets. Consultants are also being provided with quality audited data to allow them to benchmark themselves against best practice standards nationally and internationally. In turn, this will promote further efficiencies in the provision of care.

The NTPF and HSE will continue to publish monthly waiting list figures and ensure that we can all monitor the benefit of those efficiencies through the gradual reduction of waiting lists and waiting times. The HSE has also made provision where possible to address services where there are particular challenges. For example, funding has been allocated in the HSE service plan for 2015 for the appointment of an orthopaedic surgeon, an anaesthetist and support staff at Crumlin in recognition of the pressures relating to surgery for scoliosis. This will maximise the use of the available theatre sessions in the hospital. The provision of funding for additional funding and support staff is expected to allow an additional 25 cases to take place in 2015. That is roughly an increase of 50% on the number of cases that took place last year. That is part of a total of €5 million made available for the overall development of the orthopaedic service infrastructure nationally. A sum of €1 million has also been provided for a paediatric ophthalmic waiting list initiative and a colonoscopy initiative is underway to reduce waiting lists in that regard.

Picking up on the remarks of Senator Colm Burke on GP access to diagnostics, which is an enormous problem, I note that it is one of the most prevalent criticisms heard in the last number of years. This year, the HSE is implementing a pilot project which will provide GPs with direct access to ultrasound at approximately eight primary care centres across the south and west with the aim of addressing existing GP referrals to ultrasound in those areas. It will mean that GPs can refer patients electronically to the preferred provider who will see urgent patients within five working days and non-urgent patients within ten working days, thus negating the need for referral to outpatient departments or hospitals in the first place.

As Senator Eamonn Coghlan eloquently pointed out, the long-term solutions must involve public health and a shift from the worsening ill health of our population to greater wellbeing through societal change supported by the Healthy Ireland initiatives on obesity, smoking, alcohol and greater physical activity. Among the things we will see happen this year is the publication of the first Healthy Ireland survey. This will be the first snapshot of our nation's health since 2007. The survey will be repeated on an annual basis. I have sought and received approval from the Government to introduce new legislation on alcohol. The Minister for Children and Youth Affairs, Deputy James Reilly, is pressing ahead with legislation on tobacco plain packaging and I will also be bringing forward specific legislation on obesity, specifically calorie posting and workplace plans.

The motion is a Fianna Fáil one. I point out once again that Fianna Fáil remains a party with no policy on health whatsoever. I can only echo the comments of Deputies Éamon Ó Cuív and Michael McGrath who pointed out that Fianna Fáil should concentrate more on its policy development. I agree. In the alternative budget put forward by Fianna Fáil only a few months ago, there was less money provided for health than was provided by the Government.