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Estimates for Public Services 2016 (Resumed)

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Snippet Contents:

We are debating whether to sign off on an additional €500 million for the health budget, an issue I will address alongside the lack of an analysis provided for the Dáil on same. While we are discussing health services that need more funding urgently, I wish to raise a particular matter, that of Cappagh National Orthopaedic Hospital, about which a constituent of mine contacted me in recent weeks. She needs a hip replacement and is in severe pain and her condition is deteriorating. She is on her way to being in a wheelchair, something I have had confirmed by her surgeon. She was told that she would have to wait 15 months.
When I looked further into what was happening at Cappagh hospital, what I discovered was disturbing. If a general practitioner, GP, believes someone in the greater Dublin area needs orthopaedic surgery, or if anyone in the country needs complex orthopaedic surgery, it will take 15 months to see a consultant. It will take a further 15 months to get into an operating theatre. As such, it takes two and a half years to get from a GP to the operating theatre. In the United Kingdom it takes four months and in New Zealand, three.
I have spoken to surgeons in this field. To say they are demoralised, frustrated and angry would be a gross understatement. Anyone who attends a GP and needs orthopaedic work, be it on a hip or a knee, is typically already in serious pain. In the two and a half years someone will wait for surgery, the pain will escalate, the person's condition will deteriorate and the complexity, cost and recovery time of the operation will move in the wrong direction, as will the clinical outcomes.
I will explain what is happening in Cappagh hospital and why people in Ireland are waiting two and a half years for a hip operation. By the way, if someone needs the other hip or knee to be operated on, he or she must go back to the start of the list. Compare this with the figure of 12 weeks in New Zealand and 16 across the water in the United Kingdom. In 2014 Cappagh hospital suffered a serious cut in Government funding, which meant that it needed to reduce the number of procedures it could carry out that year by 700. It let staff go and scaled down. In 2015 the situation was so bad that the Government increased its funding. Last year Cappagh hospital started to scale up again, but it incurred higher costs by hiring agency staff because it did not want to have to fire anyone again. At the start of this year the HSE could not tell the hospital how much money it would be given for the year. For the first three months it operated on the understanding that it would have the same budget as last year. After the first quarter, however, it discovered that it would suffer a further cut in funding. It must let staff go and scale back again.
There are six operating theatres in Cappagh hospital, only three of which are being used. Typically, an orthopaedic surgeon can perform five procedures in an operating theatre on a given day. The surgeons in Cappagh hospital have been instructed to stop after three. The State is paying all of the hospital's fixed costs - for the six operating theatres, the wards, the beds that are not being used, the theatre staff and the surgeons - but the hospital no longer has money for implants, which typically cost between €1,500 and €3,000 each. For a complex operation, it might cost up to €6,000 and, obviously, the cost increases. I told the patients that, were my relative affected, I would borrow the money to buy an implant on eBay and bring it to the hospital, but when I asked them about doing this, they said they were not allowed to do so. When I asked the surgeons what they did after performing the three procedures, they told me that they went home or into private practice where they could actually treat patients.