Cancer Operation Waiting Lists

Oral Answers to Questions — Health – in the Northern Ireland Assembly at 2:15 pm on 22nd November 2021.

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Photo of Matthew O'Toole Matthew O'Toole Social Democratic and Labour Party 2:15 pm, 22nd November 2021

4. Mr O'Toole asked the Minister of Health for an update on cancer operation waiting lists. (AQO 2756/17-22)

Photo of Robin Swann Robin Swann UUP

I thank the Member. According to the latest statistics, in June 2021, 93·4 % of patients received their first definitive treatment within 31 days of a decision to treat. In that context, treatment can mean surgery, drug therapy, radiotherapy, specialist palliative care or active monitoring. There is, however, no doubt that, despite the incredible efforts of our front-line workers, the current extreme pressures on our hospitals are already having an impact on the system's ability to deliver planned surgery. Clinicians and health and social care trusts will continue to prioritise time-critical patients, and available capacity will be allocated on a regional basis in order to ensure that patients from across Northern Ireland have equity of access to surgery. Whilst we continue to try to protect elective care as much as possible, the stark increase in hospitalisations has, undoubtedly, seen an impact on delivery. It is expected that surgical capacity will continue to be constrained for as long as that level of pressure persists.

Photo of Matthew O'Toole Matthew O'Toole Social Democratic and Labour Party

I thank the Minister for that answer. I agree with him that one of the reasons why we need to manage COVID pressures on our hospitals is because of the pressure that it puts on cancer care. Does he or his Department have any data on how many patients have required more complicated treatment or, indeed, have suffered from reduced life expectancy as a result of delays in treatment because of COVID? Does he also agree that those who do not think that we need to reduce pressure on our hospitals should go and say that to people who are waiting for cancer care and tell them that their procedures are not vital?

Photo of Robin Swann Robin Swann UUP

I thank the Member. Since coming into this post, I have repeatedly said that the pressures we are currently seeing are not solely caused by COVID but are being highlighted by it. The pressures that we are seeing across our health and social care system are due to 10 years of underinvestment in the structures and in our workforce. In order to make sure that patients are seen as effectively and efficiently as possible, I announced and produced the elective care strategy back in June, which contains a number of additional steps that can be and are being taken by our reprioritisation organisational group, which is looking at waiting lists across the entirety of the region, rather than being simply based through trusts.

That elective care framework outlines the different scenarios and procedures in different locations that we are doing to keep the COVID-light sites as open and effective as possible. It also highlights our waiting list initiatives with regard to the funding that we have in place to support additional services, either in the independent sector or in other places.

Photo of Órlaithí Flynn Órlaithí Flynn Sinn Féin

Given the pressures that the system is under, particularly in relation to cancer healthcare, which is, obviously, time-critical for a lot of people, will the Minister confirm whether patients have been referred to other jurisdictions for treatment via an extra contractual referral (ECR) process or healthcare directive?

Photo of Robin Swann Robin Swann UUP

I thank the Member for her question. I do not have those specific numbers with me. I can update the Member on waiting list initiative programmes that we have taken forward, which, as she will be aware, have been based on different monitoring round bids.

Just shy of 81,500 people have received additional elective activity outside our normal services that we were able to provide by additional payments to trusts, through GP federations or in the independent sector. We are using every available resource that we can. Our health and social care consultants continue to utilise local independent sector theatres at the Ulster Independent Clinic (UIC) and Kingsbridge to ensure that priority patients can be treated. We are looking to utilise resources in the Republic of Ireland and elsewhere.

What the Member is, I am sure, realising, and it was part of the debate earlier, is that COVID is not happening solely in Northern Ireland. When we look to the additional capacities that we could buy outside Northern Ireland, a lot are being taken up by those regions themselves.

Photo of Rosemary Barton Rosemary Barton UUP

Thank you, Minister, for your answers. You spoke about elective care. There has been an initiative in the South West Acute Hospital in relation to elective care surgery. Will you comment on the success or otherwise of that, please?

Photo of Robin Swann Robin Swann UUP

What the Member is referring to is what we have seen over the last 18 months, and that is about looking at our operational ability across the region. We are looking at the regional prioritisation oversight group coming together weekly to look at the long-waiters — those most in need of time-critical and time-pressured surgery — to make sure they are seen and operated on as quickly as possible.

We have looked at a number of initiatives across Northern Ireland. At one point, Belfast surgeons were operating in the South West Acute Hospital to make sure that we were getting the maximum utilisation of those theatres. We are looking at the additional capacity that we may use in Omagh Hospital as well, to make sure we are using and making available every square foot of health estate across Northern Ireland.

Photo of John Blair John Blair Alliance

Does the Minister agree that taking steps beyond merely voluntary vaccination, such as prohibiting high-risk venues from opening without mitigations, would reduce coronavirus infections and COVID-19 hospitalisations, and, therefore, facilitate a refocus on waiting lists? That is why new actions have been identified and why we should stick to them.

Photo of Robin Swann Robin Swann UUP

I thank the Member for his question. The utilisation of COVID certification is a conversation that is ongoing in the Executive. That will be part of a wider debate at another time with regard to where that comes in and where it can be of benefit.