Brendan Smith (Cavan-Monaghan, Fianna Fail)
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156. To ask the Minister for Health if additional capacity will be provided without further delay at the National Orthopaedic Hospital, Cappagh in view of delays in persons being assessed and having orthopaedic procedures carried out; if his attention has been drawn to the long waiting times for paediatric orthopaedics resulting in children not receiving interventions in a timely manner; and if he will make a statement on the matter. [22551/21]

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

Elective hospital care was curtailed for the first quarter of 2021, in line with the rapid increase in Covid-19 hospital admissions, with only critical time dependent elective procedures undertaken.

On 23 March the HSE published the “Safe Return to Health Services Plan”. This plan outlines a three phased approach for the proposed restoration of services across Community Services, Acute Hospital Operations, Cancer Services and Screening Services. It sets target times for their safe return and details the conditions and challenges that will have to be met. Every phase of the plan has been informed by clinical guidance and putting patient and staff safety first. Decisions in relation to the type and volume of activity will be made at site level based on local COVID-19 numbers, available capacity and guidance from national clinical leads.

The schedule outlined in the plan for resumption of services will be regularly monitored by the HSE and updated as appropriate, dependant on public health advice and healthcare capacity.

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 work of the HSE to improve access to elective care and reduce waiting times for patients is supported by the National Treatment Purchase Fund (NTPF). This includes increased use of private hospitals, funding weekend and evening work in public hospitals, funding “see and treat” services where minor procedures are provided at the same time as outpatient consultations, funding hybrid services where public and private hospitals contribute to the treatment of patients, virtual clinics and clinical validation. 

€240 million has been provided in Budget 2021 for access to care, €210m of which has been allocated to the HSE and a further €30m to the National Treatment Purchase Fund. This will be used to fund additional capacity to address the shortfall arising as a result of measures taken in the context of COVID-19, as well as to address waiting lists. 

Since January 2021, the NTPF has been working closely with public hospitals to arrange treatment for clinically suitable long-waiting patients on hospital outpatient and inpatient/day case waiting lists. Year to date at the end of March 2021, the NTPF had arranged 6,951 Outpatient appointments, of which 1,971 were Orthopaedic appointments. During the same period, 5,877 patients on the Inpatient/Day Case waiting lists had accepted offers of treatment funded by the NTPF, of which 1,221 were for Orthopaedic procedures. 

More specifically, the NTPF has advised that 587 Orthopaedic Inpatient /Day Case procedures have been approved at the National Orthopaedic Hospital, Cappagh through NTPF insourcing initiatives. 

In terms of paediatric waiting times, in recent years there has been an increased investment in paediatric orthopaedics and scoliosis services, which has improved access to surgery and outpatient appointments. In 2018 Children’s Health Ireland (CHI; previously the Children’s Hospital Group) was provided with an additional €9 million in funding to address paediatric orthopaedic waiting lists, including the provision of scoliosis services. Scoliosis activity accounts for 20% of overall orthopaedic activity across CHI.  

This funding supported the recruitment of approximately 60 WTE in 2018 and 2019 to enable the expansion of paediatric orthopaedic services including scoliosis services. The posts relate to the multi-disciplinary team at diagnosis, pre-assessment, during surgery in theatre, and post-operatively. The majority of posts were allocated to each hospital in 2018. 

A number of clinically suitable patients from Children’s Health Ireland currently undergo orthopaedic procedures at the National Orthopaedic Hospital Cappagh and Children’s Health Ireland and the HSE are exploring initiatives to treat additional paediatric orthopaedic patients at Cappagh Hospital. 

With regard to the particular query raised in relation to additional capacity at the National Orthopaedic Hospital, Cappagh, as this is a service matter, I have asked the Health Service Executive to respond to you directly as soon as possible. 

Brendan Smith (Cavan-Monaghan, Fianna Fail)
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157. To ask the Minister for Health if additional capacity will be provided to reduce waiting lists for treatment (details supplied); and if he will make a statement on the matter. [22552/21]

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

Elective hospital care was curtailed for the first quarter of 2021, in line with the rapid increase in Covid-19 hospital admissions, with only critical time dependent elective procedures undertaken.

On 23 March the HSE published the “Safe Return to Health Services Plan”. This plan outlines a three phased approach for the proposed restoration of services across Community Services, Acute Hospital Operations, Cancer Services and Screening Services. It sets target times for their safe return and details the conditions and challenges that will have to be met. Every phase of the plan has been informed by clinical guidance and putting patient and staff safety first. Decisions in relation to the type and volume of activity will be made at site level based on local COVID-19 numbers, available capacity and guidance from national clinical leads.

The schedule outlined in the plan for resumption of services will be regularly monitored by the HSE and updated as appropriate, dependant on public health advice and healthcare capacity.

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 work of the HSE to improve access to elective care and reduce waiting times for patients is supported by the National Treatment Purchase Fund (NTPF). This includes increased use of private hospitals, funding weekend and evening work in public hospitals, funding “see and treat” services where minor procedures are provided at the same time as outpatient consultations, funding hybrid services where public and private hospitals contribute to the treatment of patients, virtual clinics and clinical validation. 

€240 million has been provided in Budget 2021 for  access to care, €210m of which has been allocated to the HSE and a further €30m to the National Treatment Purchase Fund. This will be used to fund additional capacity to address the shortfall arising as a result of measures taken in the context of COVID-19, as well as to address waiting lists. 

With regard to the particular query raised by the Deputy, the NTPF has provide the attached tables showing the breakdown of patients on the Outpatient and Inpatient/Day Case Waiting Lists by area of residence for Cavan and Monaghan as at 25 March 2021. 

The NTPF has further advised that year to date, 250 Orthopaedic Outpatient appointments have been approved at Cavan General Hospital though NTPF funded insourcing initiatives.