Seanad Éireann debate -
Thursday, 9 Mar 2023

Vol. 292 No. 10

Nithe i dtosach suíonna - Commencement Matters

Water Quality

Senator Garret Ahearn

I welcome the Minister of State to the House and thank him for taking this important Commencement matter. It is my first opportunity to congratulate the Minister of State on his new role. We in County Tipperary call him, "the Tipperary Minister", because a region of ours is in his constituency. I know from mutual friends we have in Newport and Birdhill that they are very proud of the Minister of State's elevation and he is regarded as an incredible worker in that area.

I have brought up Irish Water numerous times with regard to the moving away of water services from local authorities to Irish Water. Before I delve into the Clonmel and business issues, it is important to acknowledge the work that has been done in the past number of months in the Minister of State's Department and the Minister, Deputy Darragh O'Brien, in particular, with the publication of the framework for the future delivery of water services last June. The transformation team of Irish Water has played a key role in building up relationships between staff in local authorities and Irish Water. I think the team has from now until 2026 to put a plan in place for staff moving and what choices and options they have in moving. By all accounts, from staff I have spoken to in water services, that relationship has improved considerably and they are certainly more engaged and positive about the move.

I will touch on the operational side of things today. Councillors John FitzGerald and Michael Murphy in Clonmel and I face a constant challenge with water services in the area in terms of outages. I am conscious it happened yesterday to a large area of the rural side of Clonmel. In fairness to Irish Water, it has plans in place, some of which will be completed this year, to improve the operational facilities of the plants in Clonmel.

One of the issues we have is a real challenge from a business perspective. Three plants are running in Clonmel. A simplistic way of looking at it is that Poulavanogue manages the east side of Clonmel town centre on the Mountain Road; Glenary covers the west side and Monroe covers everything north of the Clonmel bypass. The future development of Irish Water essentially means that it is changing things around, whereby the Glenary plant will cover Mountain Road and the town centre and Monroe will come in towards the town centre. The difficulty I and an awful lot of other people in Clonmel have with this concerns the quality of the water. Poulavanogue is a plant on top of the Comeragh Mountains from which water comes right down into the town. The quality of the water is second to none. It is top class.

I know the measure to be brought in is temporary, but the challenge we face going forward is that the plant which will replace Poulavanogue for a short period, in Monroe, has very poor-quality water. That is fine if one is a domestic user. One can put in filters and improve the hard water. There is no problem there but, from a business perspective, this has a real impact. If a restaurant or a coffee shop, in particular, needs good quality water going into machines, it will cost considerable money to put systems in place to be able to get that top-quality water and it will cost an awful lot of money to maintain them.

Business people are afraid. We have a perfectly good plant that produces top-quality water, which comes from the Comeragh Mountains down into the town. There are many towns across the country that would want this type of water to be coming in from a source on a mountain right beside the town. It is free water. In my view, we are not maximising that top-quality water.

Water supply is a massive issue for businesses. I am not sure all of the business operators in Clonmel realise the impact that this could have for the next number of years. I am interested in hearing the Minister of State's response.

Minister of State at the Department of Housing, Local Government and Heritage (Deputy Kieran O'Donnell)

I thank the Senator for his congratulatory comments and I thank him for raising this very important issue.

The policy paper on water sector transformation, as published in 2021, set out the Government's vision for the development of water services in Ireland based on the full integration of water services under Uisce Éireann as a single national water services authority in public ownership. The objective is to deliver a world-class public water services authority that meets customer needs, operates in line with best practice, represents value for money and facilitates economic development in urban and rural locations.

The engagement with unions on a framework for future delivery of water services was concluded successfully at the Workplace Relations Commission last June. The framework now enables Uisce Éireann to work in conjunction with local authorities to complete the full integration of public water services into its own organisational structure over a four-year period from 2023 to 2026. Staff are hugely important in that integration. The preparations for the implementation of the framework are progressing well.

The Senator mentioned a specific public water supply in Poulavanogue and mentioned that his colleagues, councillors John Fitzgerald and Michael Murphy are working with him on this particular issue. I will give the up-to-date position. The Clonmel Poulavanogue public water supply is currently on the EPA's remedial action list for turbidity and cryptosporidium. It is a river stream source and the treatment consists of slow sand filters and chlorine disinfection. Due to the site location infrastructure, it is not possible to undertake the required upgrades to ensure treatment of the water treatment plant addresses the cryptosporidium risk. Prior to the installation of an automatic shutdown on the raw water in 2020, we had regular cryptosporidium detections. Treatment of the existing Poulavanogue sources was also ruled out on the basis that the sources do not have an adequate yield to meet the current demands as demonstrated during recent dry weather events and thus, if retained, would result in a risk of interruptions to supply for parts of Clonmel town. A new source of supply is required to ensure Uisce Éireann can meet the needs of existing customers while allowing for growth in the area.

