Speech by Minister for Health Simon Harris TD at the National Treatment Purchase Fund Conference


I am delighted to be here this morning to officially open the NTPF Conference and to launch the NTPF’s new Strategy for 2017 to 2019. I would like to thank John Horan, Chairman of the NTPF Board and Jim O’Sullivan, CEO of the NTPF for their kind invitation. I would like to welcome Tony O’Brien, Director General, HSE, who is here today to support this event.

We are very fortunate to have a range of eminent speakers today, such as Professor Luigi Siciliani, and Dr Colm Henry, Dr Chris Steele, Dr Tadgh Nagle, Professor Mary Day, and some of the NTPF’s very own specialists.

I know that you are all very much looking forward to hearing their insights on waiting list management and how we can learn from each other, in order to improve patient access to scheduled care.

I believe that we are all here today because we share a common goal which is to put patients at the centre of our health service. It is important for us to remember that patients can often be at their most vulnerable when they are waiting for a medical procedure and it is our responsibility, our collective responsibility, to enable patients to access acute hospital services in a timely manner.

Increasing Demand for Services

Ireland, as we know, has an ageing population. We are living longer and are healthier than ever before, and this is something to be celebrated. However, it also means that there are increasing demands on our healthcare resources.
Every year there are over 3.2 million outpatient attendances in our hospitals, 94,000 patients having elective inpatient procedures and 1 million having a planned day case procedure. And the demand continues to rise.

For example, since 2000 the number of daycase discharges carried out have effectively quadrupled for the over 65 age group and almost doubled for patients under 65. The outpatient lists are also increasing with an average weekly increase of 1,200 this year.

Waiting List Achievements for 2016

Despite this marked increase in activity and demand, during 2016 there were concerted efforts to reduce the number of long-waiting patients on the inpatient/daycase waiting list. The NTPF data for December 2016 show evidence of this with the overall Inpatient/Daycase and the Outpatient waiting lists both decreasing since November.

In August 2016, I asked the HSE to develop and implement an Action Plan on Waiting Lists focused on those patients waiting longest. The Action Plan set a target to reduce the number of patients waiting 18 months or over for an inpatient or daycase procedure by 50%, to no more than 1,800 patients by the end of 2016.

Ten days ago I was delighted to announce that the HSE had achieved the target set in its Waiting List Action Plan and had reduced by half the number of patients waiting longer than 18 months for inpatient treatment or day case procedures.

The figures published on 9th January by the NTPF showed that since I approved the Action Plan last August, the number of people on the Inpatient/Daycase waiting list has reduced by 11,519, leading to no more than 1,800 people waiting over 18 months for treatment. The actual number of people waiting for procedures at the end of December was 1,738.

While that is still too many patients waiting 18 months or more for their inpatient/daycase procedure, there is no doubt that this is real progress in reducing the number of patients waiting longest. At the end of July the number of patients waiting over 18 months constituted 4.5% of the total Inpatient/Daycase Waiting List, whereas at the end of December this has reduced to 2%.

In addition during 2016, the NTPF rolled out the Endoscopy Waiting List Initiative to arrange for the provision of endoscopy procedures to patients waiting over 12 months. By the end of December, over 5,500 people had come off the waiting list and the NTPF managed to clear over 99% of the people waiting the longest.

Further, the Outpatient Waiting Lists also decreased by over 3,000 people in December. In November, the HSE launched the Strategy for the design of Integrated Outpatient Services 2016-2020.

This Strategy seeks to improve waiting times for outpatient services by enhancing patient referral pathways and utilising technology to enable better planning.

Before I move on to talk about plans for 2017, I would like to take this opportunity to acknowledge the considerable work carried out in hospitals to deliver on the HSE’s Waiting List Action Plan 2016.

I appreciate that it was challenging for hospitals and Hospital Groups in maintaining a focus on driving down waiting times for patients, while at the same time managing the growing demand for emergency care during the latter months of 2016, however, let’s not forget that through your efforts over 11,000 patients who had been waiting a long time came off the inpatient/daycase waiting list.

Waiting List Plan for 2017

I am determined that we do not lose ground on the achievements from 2016 and that under waiting list initiatives to be implemented this year we continue to drive down waiting times for patients. It is not acceptable for patients to have to wait excessively long periods for necessary procedures or for outpatient appointments. Continuing to drive down the length of time patients are waiting for procedures is a priority for me in 2017.

The plan, which entails close collaboration between the NTPF, the HSE and the Department includes:

1. Firstly the NTPF allocation for 2017 will utilise capacity in the private acute hospital sector to provide treatment for our longest waiting patient on the Inpatient/Daycase waiting list;
2. In addition, I have asked the HSE to submit an Action Plan to improve waiting lists in the public acute hospital sector for inpatients and daycases and outpatients;
3. Finally, during 2017 the HSE and the NTPF will work strategically and collaboratively together to ensure the best use of public and private hospital capacity to reduce patients waiting times.

