Topical Issue Debate

I am raising this issue tonight because I continue to hear from people across County Cork who are waiting far too long simply to be seen by an orthopaedic consultant at South Infirmary Victoria University Hospital, SIVUH. The scale of this problem is extremely concerning. The most recent figures provided to me showed that 7,444 patients are waiting for an outpatient orthopaedic appointment at SIVUH. Let us pause for a moment to consider what that figure actually means. Almost 7,500 people are waiting for an assessment by a specialist. Many of these people are living with significant pain, reduced mobility and a deterioration in their quality of life while they wait. I want to give one specific example from my constituency. John is a young man who has been on the urgent outpatient waiting list for an orthopaedic consultant since February 2025. He has been waiting for well over a year and he still cannot get an appointment. He is not someone who has been categorised as "routine"; he has been classified as "urgent". The situation has become so difficult for him that his pain is now having a serious impact on his daily life. In May this year, because of the severity of his pain, he was referred to a pain management consultant but surprise, surprise, he cannot get an appointment for that either. We, therefore, have a young man who has been waiting since February 2025 to see an orthopaedic consultant despite being categorised as urgent. His pain has become so severe that he requires a specialist referral and now he is waiting again. That is exactly what I mean when I say that behind every waiting list figure is a person. John is not a number. He is a young man who wants to get on with his life, who wants to work, who wants to be active and who wants to have his condition properly assessed and treated. Instead, he is stuck in a system where one waiting list leads to another. I am sure many other people in Cork are in a similar position. I have been contacted by constituents waiting for hip and knee assessments. I have heard from older people whose mobility and independence are being affected. I have heard from people whose conditions are impacting on their ability to work and to carry out normal day-to-day activities. Perhaps most concerning, I have been contacted about patients who have been categorised as urgent yet still cannot get an indicative date for when they will be seen. This is extremely difficult for patients and their families to understand. If a patient is told by their GP that they need an urgent orthopaedic assessment, they quite reasonably expect that the health service would find a pathway to deal with that urgency. Instead, people are waiting and being left in limbo. They do not know when they will be seen. They do not know when they will receive a diagnosis. They do not know when they might begin treatment and all the while, they are living with pain. The SIVUH plays a hugely important role in Cork and I want to put on the record my appreciation for all the doctors, nurses, consultants and all the staff working there. The staff are not the problem; the problem is capacity. We have to acknowledge that demand for orthopaedic services has increased significantly. We have an ageing population, people are living longer and they rightly want to remain active and independent for as long as possible but the current level of capacity is clearly not meeting the demand. We cannot simply accept that thousands of people in Cork should remain on an orthopaedic waiting list for months or, in some cases, years. I have been raising this issue directly with hospital management and HSE South West for many months. I welcome the fact that the options are being explored but almost 12 months later, we have no options presented to us. I would really like an update on this matter.

I thank the Deputy for raising this issue and for giving me the opportunity to provide an update to the House on this important matter on behalf of the Minister for Health, Deputy Carroll MacNeill. I acknowledge the importance of addressing the long waiting lists. Many patients are still waiting too long for hospital appointments and treatments and the Government is conscious of the burden that this places on patients and their families as the Deputy rightly outlined. The Government has invested significantly in South Infirmary Victoria University Hospital and its budget has increased from €62.5 million in 2020 to over €102.5 million in 2026, an increase of 64%. Staffing at the hospital has also grown by 33.6% since 2020 and significant capital projects have been completed in recent years, including the refurbishment of two theatres to facilitate the relocation of ophthalmic surgery from Cork University Hospital to the infirmary in 2022. These investments contribute to allow more capacity for more activity in SIVUH. There has been an 8% decrease in the orthopaedic inpatient and day case waiting list when compared to the same period last year. Currently, 330 patients are waiting for a procedure. However, there is a 10% increase in orthopaedic outpatient waiting list when compared to the same period last year. Overall outpatient referrals at the hospital have increased by over 4% across all specialties inthe first six months of 2026 when compared with the same period last year. Therefore, while capacity has increased, the referral rate is also increasing. There are multiple streams through which this is being addressed. The Waiting Time Action Plan 2026 embodies the Government's commitment to reducing waiting times for these patients and patients everywhere. Under the National Treatment Purchase Fund, outsourcing initiatives are ongoing for suitable patients, focusing specifically on those patients waiting the longest. Some 800 patients have been offered this option so far in 2026. This involves a full package of care, including both outpatient review and procedure. Physiotherapy-led musculoskeletal clinics are run for suitable patients on the orthopaedic outpatient waiting list. Here patients are seen and treated by a physiotherapist while they remain on the outpatient waiting list to see a consultant. Additional weekend clinics are being run to address the longest-waiting patients. Four weekend sessions have taken place in the last three weeks. South Infirmary Victoria University Hospital is also running evening clinics to address the longest-waiting patients in relation to upper limbs. From this Friday, 18 September, additional theatre capacity will also become operational at the hospital. This has been supported through additional funding for an existing theatre to facilitate additional sessions each week. The theatre will run from 8 a.m. to 5 p.m. initially and once the full complement of staff is in place, the extended day will commence with theatre schedules running until 10.30 p.m. The Cork surgical hub is anticipated to be operational by the end of this month. The hub is part of Government's commitment to increasing elective care capacity through a national network of surgical hubs to meet medium-term demand. With an initial focus on the longest waiting patients, this surgical hub will have a significant impact on waiting lists through the delivery of additional activity for high-volume, low complexity day cases across 12 specialties, including orthopaedics. Once fully operational, each new surgical hub is expected to deliver additional annual activity of up to 18,500 outpatient appointments.

