Seanad debates

Thursday, 23 June 2016

Commencement Matters

Hospital Waiting Lists

10:30 am

Photo of Trevor Ó ClochartaighTrevor Ó Clochartaigh (Sinn Fein)
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Cuirim fáilte roimh an Aire Stáit. Ba mhaith liom comhghairdeas a dhéanamh léi i dtosach as ucht a ceapachán. Guím gach rath uirthi. I congratulate the Minister of State on her appointment and I wish her all the best.

A number of years ago we were told with great fanfare that the west was getting a new hospital group called Saolta that would go a long way towards solving the crisis in our health services in the west. Unfortunately the practice has not proven to be as successful as planned. The latest figures and statistics from the National Treatment Purchase Fund are stark for University Hospital Galway in particular. We have had much talk of leagues and people winning games etc., but unfortunately University Hospital Galway is top of the league again for all the wrong reasons for outpatient and inpatient waiting lists.

According to the latest figures University Hospital Galway is top of the list nationally with 31,417 waiting on its outpatient waiting list. When the figures are parsed more closely we can see that 4,744 on those waiting lists have been waiting for more than 12 months. The particular pressure points seem to be in cardiology, dermatology, general medicine, general surgery, gynaecology, neurology, ophthalmology, orthopaedics and ENT. Particularly worrying would be orthopaedics where 4,248 people are waiting on the outpatient list for University Hospital Galway.

Unfortunately the picture gets worse with the inpatient day cases by hospital. Not only is University Hospital Galway "top of the pops" again, but it is actually almost double its closest rival. It has 11,099 people on the waiting list. Its closest rival is Beaumont Hospital with 6,065. Again when the figures are parsed we can see that 2,907 people have been waiting for more than 12 months. So almost one in four people have been waiting for more than a year for the treatment they need.

Representatives of the Saolta hospital management group recently gave a presentation to Oireachtas Members and members of the regional health forum where they finally said publicly that they believe there is a massive issue with the hospital in Galway. We have been saying this for years. They said it was clear that the capacity of the present hospital cannot deal with the numbers passing through it and that is part of the reason for the consistently high numbers of people on waiting lists.

The physical building is not the only problem. There are huge issues with staffing, particularly a lack of nurses. The lack of theatre nurses has been highlighted as an issue as are specialists in various areas. Over the past five years I have heard that this would be addressed and there would be recruitment processes etc. However, the lists are getting ever longer and people are suffering for longer with no apparent solution in train. That is why this is a crucial question for the people of Galway.

As Senator O'Mahony will know part of the reason for the lists being so long is that the Saolta hospital group now covers the hospitals from Donegal down to Galway, including those in Mayo and Roscommon as well. People from all those regions are affected by such long waiting lists in Galway. It is totally unacceptable, and needs to be addressed as a matter of urgency. I look forward to the Minister of State's response to see what plan and strategy the Department has to ensure this is addressed as a matter of urgency.

Photo of Helen McEnteeHelen McEntee (Meath East, Fine Gael)
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Tá brón orm nach bhfuil mórán Gaeilge agam, so I will respond in English. I thank the Senator for giving me the opportunity to address the House on this issue. I again apologise for the mix-up yesterday. I am taking this debate on behalf of my colleague, the Minister, Deputy Harris, who sends his apologies; he is elsewhere on Government business.

Tackling waiting lists has been a challenge for hospitals this year to date, particularly due to increased demand for emergency care, which increased by 5.6% over last year. Waiting lists for specialties such as rheumatology, orthopaedics, ophthalmology, urology, plastics and ENT are challenging nationally. However, the 2016 HSE service plan undertakes to maintain 2015 levels of service in respect of scheduled care.

The HSE oversees and supports hospital groups in meeting the waiting list targets and has established a scheduled care governance group to co-ordinate key actions to reduce waiting times.University Hospital Galway, UHG, as part of the Saolta University Health Care Group, continues to monitor and act on outpatient, inpatient and day-case targets in line with the HSE national service plan. The hospital provides tertiary level services and accepts referrals from a large catchment area, contributing to waiting list length.

The HSE has advised that specific measures have been taken to reduce the length of current waiting lists. Additional outpatient clinics are taking place within UHG, while some activity is being transferred to Mayo, Roscommon and Portiuncula University Hospitals. UHG is developing the elements required to support specialties with the longest waiting times regarding inpatient beds, high-end equipment, access to theatre and staffing, all of which are required to support greater elective surgery throughput. Initiative clinics are running in some specialties to reduce particularly challenging waiting lists, some led by allied health professionals, such as physiotherapists and nurses.

The HSE has further advised that IT solutions are being deployed to validate current waiting lists and streamline outpatient appointment scheduling, as well as minimising those do-not-attend cases. The shortage of radiographers, causing recent issues with the MRI and DXA scanning facilities, is being addressed by ongoing recruitment. Extended hours of operation are being implemented for the MRI facility. UHG has recently protected the surgical day ward for elective activity as demand for emergency care decreases. Construction work is ongoing on a new 75-bed ward block, as well as a new UHG acute mental health department.

The Minister is confident the Saolta group, in conjunction with the HSE, is working to address waiting lists at UHG in the best interests of patients. The programme for a partnership Government emphasises the need for sustained commitment to improving waiting times for patients, with a particular focus on those waiting longest. It commits to €15 million funding to the National Treatment Purchase Fund in 2017 for an initiative targeted at those waiting longest as part of continued investment of €50 million per year to reduce waiting lists. The Department of Health is engaging with the NTPF, while the HSE in planning a dedicated 2016 waiting list initiative focussed on endoscopy. It has also commenced engagement with the NTPF and the HSE to deliver on the programme for a partnership Government waiting list commitments. The fact a high number are waiting over 12 months needs to be a priority for the Minister. I will bring it to his attention. We have been successful in many areas but we still have much work to do in this regard.

Photo of Trevor Ó ClochartaighTrevor Ó Clochartaigh (Sinn Fein)
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I thank the Minister of State for her response. I am glad she acknowledged that waiting lists in Galway are higher than anywhere else. The short-term needs must be addressed and I hope the NTPF can examine prioritising Galway. The elephant in the room, however, is the need for a new hospital, along with the necessary resources, in Galway to deal with the needs of the area. Previously, I have called on the Minister to put together a working group to look at building a new hospital in Galway on a greenfield site with the requisite staffing and resources. Dr. Pat Nash, the clinical director of the Saolta hospital group, has called for that. Anyone in Galway and across the region can see that it is imperative if the hospital group is to continue servicing the region. Will the Minister of State ask the Minister for Health to consider setting up a working group immediately to look at the need for a new hospital in Galway on a greenfield site?

Photo of Helen McEnteeHelen McEntee (Meath East, Fine Gael)
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I will do that. I will also ask the Minister if the €15 million fund can be specifically used for dealing with Galway.