Rose Conway Walsh (Sinn Fein)
Link to this: Individually | In context | Oireachtas source

I thank the Minister of State, Deputy Catherine Byrne, for coming to the Seanad, which enables me to demonstrate why it is vital that the Minister, Deputy Harris, does everything in his power to address the waiting lists for orthopaedic surgery at the Galway university hospitals. We often hear of hundreds of thousands of people waiting for procedures and appointments at hospitals throughout the country. Today I want the Minister of State to hear the case of one individual from my area. I have his full permission and that of his family to use his name in this regard. Nothing brings home the seriousness of the situation like hearing the details of the individual cases.

His name is Neil McEleney. He first underwent spinal surgery at UHG in November 2015. This was a triple spinal fusion which consisted of eight screws, three rods and extensive bone grafting. Two months later the screws slipped and broke two vertebrae, which resulted in the screws pulling out.

He then had a second operation in February 2016. This time the screws and plates were removed and more extensive hardware was used further up his spine. Unfortunately, he experienced severe pain for several months after the operation, at which time a scan showed that the screws had pulled out of the vertebrae and four screws loosened further down the spine.

The CT scan showed a haloing effect where the bone around the screws is being eroded with the constant movement. Every time he moves the screws and frame move, and the four loose screws further down are causing frame movement.

The unimaginable pain Neil is experiencing every minute of every hour and every hour of every day can only be described as inhumane. To complicate things further Neil has two underlying diseases, one is sarcoidosis which affects the lungs and muscles, and has unfortunately gone into the pituitary gland which has in turn caused Addison's disease. His consultants understand his operation requires a multidisciplinary approach involving respiratory and orthopaedic input, as well as endocrinology.

Neil desperately needs a third operation as his spine is out of alignment. This is called an osteotomy where basically a cut in the shape of a "V" is made in the spinal column and the spine is either bent or broken to realign it, and extensive screws and rods are fixed for two thirds of its length and anchored to the pelvis.

His consultant at the time Mr. Jadaan assisted by Mr. Fergus and Mr. John McCabe organised for Neil to have the surgery on 26 September 2016. He was admitted to UHG on 25 September 2016, put on a pre-operation IV drip due to the Addison's disease and was advised that he would be first to the theatre on Monday morning at 7.30 a.m. He was gowned and ready for surgery on 26 September, but as there was no spinal cord monitor the surgery had to be cancelled. Neil was discharged and sent home.

Since then he has been waiting in desperation. His endocrinologist has said he is in exquisite pain and he is concerned about the huge amounts of painkillers he has to take.

I quote his consultant orthopaedic surgeon who has stated,

This is major complex revision spinal surgery which is only performed in two centres in Ireland and the waiting lists for it are serious. This is largely due to failure to provide funding at the necessary level for pathway of care commensurate with modern spine practice and has not been adequately addressed.

The Galway university hospitals are also awaiting appointment of further consultants. Again I quote the consultant, who has stated,

I have patients waiting [since] as long as 2013 for spinal surgery under my care. I am not in a position to effect change in the pathway of care unless I get appropriate funding.

How Neil can get the vital surgery he needs? Last week he was sent to UHG by his GP for a much-needed CT scan. He was hoping to being admitted to the accident and emergency department. However, no CT scan was conducted and he was sent home again.

When the Minister, Deputy Harris, was in UHG last week, Neil and his wife Kathleen were there. They saw his entourage pass by but did not have the strength to speak to him. They have nothing left. They are mentally, physically or emotionally drained. I have a simple question for the Minister of State today. Neil has been given several reasons for not being able to have this vital operation at UHG including lack of staff, facilities and funding. He cannot wait in this excruciating pain indefinitely. Can this operation be done in a different hospital, specifically the spinal unit at the Mater Hospital, as a matter of urgency? I say that in the context of the desperation of people on the waiting list for orthopaedic surgery and the pain they are experiencing.

Denis O'Donovan (Fianna Fail)
Link to this: Individually | In context | Oireachtas source

The Senator is way over her limit.

