Colm Burke (Fine Gael) | Oireachtas source

I welcome the Minister to the House. I thank the Sinn Féin Senators for bringing forward this motion. It is an important debate. I also thank the Fianna Fáil Senators for bringing forward their amendment because it is by debating and coming to agreement that we can progress the difficulties in the health system.

There is a major problem with figures and I do not like the impression being given that the whole health system has come to a full stop. It implies there are 100,000 staff not working. I have given the figures and I will repeat them. There are more than 65,450 attendances in outpatient clinics every week. I checked the most recent figures available. Some 1.3 million go through accident and emergency per annum, which works out at 25,000 a week. There were 879,000 day case procedures in 2015. This is the 2015 figure because I do not yet have the 2016 figure. Therefore, there were approximately 16,900 day case procedures per week. Overall, there are more than 100,000 patients going through the health system in one way or another every week other than the number of patients who are in hospital at any one time. In addition, there are another 23,500 in nursing homes under the fair deal scheme and there are community hospitals. We are delivering a service.

I agree with my colleagues that there are many deficiencies and they have been allowed to build up over a long number of years. It is not something that has happened overnight.

On the waiting lists, while 58% are waiting less than six months, the figure for those waiting less than six months is still too low. People should be able to get access at the earliest possible time. In fairness to the Minister, €20 million is allocated this year for the National Treatment Purchase Fund, NTPF, with €55 million for 2018. I am not convinced that the NTPF, in the way it is structured at present, is the way forward.

For instance, in Cork, we have a long waiting list for gynecological services. The question of how that was allowed to be created needs to be answered. In fact, there are more than 4,000 on the waiting list in Cork for gynecological appointments and it represents 42% of all the waiting lists for gynecological services in the country. One solution with which the obstetricians and gynaecologists in Cork came forward was that they would be allowed to rent space in another facility to remain in charge of the patients either under their care or waiting to see them to avoid the problem which sometimes arises with the NTPF where patients avail of the fund and then come back into the HSE system which picks up the pieces. It is important there would be continuity of care, and the proposals from the obstetricians and gynaecologists in Cork should be taken on board.

One of the problems in the health system is that there are 2.8 beds per 1,000 of population. Irrespective of whether one wishes to undertake a day case procedure or an inpatient procedure, there three core issues. A consultant is needed, theatre space is needed and a bed are needed. If one of those is missing, the procedure cannot go ahead. The most immediate way of dealing with some of the lists is to open up day case facilities because many procedures which previously necessitated an inpatient procedure are now day case procedures. For instance, I was in Cork on Monday where the Taoiseach was opening a day case facility for paediatrics. That is an important development. Medicine has moved on quite a lot. However, it does not sort out the problem. If we do not have the day case beds, we still cannot do the procedures. We need to look at how can we fast-track any proposals on day case procedures.

I raised the Cork situation and the Minister met the consultants in Cork University Hospital. That is something that needs to be fast-tracked to come to a solution and deal with it. There are 17 consultants or 12.5 whole-time equivalents. On the problem about theatres, one theatre is open 3.5 days a week and the other theatre is not open at all. It is about access to staff. I note the Fianna Fáil amendment refers to opening up beds. We can only open up beds if we have staff. That is our big problem as well. We need to be able to recruit the staff. The Minister has given a commitment to recruit an extra 1,000 nurses this year and I welcome that. However, in all the units throughout the country, to open up the beds, staff are needed to manage them.

I have a problem with our health service. We have followed the health system of the UK over the past 40 or 50 years and we now need to look at alternative systems. In the way we structure the employment of doctors, nurses, care assistances, I am not convinced it is the best system. It is something we need to review urgently. I hope the ten-year strategy would look carefully at that.

I refer to the Cork situation to highlight this issue. The Minister was not present in the House when I stated that the population of Cork has increased from 410,000 to 542,000 in the past 30 years and there has been no increase in the number of hospital beds in that period. There has been an increase in population of 130,000 and it is something that needs to be prioritised.The Fitzgerald report of 1968 referred to a second major facility in Cork. It referred to two new hospitals. One was built and we forgot about the second. Now with the increase in the population and the talk of Dublin not being able to deal with it, we need not only to consider other areas of the country, but also to have backup support in other areas, whether in education, medical facilities or many other areas. Regarding access to hospital facilities, one of the areas we need to consider urgently is the southern region. As recently as this morning I received from someone in Brussels a text message stating that anyone seeking to have the European Medicines Agency relocated in Ireland should come to Cork. One must make sure all the necessary infrastructure is in place. People considering the relocation are watching these important issues.

Sinn Féin has referred to the issue of computerisation, of which I am a very strong advocate. Over the past 25 years, we have put too little money into capital expenditure on our health service. I am convinced we are 20 years behind in computerisation. We have 1,700 different computer systems in our health care system. Denmark's system has 25 and is working towards reducing this to five. It has saved a huge amount of money because of this computerisation. In fairness, this ties in with the point raised by Sinn Féin that computerisation results in far more accurate figures.

I wish to raise one final matter. More than 3.2 million people had outpatient appointments in 2015, of whom 487,000 people did not attend. This is over a 12-month period. My colleague raised Galway in this regard. In 2015, 35,000 did not attend their appointments in Galway. This raises the questions why and how this arose. It may not have anything to do with the patient but it is a huge issue in that the non-attendances are a waste of the valuable time of nurses and doctors.