A new system where hospital patients are scheduled chronologically is part of a five-point plan announced by Minister for Health Simon Harris to tackle waiting lists.
On Tuesday, Mr Harris also said it had been a mistake to deactivate the National Treatment Purchase Fund (NTPF).
He told RTÉ's Morning Ireland that there is an urgent need for a sustained investment in waiting list initiatives and that it had been a mistake to deactivate the NTPF. "Whatever people's ideology, if you're sitting at home today in need of an operation what you don't want is a big ideological debate about the health service, what you actually want is action."
The Minister said there is a need for targeted, funded actions. “The Programme for Government is very clear, it says in the Budget there will be €50 million at least for waiting list initiatives and, of that €50 million, at least €15 million will go to the NTPF.
“I’ve met the NTPF, I’ve told them to gear up, to be ready, I’ve told them to come back to me with proposals and I’ve given them a ring-fenced €1 million to get on and do 3,000 endoscopy procedures.”
Mr Harris said he has instructed the HSE to come up with an action plan for what every hospital can do between now and the end of the year to reduce waiting lists. “For the first time in recent years the HSE director general has been able to say publicly and privately that the HSE is now adequately funded to deliver its service plan, which is very specific in relation to waiting lists.”
The Minister went on to announce specific actions to be taken in the remainder of the year. “By the end of this year I want to see a 50 per cent reduction in the number of patients waiting more than 18 months for in patient procedures, that’s about 7,500 people. We’ve got to start with the people waiting the longest.
“We need to make sure our waiting lists are accurate, we need to make sure people are on it only once, in the right places, we need to make sure that people are clinically validated, so those that need to proceed are getting treatment the quickest. At the end of this month, a clinical validation of all of the inpatient waiting lists will be carried out. This will make sure we have accurate lists.
“We will also make sure we have chronological scheduling. Doctors will actually look at lists and say that person needs a procedure, needs that procedure quicker and they will make sure that the list is accurate and chronologically accurate.
“The Special Delivery Unit (SDU) will be asked to oversee the implementation of a waiting list improvement plan. Every hospital group has been asked to come up with a waiting list improvement plan – what can your hospital do?
“Some hospitals are really good at dealing with emergencies, other smaller hospitals might be able to do more day case procedures. So all of the hospital groups had to come up with an improvement plan.
“The fourth point of the plan, the SDU will appoint for each hospital group an improvement lead who will be responsible for tackling waiting lists to ensure that all hospitals grouped together are carrying out the maximum amount of procedures possible.
“The last element, I’ve asked the HSE to come back to me to see if there’s any specific waiting list proposals they have for this year – is there any that should be ring fenced for specific procedures. This is no longer a question of asking hospitals to do more with less, we are now asking hospitals to do more with more.”
Liam Doran of the Irish Nurses and Midwives Organisation (INMO) said on Tuesday that the Minister’s plan to reduce waiting lists will not work because there are not enough front-line staff within the health service.
“The Minister won’t reduce lists until we get staff. That’s the core issue, not more layers of management overseeing what other layers management should be doing. New people being employed to see if existing people are managing the system is the last thing we need,” he told RTÉ’s Today with Seán O’Rourke Show.
“We’re with the Minister in wanting to sort this out, in wanting more political involvement, in delivering action plans, in not having them sitting on a shelf. The problem is you cannot deliver any of those things unless you have staff, unless you have the bed capacity.”
Mr Doran said that there are now 3,300 fewer nurses in the public health system than there were in 2008 when 39,006 nurses and midwives were employed.
“Every commitment to reduce waiting lists, every commitment to reduce emergency department over crowding must be welcome but will only become a reality when politically and at managerial level there is an acceptance that our current health system is too small, in terms of physical capacity and human resources, to deliver upon any target or any plan, no matter how well intentioned it might be.”
“This isn’t just about nurses, or midwives, but I make no apology for saying that the health system does not function without nurses and midwives. It can’t expand its bed capacity.”
The INMO general secretary said the Minister’s funding for the NTPF is “robbing Peter to pay Paul”.
“The NTPF is all through private hospitals – if they step up to the plate it will be at the loss of public hospitals because they will take staff from the public sector. We need the NTPF now to tackle waiting lists, nobody should be left on a waiting list. We need to size our health service in steps. We need a five-year plan in order to do that.
“No matter how the HSE or the Minister speaks about reducing emergency department overcrowding or reducing waiting lists, we cannot do that until we address the recruitment crisis that is at the heart of the health service at the moment.