Jim Daly (Cork South West, Fine Gael) | Oireachtas source

I thank the Senator for raising this issue.

The NTPF publishes the inpatient and outpatient waiting list figures by specialty and hospital each month. This information is available on ntpf.ie.The most recent figures published by the NTPF for January 2018 indicate that there is a total of 38 people on the national inpatient day case waiting list for endocrinology and a total of 9,339 on the outpatient waiting list for endocrinology. Of this figure, almost 1,900 are on the waiting list at St. Columcille’s Hospital. Figures show that 42% of these patients have been on the waiting list for 12 months or less. Almost 40% have been on it for 18 months or more. However, I am advised by the HSE that urgent referrals are usually accommodated within four to six weeks. It is important to highlight that the NTPF waiting list data are extracted from the overall waiting list figures for the specialty and do not differentiate specific procedures for transgender patients from procedures for other patients on waiting lists. Reducing waiting times for the patients who have been waiting the longest is one of the Government’s key priorities. Consequently, in budget 2018, €55 million was allocated for the NTPF. This significant increase in funding almost trebles its 2017 total allocation of €20 million.

To date, the transgender service in Loughlinstown has developed on an ad hocbasis and all referrals are managed within general endocrinology OPD clinics. The service is operated between the psychiatry services, primarily in Cluain Mhuire, and the endocrinology service in St. Columcille’s Hospital. Patients who require an endocrinology assessment must have been initially assessed and referred by a consultant psychiatrist. The psychiatry clinics are held weekly in St. Columcille’s Hospital and can accept only one new referral per week.

It is welcome that the HSE has, as part of its 2018 budget, allocated funding of €100,000 to St. Columcille’s Hospital which will ensure dedicated funding for transgender services and see increased capacity within psychiatry and psychology services. This will increase the capacity of the clinic to see additional referrals. The HSE has advised that recruitment to fill the additional new posts at St. Columcille’s Hospital will commence in early 2018.

The existing care pathway for transgender people in accessing HRT follows international best practice. The guidelines were devised by experts in transgender health care, with members of the international transgender, transsexual and LGBT community, and supported by TENI. The care pathway generally begins with an approach by an individual to his or her GP. The GP may refer the person to the local community mental health team for support and a diagnosis of gender dysphoria by a psychiatrist or a clinical psychologist. A thorough assessment is a prerequisite to commencing hormone suppressers. This is to ensure the correct path is being taken for the individual and comorbidity issues are identified and addressed.It would be inappropriate for me as Minister to comment on the assessment process as this is a matter between clinical personnel and the individual concerned.