I propose to take Questions Nos. 214 to 217, inclusive, together.
My Department has raised these issues with the Health Service Executive. The policy of the HSE on the matter of waiting lists is clear. All hospital managers are expected to efficiently manage waiting lists in chronological order, except where clinical need dictates that a patient needs to be prioritised. The HSE does not condone the manipulation of waiting lists and will take appropriate disciplinary action if this can be proved.
In late 2013, a number of patients waiting for a first outpatient appointment were outsourced to the private sector for assessment and were then referred back to the public system for surgical procedures. The HSE has advised that this practice has now ceased. Patients can be removed from waiting lists as part of the HSE waiting lists validation protocol but GPs and consultants concerned are told if a patient is being removed from the list and if the GP or consultant considers the patient should be reinstated on the list, this is done as part of the protocol.
A recent media article alleged that patients who needed further tests were suspended from waiting lists. In some instances, it is appropriate to defer formally placing a patient on an inpatient or day-case waiting list after they have been seen for the first time as out-patients until all investigations confirm that a surgical procedure is actually necessary. This may require sending the patient for further tests as outpatients.
The HSE continues to implement further measures to tackle waiting lists. These include: increasing the throughput of patients in public outpatient clinic, reducing the number of patients who do not turn up for their appointment, and increasing the number of new patients in the clinic rather than just reviewing previous patients who are often better returned to their GP.
It is important for the Deputy to note that there is no policy to manipulate waiting lists. The only waiting lists that I'm interested in are accurate ones. Accurate waiting lists allow us to plan services. When it comes to negotiating a good budget for health, waiting list figures that make the situation look better than it really is are no benefit to me. I will continue to work with the HSE to ensure that the issues relating to hospital waiting lists are resolved.