Kathleen O'Meara (Labour)
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I appreciate the Cathaoirleach's decision to allow me to raise this important matter on the Adjournment. I thank the Minister of State, Deputy Seán Power, for coming to the House to respond to the points I will make.

I imagine that the Cathaoirleach is familiar with the location of Croom Orthopaedic Hospital. I would like to highlight the problems faced by two people from Nenagh who have come to see me to discuss their problems. They have been told by their general practitioners, to whom I have spoken, that they will have to wait two and a half years before they get an appointment for their complaints to be examined at Croom Orthopaedic Hospital. I saw one of the people to whom I refer in Nenagh this morning, before I travelled to Dublin. He is losing weight at such a rate that he will turn into a skeleton shortly. The great pain he is suffering in his back means he cannot go up and down the stairs in his house, even though the bathroom is upstairs. He is totally miserable because he is suffering severe pain. I find it extraordinary that he has been told that nothing can be done about the two and a half year waiting list.

Having done some investigations, I have found out that no clinics from Croom Orthopaedic Hospital have taken place in Nenagh since last February, even though Nenagh is supposed to benefit from a clinic rotation whereby orthopaedic services are provided there every fifth Monday. However, that system is not currently operating because of a shortage of consultants.

I understand some changes were made to the relevant rota following the retirement of a consultant, who presumably has not been replaced. It seems the matter is under review, although I hope the Minister of State will say a little more than that in his response. It is extraordinary that public patients have been told by their GPs, who are equally highly frustrated by the current problems, that they will have to wait for two and a half years.

The second case with which I am familiar relates to a man who is not old, but is of advancing years. He is starting to wonder whether his complaint will ever be assessed and dealt with. It would be a very different matter if the people in question were private patients. I thought we had made a commitment to equality of treatment, but that is clearly not the case in this instance. It is nothing short of a scandal that patients in the public system have to wait for two and a half years to get an appointment. It is simply not acceptable. I hope the Minister of State will not just tell me that the matter has been raised, that it is under review and that something may happen in the near or distant future. I look forward to the Minister of State's response.

I appreciate the Cathaoirleach's agreement to allow me to raise this matter. As we are aware, in recent times matters relating to the Health Service Executive or health in general have been kicked forward, which has been very unsatisfactory for public representatives. The HSE knows about this unacceptable situation because we all raised it with its representatives last Wednesday week.

Seán Power (Kildare South, Fianna Fail)
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I thank Senator O'Meara for raising this matter on the Adjournment. I will respond to it on behalf of my colleague, the Tánaiste and Minister for Health and Children, Deputy Harney.

The Health Service Executive is responsible for the provision of acute hospital services at Croom Orthopaedic Hospital. Having made inquiries of the HSE, the Department of Health and Children has been informed that all general practitioner referrals for orthopaedic consultants are currently placed on Croom Orthopaedic Hospital's outpatient waiting list. If a GP referral indicates that an appointment is urgent, it is reviewed by the consultant orthopaedic surgeon. If the referral letter does not make reference to the degree of urgency, the referral is assigned an appointment based on the available time slots. Referrals marked for the attention of a particular consultant orthopaedic surgeon are reviewed by the consultant and prioritised for assessment. Every effort is made to see urgent referrals on a timely basis. There are six orthopaedic surgeon posts in the mid-west, one of which is currently vacant pending the filling of it on a permanent basis by the Public Appointments Commission.

The HSE has initiated an independent external review of all acute hospital services in the mid-west, to ascertain how they can be developed in accordance with best practice. The review will be completed by the end of the year, following which its findings will be published. The process of appointing consultants to conduct the review is about to commence. The consultants will be asked to consider and make recommendations on the options for reconfiguring and redesigning services, to identify the elements of health care which can be most effectively delivered at each site and to set out what needs to be done to achieve this goal. The report will allow the HSE in the mid-west to define more clearly the level at which services should be planned, give examples of how they should be provided at and across each acute hospital site and offer some practical guidance to management and clinical personnel. I emphasise the Government's commitment to the continued development of services at Croom Orthopaedic Hospital and the continued provision of high quality and safe acute hospital services to the people of north Tipperary and the mid-west.

The National Treatment Purchase Fund is a health strategy initiative, the task of which is to achieve reductions in waiting times and, in particular, to offer treatment to patients who have been waiting longest. It has made significant progress in reducing waiting lists and waiting times since it was established in April 2002. Patients are now waiting between two and five months for the most common surgical procedures. Over 43,000 patients have had treatment arranged under the fund to date. Those waiting for more than three months will be facilitated by the fund in most instances. Some 470 patients from the mid-west region received treatment under the fund in 2005. At the Tánaiste's request, the fund established a number of outpatient pilot projects throughout the country in 2005. Over 4,400 patients received outpatient consultations in private hospitals as a result. As the fund is expanding the outpatient initiative in 2006, it has asked for proposals from hospitals in this regard.

I have been informed that the mid-west region of the HSE will be commencing referrals for outpatient appointments for patients waiting for assessment or surgery at Croom Orthopaedic Hospital. I understand that up to 150 patients who are waiting for outpatient appointments at the hospital are being referred to the Bon Secours Hospital in Cork. If Senator O'Meara wants to pass on the details of the cases she has raised, I will be more than happy to follow them up with the HSE.

Kathleen O'Meara (Labour)
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I thank the Minister of State. I will be happy to supply the details in question to him. I note that 150 patients are waiting for outpatient appointments at Croom Orthopaedic Hospital. I am sure the Minister of State will agree that is an extraordinary situation. When is it likely that the system of referring the patients in question to Cork will start? The Minister of State's response did not indicate when that will happen.

Seán Power (Kildare South, Fianna Fail)
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It is following on from the success of the National Treatment Purchase Fund.

Kathleen O'Meara (Labour)
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When will the specific referrals from Croom to Cork begin?

Seán Power (Kildare South, Fianna Fail)
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I cannot give the exact timing of that but I will check with the HSE on the matter. Following on from the success of the National Treatment Purchase Fund, it was decided these pilot projects would be put in place, which appear to be working successfully. I assumed they were already in place with immediate effect. I will have the matter clarified and come back to the Senator.

Kathleen O'Meara (Labour)
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The Minister of State used the future tense, "will be commencing".

Seán Power (Kildare South, Fianna Fail)
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Rather than give the wrong answer, I will check the matter and come back to the Senator on it.