Written answers

Thursday, 31 March 2022

Department of Health

Hospital Waiting Lists

Photo of Gino KennyGino Kenny (Dublin Mid West, People Before Profit Alliance)
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110. To ask the Minister for Health the steps he is taking to ensure the recent rapid increase in Covid-19-related hospitalisations does not increase the already lengthy waiting lists for hospital treatment and will not result in the cancellation of transplant operations due to lack of bed capacity; and if he will make a statement on the matter. [17016/22]

Photo of Stephen DonnellyStephen Donnelly (Wicklow, Fianna Fail)
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It is recognised that waiting times for scheduled appointments and procedures have been affected by the Covid-19 pandemic. While significant work continues to positively impact on waiting times and improve pathways to elective care, acute hospitals have been impacted by operational challenges arising from surges in cases related to the Omicron variants.

As a response to the recent surge in both ED attendance and COVID-19 cases the CEO of the HSE has written to the CEOs of all hospital groups advising them of the need to prioritise unscheduled COVID-19 care and urgent time sensitive work for 14-day period. The resulting curtailment of elective care (and associated staff shortages) will negatively impact achieving waiting list reduction targets.

The HSE has confirmed to the Department that 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 Waiting List Task Force continues to regularly monitor the impact of COVID-19 on waiting list reduction targets. Additional capacity is being sough through the Private Hospitals to minimise the impact of the current surge on core activity.

With the onset of the 4th wave of Covid-19 at the end of December 2021 and January 2022 the HSE with the support of the Department negotiated a new amended Agreement with the Private Hospitals to run to the end of June 2022. The new Agreement sought to draw on the lessons from the operation of Safety Nets 2 and 3.

The most significant change from the previous Safety Net Agreements was the adoption of a dual approach to obtaining access to the private hospital capacity. As with the outgoing agreement it would allow access of up to 15% or 30% of the private hospitals’ capacity depending on which metrics were met. At each level, the HSE would have the option to seek access on either a reasonable endeavours basis i.e. voluntarily, or by issuing a guaranteed capacity demand, which would require the private hospitals to provide the capacity. Under the agreement payments for capacity unused by the public system i.e. retainer payments will not be payable where the agreement is invoked on a reasonable endeavours basis but will be payable where a guaranteed capacity notice is issued.

In August 2021 the HSE established a procurement framework to allow public hospitals to access services in private hospitals. The procurement framework that was put in place sought tenders from private hospitals, based on competitive pricing, for approximately 700 types of medical and surgical procedures for adult and paediatric inpatient, day care and critical care beds. A separate procurement framework was put in place for diagnostic services. The Framework is in place for a period of 4 years.

The HSE has advised that all necessary action is currently being undertaken in the context of the Covid-19 pandemic to ensure that organ donation and transplant services continue in so far as practically possible. However, due to the risk Covid-19 presents to transplant patients, and the negative impact increased pressure on ICU capacity has on transplant services, it is possible that reduced levels of organ donation and transplant service activity will be experienced while infection rates of Covid-19 remain high.

The HSE has advised that Organ Donation and Transplant Ireland (ODTI) and the transplant centres have and continue to work to ensure that the most time critical and life-saving transplants proceeded based on careful risk-benefit assessment.

With regard to critical care capacity baseline critical care capacity is now 301 beds, up from a figure of 297 at the end 2021. We had 255 critical care beds at the beginning of 2020. The 301 reflects an 18% increase since the start of the pandemic. Funding provided to date will allow for capacity to reach 340 by 2023.


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