The number of patients returning to hospital for repeat appointments is to be drastically reduced as part of a plan to cut waiting lists, the Oireachtas health committee has heard.
The diversion of patients from repeat appointments in hospital to services in the community, and a “deep assessment” of the way waiting lists are validated are part of the plan to reverse the ongoing rise in waiting lists.
New HSE director general Paul Reid also announced an independent review of nine emergency departments across the State, which is likely to focus in the massive variations in overcrowding at different sites.
There were about 40 patients waiting for admission to hospitals in Limerick, Cork and Tallaght on Wednesday morning, yet only four patients on trolleys at Beaumont Hospital.
Fianna Fáil health spokesman Stephen Donnelly pointed to a "massive geographic variance" in the number of patients on waiting lists, which he described as a "postcode lottery".
While waiting lists at some hospitals and in some specialties were small, Mr Donnelly pointed out there are 40,000 outpatients at University Hospital Galway and University Hospital Waterford, and 35,000 at Tallaght Hospital.
He instanced a “big spike” of 2,500 people awaiting physiotherapy appointments in Waterford, while in Wicklow, 1,100 patients were on the occupational therapy list.
‘Fixed’
“Given unprecedented increase in healthcare funding in the last three years, why are people waiting longer than ever to see doctors and to get diagnostics?” he asked.
Minister for Health Simon Harris the outpatient list could be "fixed" by reducing the number of patients "who have to back and back to the hospital".
Of the 3.3 million people in outpatients each year, only one million are first appointments and many of the rest - for example chronic disease - could be treated in primary care, he pointed out.
Mr Harris also questioned why 550,000 patients did not turn up for their appointments last year, and said this needed investigation.
Mr Reid, who was making his first appearance before the committee, said the independent review of emergency department would reveal a lot about which parts of the country have better processes.
Putting money into the current system of congested acute hospital would result in only slow progress but waiting lists could be “chipped away” through a move to an integrated model of care, including increased capacity in the community.
Mr Reid warned that, in common with other public servants, he did not have a mandate to spend beyond his budget.
The HSE budget has increased from €14.5 billion at the start of 2018 to €16.2 billion this year, he pointed out. The challenge was how to spend this in a manner that delivered services and provided quality care and safety.
Asked by Mr Donnelly when a decision would be made on approving the muscular dystrophy drug Spinraza, Mr Reid said the issue would be brought back before the HSE leadership again in early June.
Mr Reid said he understood the concerns of the families seeking access to the drug for their children and was conscious that it had recently been approved in the UK.
He pleaded for “space and time” for the issue to be considered while negotiations and considerations on cost-effectiveness of the treatment were ongoing.
Asked about the plan to move the Coombe hospital adjacent to the new national children’s hospital being built at St James’s Hospital, Mr Harris said he had asked Children’s Health Ireland to make proposals in relation to preparatory work for this project.
