Ciarán Lynch (Cork South Central, Labour)
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Question 462: To ask the Minister for Health further to Parliamentary Question No. 509 of 17 May 2011 and in view of the 4,478 orthopaedic patients awaiting outpatient treatment in Cork University Hospital, the number of patients at present awaiting treatment in other hospitals including the average waiting time and the longest waiting time in each case; and if he will make a statement on the matter. [16990/11]

James Reilly (Dublin North, Fine Gael)
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The current situation in relation to the waiting lists for orthopaedic services in Cork University Hospital is totally unacceptable. Patients need a service that is timely and effective.

A key immediate priority is the establishment of the Special Delivery Unit (SDU), which I announced on the 1st of June. The purpose of the SDU is to tackle hospital system inefficiencies and unblock access to acute services by dramatically improving the flow of patients through the system and by streamlining waiting lists. The SDU's priorities will encompass reducing the waiting times for admission from Emergency Departments, reduction in in-patient and out-patient waiting times and improved access to diagnostics.

I have appointed Dr Martin Connor, an international expert, as the Senior Advisor on the SDU. His principal task will be to build up the SDU and to prepare proposals for me on how best it can be placed on a permanent footing within the next six months. The resources of the National Treatment Purchase Fund (NTPF) will be refocused to align with the work of the SDU and, crucially, will allow for a progressive improvement in the performance of the nation's hospitals.

In addition to the SDU, there are a number of encouraging initiatives underway to alleviate this problem. In HSE South, these include:

§ additional staffing

§ a physiotherapy initiative

§ validation of waiting lists

§ improved management of OPD processes, including reducing missed appointments (DNAs - Did Not Attend) and increasing the numbers of new patients seen at clinics

Additional Consultant Posts

In the HSE South, there are 5 permanent consultant orthopaedic surgeons in post in the trauma and elective service, with 2 locum consultants in the trauma service. There are currently 100 referrals per week. This has increased over the past twelve months, with two new permanent consultants providing revision surgery.

HSE South has approval for three consultant orthopaedic surgeon posts at Cork University Hospital/South Infirmary Victoria University Hospital. These are:

§ 2 orthopaedic surgeons with a special interest in paediatric orthopaedic surgery – new posts

§ 1 orthopaedic general surgeon – a replacement post

Recruitment has been completed and it is anticipated that formal letters of appointment will be issued soon.

Physiotherapy Initiative

Physiotherapist-led clinics were introduced in 2010, to address the waiting list for OPD appointments. The physiotherapists triage patients based on the longest waiters, primarily from the hip and knee lists. 35% of the patients seen at these clinics were referred to an orthopaedic consultant for surgical review. A review of this initiative has been completed, in order to continue to improve patient flows.

Approval for three additional physiotherapists under the Outpatient Programme for Rheumatology and Orthopaedics has been sanctioned. These posts will allow for more musculo-skeletal physiotherapy led clinics. The recruitment process has begun.

HSE National OPD Project:

At national level, an Outpatients Department (OPD) Performance Improvement Group has been established to improve OPD Services throughout the country. The Project aims to address the significant numbers on waiting lists for some specialties. This Project will standardise all aspects of OPD, including waiting lists validation, management of DNAs, improvement in new to return ratios and improved triaging.

Cork University Hospital and South Infirmary Victoria University Hospital have been selected to participate in the initial phase of this project.

Cork University Hospital is undertaking a validation exercise on its OPD waiting lists. This exercise will link in with the National OPD Programme on the validation protocol, particularly for the clinical governance process for removing patients from waiting lists and for GP involvement in the process. It is expected that this exercise will reduce the numbers on the waiting list.

GP Referral Project

Under the reorganisation of acute hospital services in Cork and Kerry, electronic GP referral to acute hospitals is being piloted. This will enable more efficient processing of referrals and allow patients and GPs to see waiting times for individual consultants.

I believe that the implementation of these initiatives will greatly improve waiting list numbers and I will be closely monitoring the situation to ensure that these statistics become a thing of the past.

The management of waiting lists is a matter for the HSE and the individual hospitals concerned. I have therefore referred the Deputy's question regarding the numbers of patients awaiting orthopaedic treatment to the Executive for direct reply.