Rose Conway Walsh (Sinn Fein)
Link to this: Individually | In context | Oireachtas source

I understand. I thank the Cathaoirleach, but it is such a serious case.

Catherine Byrne (Dublin South Central, Fine Gael)
Link to this: Individually | In context | Oireachtas source

On behalf of Minister Harris, I thank the Senator for raising this issue.

With respect to Galway orthopaedic services, trauma services are provided in University Hospital Galway and elective cases are treated at Merlin Park University Hospital.The most recent NTPF figures indicate there are 796 patients waiting for orthopaedic inpatient or day-case treatment in Galway University Hospital. Of these, 37, or 5%, have been waiting for more than 24 months. Three patients, which represent less than 1%, have been waiting for more than 36 months. The Saolta University Health Care Group advises that a review of orthopaedic services is currently under way across the group. Findings from the review will be forthcoming shortly. It can assure the House there have been concerted efforts to address waiting lists and reduce waiting times for orthopaedic services at Galway University Hospitals. A musculoskeletal physiotherapy service has been put in place and is being expanded to manage approximately 240 referrals per month. Patients are triaged and, as determined by their consultant, are seen by the physiotherapist. Galway University Hospitals also provides a dedicated orthopaedic pre-assessment service, which helps to ensure patients are appropriately assessed prior to surgery and that appropriate discharge planning is in place following surgery. There are currently nine full-time consultant orthopaedic surgeons in position in GaIway. Two additional surgeons, one with a special interest in paediatrics and the other in spinal surgery, are due to be appointed in March and September 2017.

Reducing waiting times for the longest waiting patients is one of the Government’s key priorities. It is for this reason that €20 million was allocated to the NTPF in budget 2017 which will rise to €55 million in 2018. Last December 2016, the Minister, Deputy Harris, granted approval to the NTPF for a day-case waiting list initiative, with the aim to ensure that no patient will be waiting more than 18 months by 30 June 2017. More than 2,000 day cases will be managed through the process and appointments under this initiative will be issued shortly. The HSE is due to submit waiting list action plans for inpatient day cases and outpatient waiting lists shortly. The focus of these plans should be to ensure that no patient on either list is waiting more than 15 months by the end of October 2017. The HSE has been requested to develop the inpatient day-case waiting list action plan in conjunction with and supported by the NTPF's approach for utilisation of the remaining €10 million of the 2017 funding for patient treatment. These plans are being finalised and the Minister, Deputy Harris, expects to receive them imminently. When requesting the waiting list action plans, the Minister raised concerns about the waiting times across a number of specialties in Galway University Hospitals. He expects that particular focus will be on Galway waiting times as part of the forthcoming action plans.

Denis O'Donovan (Fianna Fail)
Link to this: Individually | In context | Oireachtas source

The Minister of State is not the line Minister but I am sure she will convey what the Senator has said.

Catherine Byrne (Dublin South Central, Fine Gael)
Link to this: Individually | In context | Oireachtas source

I have taken down some notes.

Rose Conway Walsh (Sinn Fein)
Link to this: Individually | In context | Oireachtas source

I would appreciate if the Minister of State would relay this case to the Minister, Deputy Harris. I appreciate the review is being done but for people such as Neil on the waiting list, a review is of no consolation to them. Review after review is being done right across the board yet no action is being taken. The consultants are telling us they do not have the resources to do the job. We have to ask who is accountable. Can we find one person who is making the decisions? What we see in health all the time is the Minister passing it over to the HSE where it gets lost in the quagmire again and nobody is accountable. Somebody has to be accountable for leaving people like Neil in excruciating pain for months and months on end.

I appreciate the Minister of State coming in here today but I ask her to speak to the senior Minister, Deputy Harris.

Catherine Byrne (Dublin South Central, Fine Gael)
Link to this: Individually | In context | Oireachtas source

We all have personal stories of cases we find in our work as public representatives to relate to the Minister. Deep compassion and support for such families is needed at a time when people are suffering because of what has happened to them, particularly when they are waiting for appointments and surgery. I will pass on the details of the individual the Senator mentioned to the Minister and ask him to come back to the Senator on the case. I will get more details.