David Cullinane (Sinn Fein)
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I have tabled this motion on the back of a parliamentary question my party colleague, Deputy Caoimhghín Ó Caoláin, tabled last week on hospital waiting times at University Hospital Waterford. Every time I table parliamentary questions, which I have done since 2011, the waiting times are getting worse. I will not judge the Government on my standards or Sinn Féin standards but on the standard that the Government and the Minister for Health have set themselves, which is that no patient should be waiting longer than 12 months to see a consultant, yet the figures for University Hospital Waterford show that 24,274 patients are on waiting lists. Of those 8,478 are waiting longer than 12 months. In the specialty areas, 835 are waiting for dermatology, 722 for general surgery, 736 for ophthalmology, 2,375 for orthopaedics and 1,939 for ear nose and throat services.

The reason for this - I have had this argument over and again with the Minister for Health and the previous Minister for Health - is that since 2009, University Hospital Waterford has lost more than 300 staff, 130 of whom were nurses. It also lost two surgical theatres, a ward, critical bed places and generally capacity has been reduced. Year on year the funding has been cut. The reduction in capacity from staff, beds and surgical space has meant that the hospital is not in a position to meet the needs of patients. In addition, many hospital consultant posts l have not been filled. A number of cancer specialists have been very critical of the lack of consultants in the dermatology unit. Orthopaedic surgeons who work in Waterford regional hospital or University Hospital Waterford are critical of the lack of orthopaedic consultants. It is clear there is a serious lack of capacity in the hospital that needs to be filled as is clear from the figures. It is unacceptable that nearly 8,500 patients are waiting longer than 12 months to see a consultant. Will the Minister explain to me and the people of Waterford and the south east why these people have to wait longer than 12 months to see a consultant? Why do patients have to wait for so long? Will he acknowledge that it is current Government policy that all patients should be seen within 12 months? Will he outline what extra resources will be put in place, the consultant posts that need to be filled and when those vacant consultant posts will be filled.

Michael Ring (Mayo, Fine Gael)
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I thank the Senator for raising the issue which has been raised on many occasions, including during my recent visit to Waterford.

Improving waiting lists for scheduled care is a key priority for the Government.Under Future Health, significant structural changes are envisaged for the acute hospital sector, with the formation of hospital groups and the reorganisation of services to improve both quality and access. These structural changes are under way but will take some time to fully implement. In the meantime, operating pressures remain on acute hospitals. The House will be aware that an additional €74 million was announced earlier this month to tackle delayed discharges and emergency department overcrowding. This was on top of additional funding of €25 million provided at the start of the year and an additional €3 million provided in late 2014.

As regards waiting lists, I understand the HSE has put in place specific measures to address waiting times. These measures include observation of the national waiting list protocol, adherence to the relevant HSE national clinical programme guidelines and prioritising day of surgery admission, where this clinically appropriate.

I note that the special delivery unit indicates that there is still significant potential to improve performance in hospitals. It is important, therefore, that hospital performance is closely monitored. The House will recall that a revised accountability framework for the HSE was published as part of the 2015 service plan. The framework requires a formal performance management framework for hospitals to include access, quality, outcomes and financial performance. I am assured that waiting list performance will be assessed within the revised framework.

It is also important that we know the true extent of the waiting lists to facilitate better planning and management. In that regard, an exercise to validate inpatient waiting lists to establish more precise information on the volume of people awaiting care has commenced. In addition, the HSE has started to publish waiting lists at consultant and specialty level; therefore, it will be clear to all where the bottlenecks are.

Taking into account current pressures on acute hospital services, the Minister for Health has put in place a target that by mid-year nobody will wait more than 18 months for inpatient and day case treatment or an outpatient appointment. By the end of the year the target will be revised to a waiting time of no more than 15 months. The HSE is working on an implementation plan to achieve these targets.

I understand University Hospital Waterford has worked on a local plan to tackle its waiting lists which is being considered within the south-south west hospital group.

With regard to consultant appointments, I am advised that two consultant urologists are expected to take up posts in the coming months and that progress is being made in the recruitment of two consultant dermatologists. The hospital is also in the process of recruiting a temporary part-time ENT consultant to assist with the management of the waiting list.

The Minister has confirmed that his Department will continue to work with the HSE to ensure issues relating to hospital waiting lists are addressed.

David Cullinane (Sinn Fein)
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With all due respect to the Minister of State, he did not write that script. It was obviously written for him by a civil servant in the Department of Health. It is clearly an inadequate response to the questions I have asked. It talks about reassuring people that waiting list performance will be assessed. It then talks about performance evaluation and the significant potential of the special delivery unit. Bizarrely, it goes on to indicate that the 12-month time period - the Government's own stated promise - is a moveable feast. It is now 18 months and might be 15 months before the year is out.

The Minister of State said two consultant posts would be filled. In addition, he referred to bottlenecks, but they are already included in the Minister for Health's figures. The specialties of dermatology, ophthalmology, ENT and general surgery all have high waiting lists. Some 6,000 patients have been waiting for longer than 18 months. Senator Colm Burke is passing information to him, but it is the Minister of State who is sitting in the ministerial seat. If the Senator wants to be a Minister, he will have to wait until he is appointed. I am sure the Minister of State is well able to answer my questions.

Paddy Burke (Fine Gael)
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Does the Senator have a question for the Minister of State?

David Cullinane (Sinn Fein)
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What is the Government going to do to reduce waiting times? All the Minister of State has said is that the position will be assessed and reassessed.

Maurice Cummins (Fine Gael)
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Four consultants have been appointed.

David Cullinane (Sinn Fein)
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That response is simply not good enough. If that is what the Government is going to do, it will not reduce waiting times at University Hospital Waterford.

Maurice Cummins (Fine Gael)
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The Senator should not play politics with the issue.

David Cullinane (Sinn Fein)
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In 12 months time I can guarantee that, if resources are not provided, the Minister will not have met the 18-month and 15-month targets.

Michael Ring (Mayo, Fine Gael)
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First, four consultants have been appointed.As I indicated, earlier this month the Government announced an additional €74 million to tackle overcrowding. This allocation is additional to the €25 million in extra funding provided at the start of the year and a further €3 million provided at the end of last year.

Having inherited a very serious problem, the Government is bringing order to the nation's finances. If we were to adopt the policies of the Senator's party, we would not be able to tax anyone or generate revenue. Sinn Féin does not want to pay hospital consultants more than €150,000 per annum, yet we are already experiencing great difficulties in attracting consultants to work in the health system because they can earn more abroad. We want to solve the problem of overcrowding in hospitals. The Minister for Health is committed to doing so and has worked hard at Government level to deliver the funding needed to address the problem.