2026-02-24

I am here tonight to highlight an issue that is causing real pain, distress and uncertainty for families right across Cork city and county. I refer to the unacceptably long waiting times for patients seeking to be seen as outpatients by a consultant orthopaedic surgeon in the South Infirmary Victoria University Hospital, SIVUH, in Cork. The SIVUH plays a vital role in delivering specialist orthopaedic care to people not just in Cork city but across the wider region. Every week, my office is contacted by patients, young people with sports injuries, older people waiting for hip and knee assessments and workers unable to return to their jobs due to chronic pain, all of whom are stuck in limbo waiting months and in many cases far longer than that, simply to be assessed at an outpatient clinic. Behind every statistic is a person. It is that parent who cannot lift their child because of an untreated shoulder injury. It is that farmer who cannot get through a day's work because of a deteriorating hip. It is the older person whose mobility is declining while they wait to even begin the process towards surgery or treatment. Orthopaedic conditions are not minor inconveniences. They directly impact mobility, independence, mental health and the ability to work. When outpatient appointments are delayed, diagnoses are delayed. When diagnoses are delayed, treatment is delayed. When treatment is delayed, conditions worsen, often becoming more complex and costly to treat. The simple reality is that demand for orthopaedic services in Cork has increased significantly. We have an ageing population, higher participation and support, and more people living longer with degenerative conditions, yet the resources allocated have not kept pace with that demand. Consultants and front-line staff at the SIVUH are working tirelessly. They are not the problem. They are doing everything they can within the constraints placed upon them. However, the goodwill and dedication cannot replace adequate staffing levels, theatre capacity, clinic space and funding. We need targeted investment. We need additional consultant orthopaedic posts approved and filled. We need expanded outpatient clinical capacity. We need protected theatre time to ensure that when patients are assessed, they can be moved forward for surgery without delay. We need to ensure that diagnostic supports, such as MRI and radiology, are properly resourced, so bottlenecks do not simply move elsewhere in the system. Early intervention is not just better for patients; it is more cost-effective for the health service. Treating conditions early prevents complications, reduces emergency admissions and supports people to remain independent and work independently in their communities. Patients in Cork deserve timely access to orthopaedic care. They should not have to travel long distances or consider private treatment because the public system cannot see the patient within a reasonable timeframe. I call on the House to take this genuine request and insist that the HSE prioritise additional funding and workforce supports specifically for orthopaedic services at the South Infirmary Victoria University Hospital. A focused plan must be developed to reduce outpatient waiting lists and restore confidence in the system. I do not see this plan at the moment, which worries me. Pain should not be prolonged by process. Mobility should not be sacrificed for bureaucracy. No patient should be forgotten while waiting for care. We owe it to the people of Cork to act urgently. I ask the House to address this matter tonight.