I thank the Minister of State for his response and for his engagement on this issue. I very much welcome the commitments made, particularly in relation to the additional theatre capacity, which will be available form this Friday and the opening of the Cork surgical hub in a number of weeks. I want to emphasise that for patients waiting for orthopaedic care in Cork, action is what is required now. We have almost 7,500 people waiting for an outpatient orthopaedic appointment. These are simply not numbers on a spreadsheet. They are living with pain, reduced mobility and uncertainty about when they will finally be seen. I referred earlier to the case of John, a young man in my constituency who has been on the urgent outpatient waiting list since 2025. He still cannot get a date to see an orthopaedic consultant and his pain has become so severe that he was referred to a pain management consultant in May this year, and he cannot get an appointment for that either. That is not acceptable and it is not an acceptable patient journey. I reiterate that I have been raising this directly with hospital management and I have been told repeatedly that options are being explored to increase capacity in waiting times. Almost 12 months later, however, we are still waiting for those options to translate into action. I appreciate what the Minister of State said about the additional theatre capacity that will be put in place from this week, and also the opening of the Cork surgical hub in a couple of weeks. However, additional clinics are required so let us provide them. If additional consultant capacity is required let us address that. If additional diagnostic capacity is a barrier let us deal with that. Patients cannot be expected to wait indefinitely. I ask the Minister of State to ensure that the HSE South West and hospital management put forward a clear timeframe to reduce this waiting list with measurable targets and provide regular updates.

I thank the Deputy for raising this matter and take this opportunity to confirm that the Government is absolutely committed to further strengthening orthopaedic services for all patients in line with Sláintecare. This is illustrated, as the Deputy will probably agree, in the significant funding increase South Infirmary Victoria University Hospital Cork has received over the past number of years. Additionally, the Waiting Time Action Plan 2026 and surgical hub programme demonstrate the Government's commitment to reducing waiting times and increasing care capacity for patients in the region and nationwide. Under the waiting time action plan, outsourced initiatives are in place for suitable patients waiting the longest on South Infirmary Victoria University Hospital’s outpatient waiting list. To support timely access to orthopaedic services the hospital is running additional clinics at the weekends and evenings and where clinically suitable, patients are offered physiotherapy services while awaiting appointments with a consultant. Lastly, additional theatre capacity will shortly become operational and will further allow for additional sessions each week. I assure the Deputy that the Government, HSE and the HSE South West region remain committed to improving the service for patients of the regions. I understand the Deputy has been engaging directly with the Minister's office and the Minister on this case and I am happy to follow up with the Minister and her office to ask them to engage directly with him again. I thank him for his great work and vigilance in trying to ensure people get the best possible care in his constituency and hospital. I assure the Deputy that the HSE and South Infirmary Victoria University Hospital are committed to reducing waiting times for orthopaedic services. The delivery of high-quality patient-centred care is best practice and remains at the centre of all hospital activity.