Gino Kenny presses on missed hospital waiting list targets

Good morning, everybody. Just a number of questions in relation to the opening statement. My first question is in relation to the waiting list action plan. Obviously the plan was to have a net production of 130,000, those that are on the waiting list. How is that progressing to date in this year? DEPUTY, it's behind target. I can get you the exact figures that one of my colleagues will. But the aim for the end of the year, Deputy, across the three different parts of the hospital waiting list, so if you take the outpatient department, the aim at the start of the year was that by the end of the year, 98% of people who were waiting would wait for 18 months or less. More likely by the end of the year, after a significant effort in the second part of the year after COVID in the first part, to get to about 82% rather than 98%. So we are behind in that number. But as I said earlier on, the numbers are substantially down. That waiting list is down about 40% since the peak in 2021. So not where we want to be, but progress being made. Similarly, in the other two waiting lists, in terms of inpatient and Dave, where the target is for 98% to be waiting less than 12 months, we'll hit about 83%. And again, that waiting list is down about 40% since the peak. So not where we want to be, but progress being made. And the last one, we actually will more or less hit the target. So the scope's target is that 98% of people would wait less than 12 months. We should hit about 97%. And again, that one is substantially down since the peak. So there's substantial progress made, but definitely not where we would like to be. And as I said, most of these are well down on the peak and getting back to in some cases at where they were pre-COVID. And then we need to drive on, and the targets next year will be more difficult targets, because we are trying to get towards the Santa care targets, which are much more difficult than those, and focus on people waiting much shorter times. And is there a reason why them targets haven't been met? Obviously it's very 98%, obviously very ambitious, to where it's got 82%, so it's a 16% shortfall. Is there a reason why that's happened? Part of the reason, Deputy, is COVID. So the level of COVID in the first six months of the year, as I said, at the start, in the first three or four or five days, I think in 2022, we had more COVID cases in the country than in 2020 in total. And by March we had more people in hospital with COVID, I think it was 1500 and something, than in the previous 14 months. So that made a big impact. Obviously the ongoing COVID impact is also hurting the hospital. So some of the measures we've had in place, some of which we're now stepping down a bit, and colleagues can talk about that, are not conducive to being as productive as we would like, some of the separate pathways we have had to put in place, where also people are coming to us, the evidence is sicker and frailer, and therefore they're staying longer. So the elderly people are coming to us more frail, and elderly people tend to stay longer anyway, but they're staying even longer. So the system is trying to recover from that, and it's not yet back to its full capacity, albeit it's getting there. Now we've added capacity as well, so that's what's allowed us to make some of the progress. So there's some of the main reasons. I don't know if colleagues want to… I think that summarizes the deputy. The only thing I'd add is the sort of three legs to the waiting list action plan. One is the core work in terms of trying to get more value out of what we have in the system already, the resources, the theatres and so on. Two is various modernization initiatives around policies, around technology and so on, and thirdly then are some of the clinical pathways in terms of trying to change the models in terms of where people are treated, and there's some really good examples there. Ophthalmology has been one, Dr. Henry might want to talk to some of those, but there's a range of examples of those that are also going to be rolled out, but the core reason at the start of the year essentially was the impact of COVID both on staff, on staff's absences, and also in terms of the impact on the system. And we will see deputy typically in this period through the winter that obviously brings pressure on scheduled care as the hospitals have to prioritize emergency care. And that's, it's positive, you know, that, you know, people are not waiting for years for very basic procedures and so forth. Now, obviously there's, people have a different experience than that. Now, I mean, look, I'd only be kind of negative here, but there's been instances where, you know, people are waiting in situations in A&E, like for days in relation to, you know, to be seen, and that's just not acceptable. And I've raised this on numerous occasions. And I mean, this is, it's happened in a lot of A&Es, and again, it's not the staff's fault. This is in relation to factors that are kind of, should have been kind of foreseen in relation to capacity and so forth. Just my final question is in relation to retention of staff and recruitment of staff. And obviously, this is a huge, a huge challenge, not only to our health service, but across the world. But one factor that is, I suppose, is a driving force in relation to retention of staff is obviously we have a situation, you know, kind of a cost of living crisis at the moment around accommodation for health care staff. And if you're trying to recruit people from, you know, outside the state, you know, they're going to be looking at, you know, obviously, what's, you know, obviously wages and so forth, but obviously accommodation and accommodation, particularly in Dublin, is really extremely difficult to get any sort of accommodation. And I know the HSE have said in the past that they're not in the game of, you know, building such real estate on their kind of properties and so forth. But, you know, have you ever looked at this, you know, a situation where accommodation could be provided on campus for in relation to nursing staff, whether there are, you know, whether they're, you know, coming from the state or outside the state. Because I think this could be a factor in trying to keep people in Ireland, because there's people obviously leaving, and they look at the kind of circumstances that are kind of, they're up against. And accommodation is probably a big factor in relation to, you know, keeping people qualified here, and keep people coming to here, coming to Ireland to stay here. So I'd just like to hear kind of your kind of commentary on that. NEW SPEAKER 1 I think, Deputy, there's no doubt it's a growing issue. The question of accommodation comes up more and more, and now you'll hear colleagues talk about the fact that some of the hospital side, some of the urban-based hospitals, which typically would have had better opportunities, let's say, to recruit staff and retain staff in the past, are now experiencing negative impacts on that. So it's still the case that provision of accommodation is not it's not within the core competency of the HSE. It's something we've done in the past. We have not just for nursing staff, we have provided accommodation in the past, in the distant past. So I've no doubt as government and other colleagues consider all of the policy options around retention of essential workers. Accommodation is an issue that is, as I said, starting to be talked about more and more. So the HSE is not averse to playing whatever role is appropriate for it in that context, because it is coming up more and more as a real issue in terms of attracting and retaining, particularly attracting younger staff. Thanks.