I thank the Deputy for raising this important issue. I welcome the opportunity to address the House. The Government recognises that waiting times for many scheduled appointments and procedures are too long, not only in Cork, but in hospitals throughout the country. The multi-annual action plan approach was initiated in September 2021 to substantially reduce and reform hospital waiting lists and waiting times. Since the commencement of the action plan approach, the health service has seen significant progress in reducing the length of time patients are waiting, including a reduction of 56%, or 157,000, in the number of patients waiting over 12 months. Orthopaedic services are provided in Cork by Cork University Hospital and South Infirmary Victoria University Hospital, with CUH being the trauma centre and South Infirmary providing elective procedures. I was interested to read that the waiting lists in CUH and the South Infirmary are like chalk and cheese. There are currently 199 patients waiting for an outpatient appointment at CUH and 7,444 patients waiting at the South Infirmary. Staffing at the South infirmary has increased by 232 whole-time equivalents since the end of December, from 804 to 1,033, an increase of 28%. The budget increased from €62 million in 2020 to €97 million in 2025, which is a significant increase of 56%. The Deputy can see that a lot of investment has gone in, although the demand is still significant. The Government remains fully committed to increasing elective care capacity through the elective ambulatory care programme. This is being delivered in two phases: with a national network of surgical hubs in the first instance to meet medium-term demand and capacity and, in the longer term, a national network of elective treatment centres in Cork, Dublin and Galway. In Cork, construction of the surgical hub at CUH is well advanced and is expected to open in quarter 3 of this year. Once fully operational, it is anticipated that the hub will deliver annual activity of 8,000 day-case procedures, 5,700 minor operations and some 18,500 outpatient appointments. The Deputy will know that the Minister, Deputy Carroll MacNeill, published the capital plan today, and that €34.5 million was allocated to complete the surgical hub in Cork. That should make a significant difference. I was delighted to see that it will open in quarter 3 of this year. There are several hubs that are midway through construction, and the sooner we get them open, the better. They will not be affected by issues in the acute level 4 hospitals or, for example, by procedures having to be cancelled because of staffing. We can already see the impact they have made in Dublin. Until the capacity is in place in the public system to meet the increased levels of demand being experienced, it is appropriate that we make use of all available additional capacity to ensure that patients have access to the care they need. Accordingly, the multi-annual action plan approach targets the delivery of additional capacity for patients in the public and private systems through a co-ordinated approach by the HSE and the National Treatment Purchase Fund. The NTPF works with hospitals throughout the country to offer and provide the funding for treatment to clinically suitable, long-waiting patients.

I thank the Minister of State for her encouragement and engagement in the response. There is a glimmer of hope for orthopaedic patients in Cork. I know we had the fantastic publication of the service plan this week, where the Minister, Deputy Carroll MacNeill, announced €34 million for the surgical hub, which will allow capacity for up to 18,500 outpatient appointments. I hope that will reduce some of the orthopaedic waiting list for outpatient clinics. As the Minister of State said, it is currently at 7,444. I am glad this figure was brought before the House tonight because it outlines clearly that there is a big challenge in Cork to address the orthopaedic waiting lists. I want to mention two people who have come to my office. I have received correspondence on them from the South Infirmary and the HSE. One person, a lady in her 80s, was referred for an urgent outpatient appointment, but she cannot even get an indicative date. A lady in her 60s has been to the GP twice to get a more urgent referral to the outpatient clinic. In both cases, the management of the hospital and the HSE still cannot guarantee appointments for my two constituents. I am doing my very best to represent them but, unfortunately, I cannot get an appointment time. There is some glimmer of hope with regard to outsourcing theatre capacity in Cork to private hospitals over the coming months to cater for the long waiting lists while we wait for the surgical hub to open in CUH in quarter 3. I would encourage the Minister of State to engage with the HSE and ask it to facilitate some private capacity in private hospitals to deal with the emergent outpatient waiting list. It is chronic. To have 7,444 people waiting in Cork for a basic outpatient appointment for orthopaedics is unacceptable and must be dealt with as soon as possible.

I thank the Deputy for the manner in which he has raised this issue. I can give him a bit of good news. The HSE south-west region employs 12 whole-time equivalent consultant orthopaedic surgeons based at Cork University Hospital and the South Infirmary Hospital. One vacant whole-time equivalent post is due to be filled by March 2026, which should have an impact. To return to the waiting list, in the last six months, 3,174 people have come onto the waiting list, and a significant number are waiting over 18 months. The Deputy might send on the details of the two cases that he raised, and we will see if we can do anything to expedite that. The quality of life of somebody who is waiting for orthopaedic surgery is very much impaired, especially people in their later years. Nobody can stand over a situation where people have to wait for that length of time. We will see if we can do anything to expedite that, and there might be a cancellation or something like that. It would make a big difference. We will have the funding for the waiting list initiative. It will be in place and will make a significant difference. I have no doubt the South Infirmary will receive its fair share with regard to the 12 orthopaedic surgeons being put in place and the surgical hub being opened in the third quarter. I am happy to engage with the Deputy on the two cases he raised.