Fergus O'Dowd (Louth, Fine Gael)
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Question 90: To ask the Tánaiste and Minister for Health and Children the way in which she reconciles the fact that public hospitals have extra capacity for elective surgery when the surgery comes under the National Treatment Purchase Fund; and if she will make a statement on the matter. [35414/05]

Seymour Crawford (Cavan-Monaghan, Fine Gael)
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Question 101: To ask the Tánaiste and Minister for Health and Children her views on the recent report from the Comptroller and Auditor General regarding the National Treatment Purchase Fund; and if she will make a statement on the matter. [35378/05]

Denis Naughten (Longford-Roscommon, Fine Gael)
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Question 108: To ask the Tánaiste and Minister for Health and Children further to the report of the Comptroller and Auditor General the way in which a hospital with a long waiting list for operations can have the spare capacity to do private work; if these hospitals, if funded properly, could do the same work; and if she will make a statement on the matter. [35410/05]

Mary Harney (Dublin Mid West, Progressive Democrats)
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I propose to take Questions Nos. 90, 101 and 108 together.

In the context of his examination of my Department's appropriation account for 2004, the Comptroller and Auditor General carried out a review of the operation of the National Treatment Purchase Fund, NTPF, in 2004. The responses from the fund and my Department to the issues raised in the Comptroller and Auditor General's report have been fully recorded in the text of the report and are a matter of public record.

The NTPF was established as one of the key actions for dealing with public hospital waiting lists arising from the 2001 health strategy. The strategy envisaged that the NTPF might also make use of any capacity within public hospitals to arrange treatment for public patients. It was recognised that during the start-up phase of the fund, the use of public capacity could account for 30% of total NTPF activity, once public core service planned activity was not compromised. The Department has recently advised NTPF that use by the fund of public facilities should be limited to 10% of its total referrals for treatment.

Elective activity in hospitals does not take place 24 hours per day and seven days a week. Therefore, using theatres and beds outside of normal working hours is one way of creating extra elective capacity in the public system. There are several reasons it was imperative for the fund to use public capacity for shortening waiting times for surgery. It is acknowledged that minimal paediatrics capacity exists in the private sector. In order to offer the benefits of NTPF to children there may be no other option but to utilise spare capacity.

Other situations that compelled the use of public or in-house capacity were cases where, for reasons of clinical or patient complexity, it was clearly best practice to have certain patients treated by their own consultant in the hospital where they were on the waiting list. Not to have used this facility would have effectively barred this cohort of patients from accessing the NTPF scheme.