Brian Ó Domhnaill (Fianna Fail)
Link to this: Individually | In context | Oireachtas source

I want to raise another health matter, namely, the situation at Letterkenny General Hospital which is escalating week by week of the huge delay in appointments and waiting lists for urology services at the hospital. This has been escalating since Dr. Kevin Moran resigned from his position at the hospital due to a number of factors. As a result, the waiting lists have escalated out of control. The hospital now advises GPs and patients that it cannot provide for them and people can go either to Galway or Ballykelly. In fact, I have received that communication from the office of the manager of Letterkenny General Hospital for a patient as recently as last week. This matter affects hundreds of patients in County Donegal awaiting urology and related appointments.

The figures for August 2015 showed that 880 patients were waiting on an outpatients urology appointment at the hospital, 343 of whom had been on the list for more than one year. There were also 233 patients awaiting an inpatient urology appointment. Dr. Rogers, who is based in Galway, provides some cover for inpatient appointments but there is no cover whatever for outpatient appointments at Letterkenny General Hospital.

The waiting lists at Letterkenny hospital are escalating out of control. I know the Minister visited the hospital recently. Does he agree it is acceptable to have 15,000 people waiting for an outpatient appointment at the hospital, 4,000 of whom have been waiting for more than one year? Is that an acceptable standard in the Department of Health? I do not think it is. One gentleman in particular who has been waiting for a urology appointment at the hospital for more than two years has been in touch with my office and I have spoken to him. His circumstances are such that instead of him being given an outpatient appointment, there is no alternative but to put him on severe medication which is having an adverse effect on his health. He has had no option but to ask his GP to refer him elsewhere given that Letterkenny General Hospital has advised, through my own office, that there is no chance he will be given an appointment in the near future. He is only one of 880 patients and I am aware of many other examples.However, this matter requires urgent attention and approval at the highest level by the Minister's good office to allow for the appointment of a consultant urologist at Letterkenny General Hospital. This post has been vacant. It is my understanding that a locum urologist was due to take up appointment at Letterkenny but due to a lack of scheduled operating times, he moved elsewhere.

A recent reply to a parliamentary question in the other House advised that the appointment was a matter for the hospital but the hospital management advised, as recently as in the past ten days, that they are waiting for sanction from the Department of Health to appoint a new urologist. I raise the issue to seek clarification and a commitment from the Minister that a consultant urologist will be appointed at Letterkenny General Hospital without any further delay. I am also anxious to ascertain the Minister's view on the escalating waiting lists for urology appointments and the general scheme, with more than 15,000 people waiting for an appointment at the hospital and 4,000 people waiting for over 12 months.

Leo Varadkar (Dublin West, Fine Gael)
Link to this: Individually | In context | Oireachtas source

I thank Senator Ó Domhnaill for raising this issue and for giving me an opportunity to update the House. Improving waiting times for scheduled care for patients is a key priority for the Government. In January, I put in place maximum permissible waiting times for inpatient and day case treatment and outpatient appointments of 18 months by 30 June and 15 months by the end of this year. In excess of €51 million in supplementary funding has been provided this year in order that these maximum waiting time goals can be achieved. This comprises an extra €26 million, in order that the 15-month maximum waiting time can be achieved by the end of the year, on top of €25 million provided earlier this year to help the HSE to meet the 18-month target by the end of June.

In June, the HSE reported a performance against the 18-month maximum of 99.6% for inpatient and day case treatment and 92% for outpatient appointments. To maintain progress and to make further improvements to achieve a 15-month maximum by the end of December, the HSE has launched its new initiative to ensure hospitals both comply with the new maximums and address any outstanding long waiters, following the first wave of targeted waiting list activity up to July 2015. Progress against all targets and plans for waiting lists will continue to be monitored closely and moved forward through the HSE performance management and accountability framework.

