Thursday, 8 December 2016
Hospital Waiting Lists
I thank the Cathaoirleach for taking a very important Commencement matter and the Minister of State for making time in her very busy schedule. Cardiac care for patients in the south east has been an issue of concern for quite some time. I have raised many times with the Minister of State and her predecessors the issue of inequality of access to cardiac care for patients in the south-east region and especially for those who reside in east County Waterford, south Kilkenny and south County Wexford. These people are not in close proximity for interventional cardiology care after hours. This is a matter of deep concern that must be addressed. Access to interventional cardiology in the event of a heart attack after hours is simply not available, which is unacceptable. The reason we do not have this access is quite clear from some recent controversies; it is because we do not have a second catheterisation lab. Dublin, Cork and Galway have numerous catheterisation labs and Limerick, a city in the west of Ireland, has numerous catheterisation labs as well. This is a matter of equality of access to health care in the country that must be addressed.
Further to this, I was deeply concerned to learn recently that University Hospital Waterford patients have been on a waiting list for over a year to access cardiac diagnostic procedures. They are now being outsourced to private hospitals in other parts of the country. I understand over 90 patients have been transferred to other hospitals for this care, which is unacceptable for patients in the south-east region. How many more are on the waiting list and are to be referred to this private service? How much is this costing the State, as I know the Minister of State is rightly concerned about the health budget? It seems we are spending far more money in referring these patients to private treatment rather than dealing with them within the public health service. University Hospital Waterford already has expert cardiologists and staff and the service must be enhanced, as recommended in the recent Herity report.
The Minister of State might be able to clarify the issue. My understanding is that the HSE at University Hospital Waterford has applied for a mobile second catheterisation lab to deal with this waiting list. It would be far more efficient in delivering a good public health service if these patients were treated in the hospital in which they are patients. I am interested in the Minister of State's response this morning and this is a matter of deep concern. As I stated before, as a Government Senator I see it as no longer acceptable that people, patients and citizens of this country are treated in an unequal way in comparison with patients in other parts of the country.
I thank Senator Coffey for raising this important issue this morning. I also convey the apologies of the Minister, Deputy Harris, who is personally unable to attend this morning.
The Minister, Deputy Harris, visited University Hospital Waterford recently and is aware that there are waiting lists for cardiology procedures at the hospital, which is managed by the Health Service Executive, as the Senator knows. The Minister is keenly aware of waiting lists in cardiology and other specialties in hospitals around the country and I assure the House that the Government is committed to improving waiting times for patients. For that reason, last August, the Minister, Deputy Harris, requested the HSE to develop an action plan on waiting lists, focused on those patients waiting longest. Since then, under the waiting list action plan, over 8,000 patients have been removed from the inpatient and day case waiting list, either through the provision of treatment, clinical validation or because the patient has been given a date for the procedure.
The Senator may wish to note that €11.25 million in funding from the winter initiative contingency funding has recently been allocated to progress treatment for patients on inpatient and day case waiting lists. Of course, supporting waiting list measures under the winter initiative contributes to ensuring that people receive timely treatment and consequently do not end up requiring emergency care. I am glad to advise the Senator that the HSE has put in place process improvement plans in all hospitals in order to drive improvements in waiting list management at hospital level.
In that context, University Hospital Waterford is arranging to outsource 90 patients from the cardiology waiting list to undergo cardiac diagnostic procedures in public and private facilities. These 90 patients, referred to by the Senator, have been on the waiting list for over a year and because of this outsourcing initiative, these patients will, I hope, receive their procedure by year-end. All of these procedures will be undertaken in the Munster area, with the majority being undertaken in Cork University Hospital. The House will be aware that both Cork University Hospital and University Hospital Waterford are members of the South/South West Hospital Group.I am pleased that this hospital group is operating to maximise capacity to diagnostics across the group and that spare capacity in the Cork University Hospital's catheterisation laboratory is being used to address the Waterford waiting list.
Budget 2017 provides for our longest-waiting patients. Some €20 million will be allocated to the National Treatment Purchase Fund in 2017 and this will increase to €55 million in 2018. It is important to note that additional funding will be provided to University Hospital Waterford in 2017 to implement the recommendations of the Herity review, which has been mentioned by Senator Coffey. In his review of the need for a second catheterisation laboratory at University Hospital Waterford, Dr. Herity recommended that investment be made to enhance cardiology services at the hospital. Funding will, therefore, be provided to increase the number of weekly catheterisation laboratory sessions currently provided. This will help to address waiting times and provide improved access for patients. Details of this investment will be set out in the HSE's national service plan for 2017, which will be brought to the Government shortly. I have not yet had sight of the plan, but I am looking forward to reading it.
While I welcome the enhancements that are recommended under the Herity report and University Hospital Waterford should engage in those improvements immediately, I have to say I am disappointed with the statement in the Minister of State's response that "the majority" of patients will continue to be referred from University Hospital Waterford to Cork University Hospital. The Members of this House who are from Cork will confirm that Cork University Hospital is already experiencing capacity pressures. I understand that patients are being referred to the Bon Secours Hospital in Cork, which is a private hospital, but the Minister of State did not mention this in her response. The cost to taxpayers of referring patients to this hospital is far greater then the cost of providing a second mobile catheterisation laboratory in Waterford to deal with the waiting lists.
I advise the Minister of State to take into account that some decisions are being made by officials in the Department of Health. I suspect that an effort is being made within the Department to downgrade cardiac services. Many of my colleagues share my concerns in this regard. I welcome the presence in the Chamber of Senator Grace O'Sullivan in support of what I am saying. We need to act on this. I ask the Minister of State to engage with the officials in the Department of Health and to write back to me in detail in response to my questions. What would be the cost to the Department of having these patients transferred into private services? What would be the cost of providing a mobile catheterisation laboratory, which is the obvious solution the Department should consider?
I emphasise that the hospitals across the country are managed by the HSE and not by the Department of Health. The funding that is obtained by the Minister for Health in the budget is allocated to the HSE, which manages the budgets that are needed to run hospitals. According to the information I have received from the HSE, there is spare capacity in Cork University Hospital. There is no reference in the information I have received to patients being referred to the Bon Secours Hospital. I will make further inquiries for the Senator to ascertain whether such referrals are being made. It is clear that any spare capacity that exists within our own public hospitals should be used. The point I would make with regard to the downgrading of cardiac services is that the patient has to be at the centre of everything we are doing and at the heart of the policies being developed by the Department of Health. It is clear that patients have to come first. Therefore, the downgrading of any cardiac services would be a retrograde step and would certainly not be condoned. I will ask the HSE to provide the Senator with the details he has sought with regard to costs. I will also make inquiries about the use of private hospitals.