Bernard Durkan (Kildare North, Fine Gael)
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155. To ask the Minister for Health the extent to which he and his Department expect to be able to deal with the backlog of elective procedures which has been caused by the Covid-19 crisis; if this can or will be done under the national treatment purchase scheme in Ireland or otherwise; if the private hospitals can be utilised for this purpose; and if he will make a statement on the matter. [42500/20]

Stephen Donnelly (Wicklow, Fianna Fail)
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It is recognised that waiting times for scheduled appointments and procedures have been impacted as a direct result of the COVID-19 pandemic.

In response to the Covid-19 pandemic the HSE had to take measures to defer most scheduled care activity in March, April, and May of this year. This was to ensure patient safety and that all appropriate resources were made available for Covid-19 related activity and time-critical essential work. This decision was in line with the advice issued by the National Public Health Emergency Team (NPHET) in accordance with the advice of the World Health Organisation.

As a result of the significant disruption in scheduled care, hospital waiting lists reached a peak in May. The resumption of services from June onwards has however allowed for increased activity. The numbers of patients awaiting an Inpatient / Daycase procedure dropped by 16% from May to November and the rate of growth in the Outpatient waiting list has slowed in recent months.

Patient safety remains at the centre of all hospital activity and elective care scheduling. To ensure services are provided in a safe, clinically-aligned and prioritised way, hospitals are following HSE clinical guidelines and protocols.

The HSE continues to optimise productivity through alternative work practices such the use of alternative settings including private hospitals, community facilities and alternative outpatient settings.

The Department continues to engage with the HSE and the National Treatment Purchase Fund (NTPF) on the development of the Access to Care Plan 2021 which will set out measures to improve care for patients waiting for scheduled Care in 2021.

An additional €240 million has been provided in Budget 2021 for an Access to Care Fund, €210m of which will be allocated as required to the HSE and €30m to the National Treatment Purchase Fund for the provision of treatment in both private and public hospitals in order to address capacity issues in acute hospitals and waiting lists.

The HSE is working on a number of initiatives to improve access to scheduled care and reduce waiting lists in acute hospitals. As part of the overall response to COVID 19, the Convention Centre Facility in City West was taken over by the HSE. The convention centre is supporting a number of scheduled care activities including drive-through Glaucoma pressure testing and Children’s Health Ireland (CHI) allergy testing. The HSE is working closely with Hospital Groups and City West to ensure that all potential capacity is being utilised.

Alternative patient pathways are being developed by the HSE to improve access to appropriate care and alleviate pressures on acute hospital waiting lists. Examples include a new referral to Audiology Services pathway and a national Delivery of Musculoskeletal Service, which aim to ultimately move these services from acute hospitals to a community setting. It is envisioned that the re-design of these patient pathways will have a measurable and positive impact on ENT and Orthopaedic waiting lists.

With the resumption of routine scheduled care services in June, the National Treatment Purchase Fund (NTPF) resumed the commissioning of appointments and procedures for patients. The NTPF advise that by the end of October, 24,698 Inpatient/Daycase (IPDC) treatments and 7,648 Gastrointestinal Endoscopy Scopes had been arranged and in terms of Outpatients, they had approved in principal 66,096 Outpatient appointments. 

To support access to care in the context of both COVID-19 and winter pressures, the NTPF has been sanctioned to provide Emergency Department Authorisation Notifications (EDANs) which allow acute hospitals to access available diagnostic capacity in both the public and private sectors. EDANS can be used by hospitals to support access to diagnostics for both emergency and scheduled care and provide an alternative pathway to diagnostics. This has been particularly important in the context of the Covid-19 outbreak and the ongoing need to allow for social distancing within the hospitals, which has resulted in reduced capacity in the system. The NTPF have advised that up to the end of October nearly 27,000 EDANs had been utilised.