1. NTPF Allocation

So starting with the NTPF, in Budget 2017 €20 million has been allocated, rising to €50 million in 2018.

Last December, I granted approval to the NTPF for the first €5 million of this funding for an initiative focused on daycase procedures, which accounts for approximately 70% of the Inpatient/Daycase Waiting List.

The NTPF has undertaken significant work in the last few months as it prepares to take on again a role in arranging treatment for patients on waiting lists. Plans are well under way in the NTPF to roll out the NTPF Daycase Waiting List Initiative.

Under this initiative, the NTPF estimates that around 3,000 patients waiting 18 months or more for daycase procedures will be treated, with the aim that no patient will be waiting more than 18 months for daycase treatment by 30 June 2017.

This Initiative will initially focus on key specialties with high numbers of long-waiting patients, including in Ophthalmology, General Surgery, Dental, Urology and Vascular Surgery.

The NTPF tell me that that there has been good engagement with all the major private hospitals and these hospitals are ready to play a significant role in this Initiative. Patients will be matched to the most appropriate pathway of care based on their individual procedure and the relevant hospital involved.

In addition to current Daycase Waiting List Initiative, the NTPF is working closely with the HSE, supported by my Department, to finalise an approach for the remaining 2017 allocation.

2. HSE Waiting List Action Plan for Inpatients/Day Case and Outpatients

In tandem with this, in order to ensure that all long-waiters experience improved waiting times, I have also asked the HSE to develop new Waiting List Action Plans for 2017, in respect of both the Inpatient/Daycase Waiting List and the Outpatient Waiting List. The focus of these Plans will be on ensuring that no patient is waiting more than 15 months on either List by the end of October 2017.

3. Strategic Collaboration between NTPF and HSE

My vision is that during 2017 the HSE and the NTPF will combine their respective strengths and expertise and establish a strategic collaboration to ensure the best use of both public hospital capacity and the private hospital system to reduce waiting times for patients.

I am in no doubt that working together in 2017 the NTPF and HSE will make a substantial impact on waiting times for patients receiving scheduled care.

NTPF Strategy

Today sees the launch of the NTPF’s Strategy 2017-2019 which reflects and supports the intent of the Programme for a Partnership Government. The CEO has just taken us through its main points so I will not go over the details again.

What I would like to say is that I am pleased to see that the aim of this Strategy is to support and drive performance improvement to ensure that patients are treated in a timely fashion. I also believe that the Strategic objectives that have been chosen are based on the strengths and expertise built up by the organisation since its inception and also on the desire to maximise the supporting role NTPF can play in the future.

I am confident that this Strategy will steer and focus the NTPF’s work over the coming three years as it continues to support positive advances in our health services.

I would like to take this opportunity to thank the NTPF Board and staff for their significant on-going contribution within our health service and I look forward to working with the NTPF over the coming years as this Strategy is rolled out.

Data Quality Awards

I am delighted that the NTPF has also taken the opportunity today to recognise good practice in our health system. The NTPF plays a key role in the compilation and dissemination of waiting list information receiving a staggering 2 million records per month and distributing up to 2,000 reports per month. These reports are essential in enabling the effective planning and management of individual hospitals and Hospital Groups.

The Data Quality Project has delivered tangible and sustainable improvements in data completeness, classification and waiting list management processes. I understand that a number of hospitals who have achieved compliance with NTPF Data Quality Standards are to be awarded today. I would like to congratulate the teams at those hospitals for their effort and commitment to improving how waiting lists are managed. I would encourage you all to redouble your efforts, as better waiting list data and management procedures mean that we use hospital resources more effectively and efficiently for the benefit of patients.

Launch of Inpatient, Day Case, Planned Procedure Protocol for Waiting List Management
Today really is a busy day for the NTPF. It also marks the launch of the Inpatient, Day Case, Planned Procedure Protocol for Waiting List Management.

This Protocol will provide guidance to hospitals and hospital groups to ensure that there is a consistent and standardised approach to the management and scheduling of patients on the inpatient / daycase waiting lists. The Protocol is a result of collaboration between the NTPF and staff working in the HSE, in Hospital Groups and at hospital level. I very much welcome this initiative and commend the NTPF for taking the lead on this important work which has maintained patient care as its central focus.

Today is an opportunity for us all to acknowledge the importance and synergistic nature of our relationships in working together towards the common goal of reducing waiting times for patients. We all have a contribution to make whether you work at the frontline in delivering inpatient / daycase procedures or outpatient appointments; whether you work in managing scheduled care; whether you work in public or private hospitals.

I want to take this opportunity to thank you, but also encourage you, to maintain a strong focus throughout 2017 on further reducing waiting times for patients. I can assure you that it will be a key focus of mine throughout the coming year.

Thank you.