Victor Boyhan (Independent)
Link to this: Individually | In context | Oireachtas source

I welcome the Minister of State, Deputy Jim Daly, to the House. I put down this Commencement matter some time back. There are two aspects. One concerns the primary eye care report, which has been published, so I do not need to dwell on it. I thank the Minister and the Department for issuing that report. It was long-awaited and I understand it is currently being studied.

The next aspect concerns the definitive lists in regard to cataract procedure waiting times, which are enormous. While we have heard suggestions anecdotally about the number of cases, I have the latest numbers as I made contact with the National Treatment Purchase Fund this morning. These numbers are quite shocking and show we clearly have a major crisis in the whole area of ophthalmology. To share some figures with the Minister of State, this very day there are 36,581 people on the NTPF list for the outpatient specialties, with the longest waiters - those waiting 18 months and over - numbering over 5,500. The NTPF assured me this morning that these people could be waiting two, three, four or five years.

The Minister of State might take this information back to the line Minister. The NTPF has a format in regard to reporting, which goes from five months all the way up to 18 months, but after the 18-month category, there is no other category. There is a lot to be said for extending this to include the two-year, three-year and four-year categories. We need to find out the facts. The NTPF mandate is to treat those waiting longest for treatment, and I believe this is very important.

I want to also share the statistics for inpatient case specialties. There are approximately a further 13,000 people waiting for inpatient treatment, of whom 825 are waiting more than 18 months. While these figures do not all relate to cataracts, but to ophthalmology generally, I am advised that a very high percentage of those people have cataracts. What is really disturbing for these 36,000 people who are waiting on the outpatient list is that many of them have not been seen - they have never met a consultant to have a full eye assessment. Time is everything with the eyes, as with health in general, as the Minister of State knows.

I am concerned. I would like the Minister of State to share his knowledge and that of the Department on the exact numbers on the cataracts list. Has the NTPF been mandated to ramp up its capacity through funding resources and beds, given many of these are day procedures, to deal with people who have cataracts and cannot see? It is a very simple procedure and could be ramped up with very little intervention.

To conclude, there are three points. First, there is the issue of the lists. Second, can we look again at how ophthalmology is reported in the NTPF's database so we can specifically see the figures for cataracts? The final point is that there is a crisis and it needs to be addressed quickly. To have people waiting a substantial number of years without an assessment is unacceptable. I ask that the Minister of State would bring this back to the Department to see whether it can put in place specific measures to ramp up an initial assessment for everyone who presents and has been referred for an ophthalmology procedure.

Jim Daly (Cork South West, Fine Gael)
Link to this: Individually | In context | Oireachtas source

I thank the Senator for the opportunity to update the Seanad on current initiatives ongoing to address ophthalmology waiting times and the primary eye care report. I acknowledge that ophthalmology waiting times, including those for cataract procedures, are often unacceptably long and I am conscious of the burden and quality of life issues for these patients and their families. However, work is being undertaken to address ophthalmology waiting lists nationally.

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, rising to €55 million in 2018. The NTPF is currently rolling out its day-case initiative, which is focused on those waiting longest for day-case treatment. The NTPF has advised that, to date, nearly 3,000 patient files have been transferred to private hospitals under this initiative, close to 900 patients have accepted an offer of treatment and some 400 patients have received their procedure.

With regard to patients waiting for ophthalmology procedures in particular, over 1,800 who were offered treatment under the NTPF initiative and nearly all 400 who accepted treatment were ophthalmology patients. As a result of this initiative, the number of patients waiting longest for ophthalmology procedures nationally has decreased this month from 1,065 to 825.Furthermore, to reduce the number of long-waiting patients the Minister for Health asked the HSE to develop waiting list action plans for 2017 in the areas of inpatient day-case, scoliosis and outpatient services. These plans have been published and their implementation is ongoing.

The primary care eye services review group report was published on 28 June 2017. The report examines the primary care eye services currently provided to children and adults nationwide, including HSE directly-provided services and contracted primary care services. The report sets out models of care and referral pathways for the management of most eye care conditions and has determined that there is a need to move from community ophthalmic physicians managing all referrals to a model centred on a primary eye care team based in a primary care location, with optimum accommodation facilities, equipment and resources and supported by an IT patient management system. The HSE has estimated that the establishment of the primary eye care team will require investment of €20 million by the HSE over a four to five-year timeframe. It will be a matter for the HSE to prioritise the available resources to deliver the optimal health outcomes and the Minister for Health looks forward to the HSE implementing the report’s recommendations.

In addition, the Minister, Deputy Harris, is supporting other initiatives to address ophthalmology waiting times. Last week, he opened a new theatre at the Royal Victoria Eye and Ear Hospital which will enable an additional 1,150 cataract procedures to be performed between July and December this year. It is envisaged that an additional 3,000 procedures will be carried out in both 2018 and 2019. This will see the elimination of waiting lists at the hospital by the end of 2018 and the elimination of the Ireland East Hospital Group’s waiting list by the end of 2019. This new theatre also has the potential to provide significant additional capacity to help address the waiting list for cataract procedures nationally.

Victor Boyhan (Independent)
Link to this: Individually | In context | Oireachtas source

The plan outlined by the Minister of State is not ambitious enough in terms of the number of additional procedures that will be carried out in 2018 and 2019. I am disappointed with the reply. I accept the Minister of State is only setting out the facts but as I said the plan is not ambitious enough.

Let us deal with the facts. This morning, the National Treatment Purchase Fund, NTPF, circulated its list for the period up to 29 June 2017, which shows that there are 49,711 awaiting ophthalmology procedures. That is an enormous task. The Minister of State referred in his reply to an additional 3,000 procedures being carried out and to the elimination of lists. The Government has not even considered the ongoing additions to that list. We cannot predict additional need but we can categorically say that, as of today, there are 49,000 plus people on the waiting list. As I said, the Minister's plan is not ambitious enough and it is not good enough. I ask that the Minister of State convey that to the Minister.

I can assure the Minister of State that following the summer recess I will raise this matter monthly until it is addressed, and I expect other Senators and Deputies to do likewise. There is no comfort in this plan for the 49,000 plus people who are awaiting treatment under what was supposed to be a ramped up scheme. It is disappointing.

Jim Daly (Cork South West, Fine Gael)
Link to this: Individually | In context | Oireachtas source

I will pass on the Senator's very passionate views on the issue. I agree with him that as public representatives it is our duty to raise these issues to keep the focus on them and to keep the pressure on the system to deliver. That is our core function as politicians. We cannot carry out the operations but we can keep the focus on this issue and hold the HSE accountable in this regard.

I welcome the Senator's commitment to raise this issue monthly and I will be more than happy to come to this House every month to respond to him on the issue. The removal of cataracts is a small procedure. I understand that it is this area rather than the wider ophthalmology services that is of particular concern to the Senator. People who have cataracts, particularly elderly people, are often unable to drive or move safely around their homes and this has a huge impact on their quality of life. This is an area on which the focus must be increased to ensure greater delivery. I will support the Senator in his continued efforts to keep the focus on the issue and to ensure it remains a priority within the HSE.