On urology at Letterkenny General Hospital, I am informed that the former consultant urologist in Letterkenny retired in February 2015. The hospital has tried to secure a locum consultant urologist pending the appointment of a substantive post but has been unsuccessful so far. To ensure appropriate urology care continues to be provided to the patients of the north west, arrangements are in place for both emergency and planned urology admissions. Patients who require emergency admission for urology services are referred to University Hospital Galway, as has been the long-standing practice in cases where the consultant urologist was not on call. Non-emergency urology services are being provided from within the Saolta group at University Hospital Galway and Portiuncula Hospital, Ballinasloe. Inpatient treatment for some patients has also been arranged in Northern Ireland. These measures will continue while a consultant urologist is being recruited for Letterkenny.

On urology equipment, Letterkenny has received approval to purchase a new male urodynamic machine to the value of €25,000. The national procurement service of the HSE has begun the procurement process for the purchase of this equipment. I can also inform the Senator that the volume of general surgery undertaken at Letterkenny General Hospital has expanded through the appointment of a temporary general surgeon to provide emergency general surgical services, and the permanent post has been advertised.

Urology services are an essential component of clinical care at Letterkenny General Hospital. I am assured that the Saolta university health care group and local hospital management are fully committed to restoring the full urology service at the hospital and are making every effort to restore that service as soon as possible, including working with all the appropriate medical agencies with which the hospital has a contract.

Brian Ó Domhnaill (Fianna Fail)
Link to this: Individually | In context | Oireachtas source

I have listened attentively to the Minister and the words being expressed are the normal reply given in these Houses coming from officialdom within the Department of Health. No assurance is given whatever. We have been told that efforts were made with the locum consultant urologist. I explained in my contribution what happened there. We are being told that those requiring admission or non-emergency admission can be referred to Galway or Ballykelly in the North. There is nothing in the reply stating that sanction or approval has been given by the Minister's Department to allow for the appointment of a new consultant urologist.

Is it the case that the approval has not been given? If the approval had been given, it would have been referred to in the reply. What is the hold-up in appointing a new consultant urologist at Letterkenny General Hospital? As indicated in the Dáil, is it the case that this is a matter for the hospital and approval has been given by the Department? Is the hospital waiting on that approval from the Department? The information I received from the management at Letterkenny General Hospital is that it is awaiting approval and sanction from the Department. I need clarification on that point.

Leo Varadkar (Dublin West, Fine Gael)
Link to this: Individually | In context | Oireachtas source

The Senator mentioned earlier that a constituent has been on a waiting list for outpatient treatment for more than two years. With the agreement of the patient, the Senator could pass the details to my office as anybody waiting more than 18 months at this stage is supposed to be referred to another hospital, with the money following them, or referred privately. If that has not happened-----

Brian Ó Domhnaill (Fianna Fail)
Link to this: Individually | In context | Oireachtas source

The patient is being referred to Galway because Letterkenny could not deal with it.

Leo Varadkar (Dublin West, Fine Gael)
Link to this: Individually | In context | Oireachtas source

I thank the Senator for clarifying the matter as I want to know if there are cases of people waiting more than 18 months to be seen. When I inquire and get the details, the story turns out to be a little different, as it has in this case too.

I visited Letterkenny in the past two weeks and met representatives of the cancer campaign and community groups - that was a very good meeting - and the general manager. That issue was raised specifically, including concerns around urology. I share those concerns. I would be surprised if the Senator did not know it already but ministerial approval is neither sought nor needed to appoint a consultant and my Department does not approve consultant posts any more than the Minister for Education and Skills approves teaching posts. Perhaps she does but when it comes to health, it has not been the case, if it was ever the case, that consultant posts would require departmental or ministerial approval. Such posts require the approval of the national consultant advisory committee, which is a body within the HSE that examines how posts are structured and whether they are sustainable. It will modify posts and, for example, sometimes want a post to be changed in order that a new person taking a post would do weekends or extended hours, leading to an enhanced service. Any new appointment must go through that committee.

I am not aware of any delay in approving that post but I will make inquiries and revert to the Senator.