Wednesday, 30 September 2015
Hospital Waiting Lists
I welcome the Minister of State and thank him for taking this Commencement matter. Since I was elected to Seanad Éireann, I have tabled Commencement or Adjournment matters on waiting times at University Hospital Waterford, formerly known as Waterford Regional Hospital, at least twice each year. Unfortunately, for the past seven years, under this Government and its predecessor, services and capacity at the hospital have been reduced. It has lost surgical theatre space, beds, wards and front-line staff, as have all other hospitals. These cuts have an impact on patient care. On each occasion that I raise this matter, I point out that waiting times at the hospital have increased since I last raised the issue. The most recent figures show that more than 7,000 patients have been waiting for longer than 12 months to be seen by a consultant in Waterford University Hospital and the south east. Sinn Féin did not set the benchmark that patients should be seen within 12 months. It was set by the Government, yet many patients must wait longer than 12 months. Rather than deal with this issue and face up to the fact that its policy has failed, the Minister simply moved the goalposts by changing the benchmark to 18 months.
I will give the Minister of State a flavour of how bad things have become at University Hospital Waterford despite the best efforts of managers, front-line staff and other health service employees. A newly built delivery suite is still not open or operational for funding, capacity and staffing reasons. In addition, people in the south east were promised a palliative care unit by previous Ministers for Health as far back as the period in which the Progressive Democrats Party was in government. Despite a number of announcements, the unit has not yet been built and people in Waterford must engage in fund-raising to pay to have the unit developed. The south east is the only region in the State that does not have a palliative care unit. The Government has also failed to deliver the promised 24-7 cardiology service.
University Hospital Waterford is experiencing serious capacity issues. The Government should be ashamed of its approach to the health service, especially in light of a serious incident in Waterford last week when ambulances were diverted from taking patients to University Hospital Waterford to hospitals in Wexford and Kilkenny. Can the Minister of State honestly claim that it is acceptable in 2015, four years after his Government took office, that patients are being diverted from a regional hospital? Can he imagine circumstances in which patients would be diverted from any other regional hospital?
That may be the case but he can certainly refer them to the Minister for Health. The Minister of State came to the House to take this serious matter on behalf of the Minister.The Minister for Health must be aware of what happened in Waterford last week. I am sure the Minister of State will accept that it is unacceptable that patients were diverted from a regional hospital because of capacity and funding issues. These are ambulances carrying sick patients which are told to bring those patients elsewhere. It is not good enough and it is all down to capacity. My questions for the Minister of State and the questions which were tabled are as follows. What are the current waiting times? What are the most current figures and has there been any improvement? Some patients in Waterford were diverted to Mullingar for treatment at a greater cost to the State because they could not be treated in Waterford. The Government is making a mockery of its own policy on patients being seen in their own areas where possible and within 12 months. It has tried to massage the figures as we get close to an election and is putting more pressure on patients. I am asking for the most up-to-date figures. Let us see if there has been any improvement since the last time I raised these issues some months ago.
I thank Senator Cullinane for raising this important matter. I represent south Tipperary which is part of the same hospital group as Waterford and I want to be very fair in acknowledging that huge changes have taken place in the health service in our area. There is no magic wand in relation to funding and the reality is that change has taken place notwithstanding that staff are under a great deal of pressure. People are making the changes and there is no doubt that a better service is being delivered now than was provided some years ago.
The Government is committed to developing therapy services for children with a disability, including speech and language and occupational therapy and psychology services, in so far as possible within available resources. Speech and language therapy services in Waterford are provided by HSE teams in primary care and disability services as well as by the Brothers of Charity and the Central Remedial Clinic's regional service. There are currently 15 approved speech and language therapists in the Waterford service overall with six therapists assigned to primary care services, five to the children's specialist disability services while the remainder look after adults, mental health and other needs. In addition, the Central Remedial Clinic's regional service provides more specialised speech therapy for particular children with physical and sensory disability across the whole south east region. Of the 15 speech and language therapy posts, two are temporarily vacant at present due to maternity leave. Local HSE management has prioritised the filling of these posts but I understand there are difficulties nationally in terms of filling such temporary positions. The Waterford service also includes ten additional occupational therapy posts. Five therapists are assigned to the paediatric disability services, two are working in the Central Remedial Clinic and the remaining three are employed in the CAMHS team. There are two psychology posts in disability services, one of which is on the autism diagnostic team. I understand that this particular post is currently vacant and efforts are ongoing to fill the position. The Senator may wish to note that a number of psychologists are also employed in Waterford's CAMHS and primary care services.
The Senator has also raised the issue of waiting times in Waterford for an assessment of needs. Part 2 of the Disability Act 2005 provides for an assessment of needs to be commenced within three months of receipt of an application and completed within a further three months. The HSE has advised that 28 assessment-of-needs applications under the Act were received in Waterford this year up to the end of June, all of which are being processed at present. A further 28 applications on hand for over six months are currently overdue for completion. While such delays are clearly not desirable, I stress that the assessment process under the Act can take place in parallel with any interventions deemed necessary and guidance to this effect has been issued to front-line staff. I understand that there have been particular delays for children waiting to be assessed for occupational therapy arising from staff vacancies in the occupational therapy service. However, these vacancies have now been filled in respect of services for children aged up to six years of age and for children with autism which should help address this issue. I also understand that 80 children in the Waterford area are currently on the HSE's waiting list for autism assessment or diagnosis. Priority is being given in the first instance to those children who commenced primary school in September 2015 and then to children who will be on the special educational needs organiser list for March 2016. In the meantime, HSE management in the Waterford area has agreed to outsource these assessments to an external provider. A procurement process to provide these services is currently under way and will be finalised shortly. It is expected that assessments will then commence in October 2015.
The HSE is currently involved in a major process of reforming and re-configuring its services for children with disabilities through its progressing disability services for children and young People programme. Additional funding of €4 million has been allocated to the programme this year, equating to 120 new posts, including six additional therapy posts in Waterford. These include two additional speech and language therapists and two additional occupational therapists. Along with the outsourcing of assessments of needs, I am confident that these service reforms when fully implemented will help improve the waiting times which the Senator has highlighted today.
I apologise to the Minister of State, but I tabled a number of commencement notices and there was a mix-up on my part. There was one on waiting times at the hospital and another on waiting times for children with disabilities. The latter is the one that was selected for today.
I welcome the six additional therapy posts. It is important that children with disabilities have access to early intervention and as much support as they can possibly get. That is certainly good news. There has also been some good news where there were delays in carrying out assessments due to the assessment team not being at full complement on foot of a number of posts which were not filled, including a senior child psychologist post. I understand the HSE is buying in those services now and that all children will be assessed before the end of the year, which I welcome.
If he can, I ask the Minister of State to bring the first issue back to the Minister for Health which is the issue of what happened in University Hospital Waterford with ambulances being diverted. A senior consultant who works in the accident and emergency ward was on a Waterford local radio station this week and said it could happen again. As somebody who lives in the south east, I doubt that is something the Minister of State could stand over or would want to see happen. It is a very serious and urgent issue and I ask the Minister of State to bring it to the attention of the Minister for Health.
There are ongoing issues with the health service in the south east which we must all work to improve. I will certainly relate the matter to the Minister for Health. That instance in Waterford should certainly not be happening and the Minister's attitude would be the same as mine. We should work to ensure that does not happen again. I assure Senator Cullinane that I will talk to the Minister about it.