The draft national water resources plan for the south east will set out the long-term strategy for Clonmel town and a number of smaller local supplies. In the short term, an interim plan to increase the abstraction at the existing Monroe well-field is proposed to deal with the needs of Clonmel town for the next ten or more years. The timeline for the completion of this project is 2026. The Mountain Road pipeline project, which commenced earlier this year, will address the risk of boil water notices and regular outages at the Poulavanogue water treatment plan.

Earlier this year, Uisce Éireann assumed responsibility for the direct recruitment of water services staff. A comprehensive engagement exercise is under way to communicate the framework details directly to existing staff and ensure all local authority water services workers fully understand the options available to them. One-to-one briefings will be made available to staff in the coming weeks. It is important to note that any transfer of staff to become permanent employees of Uisce Éireann will be on an entirely voluntary basis. The Government is, therefore, planning for the future in an orderly and well-managed way that ensures there will be no adverse impacts on the delivery of services to the business and domestic customers of Uisce Éireann. Ultimately the reforms that are under way, coupled with the ongoing increased levels of investment year on year in our water services, will ensure that citizens and businesses will enjoy a world-class water services system that they rightly expect and deserve, and of which we can all hope to be justifiably proud.

I will provide Senators with my full text but I wanted to deal with the Poulavanogue issue.

Senator Garret Ahearn

I thank the Minister of State and appreciate his update on Poulavanogue. The problem is the quality of water from the Monroe source, which will now be used instead of Poulavanogue for a period. Monroe was established in the 1990s as a temporary measure and now it looks like it will exist for another ten years. The quality of water that comes from Monroe, which is going to service the town of Clonmel, and the businesses in particular, is not up to scratch. Businesses will be caught with an expense through no fault of their own because the quality of water is not what it should be.

The Minister of State mentioned the framework. I acknowledge that a long-term strategy is being put in place by Irish Water in respect of Clonmel. As I have said on numerous occasions in this Chamber, the relationship between local representatives and Uisce Éireann needs to improve and especially at local authority level. On this issue, I would appreciate if there could be engagement with myself, and councillors John Fitzgerald and Michael Murphy, on the long-term strategy for Clonmel in terms of what is best for the town. This should happen before the strategy is published. Such engagement is essential so that when we go out and the strategy is there, we can defend the decisions that have been made by Uisce Éireann and explain why the strategy is good for the town. It is very hard for us to do that if we do not have engagement beforehand. I ask the Minister of State to use his influence to give us an opportunity to discuss, with the operational team of Uisce Éireann, the long-term strategy going forward for the town of Clonmel and, in particular, for businesses.

Deputy Kieran O'Donnell

The Senator has made clear points. He understands the issues at hand in Clonmel. I understand that my Department and I will make direct contact with Uisce Éireann to ask its officials to engage directly with the Senator, and councillors John Fitzgerald and Michael Murphy in Clonmel, on this particular issue.

Ultimately, we all want to improve the quality of the water supply, which is what Uisce Éireann is all about. I undertake that I will contact Uisce Éireann and that a meeting will take place.

Hospital Staff

Senator Mary Seery Kearney

I appreciate that the Minister of State is here at very short notice. I acknowledge that the Department of Health has emailed myself, and Senators Gavan and Conway, to explain that the Minister for Health is not available. Issuing an email is an improvement on the usual lack of communication.

I am here to discuss an issue that pertains to a small group of people whose quality of life is very much affected. I will quote from a letter written by a person with cystic fibrosis, CF:

I am a 36 year old CF patient and received a double lung transplant in May 2006. I was 19 years old at the time. I was a patient of Crumlin Children's hospital until January 2006 and was transferred over to St. Vincent's hospital for a short few months until my transplant where my care was taken over by the Mater Hospital.

In recent years, this lady's quality of life has seriously deteriorated. She has had multiple hospital admissions. She has lost a serious amount of weight. She suffered from bronchiolitis obliterans syndrome, which also deteriorated her lung function. She mentions in her letter that she is "currently able to manage on my current [lung capacity] level of around 25%", but it is difficult because she has a young child.

In October 2022, her consultant suggested that she would be a really good candidate for Kaftrio because it would address the issues that affect her quality of life. She sent a letter to the professor who is over all of this asking that they consider prescribing her Kaftrio at the centre in the Mater Hospital. To date, there has been no progress on this issue aside from the news that there may be a committee established to look into similar cases. Such a situation is extremely frustrating, seriously reduces her quality of life and detracts from her ability to engage in normal family life.

I raised this issue, at her suggestion, with Cystic Fibrosis Ireland, CFI. During our conversation, representatives of CFI told me that they understand that the HSE and the national clinical programme for cystic fibrosis have agreed to appoint a consultant for post-transplant cystic fibrosis care, particularly among people who have had a double-lung transplant in the Mater Hospital. CFI is concerned that there has been a significant delay in the appointment despite the fact that it has already been approved. I have some questions for the Minister. Has the appointment been advertised?

When will the consultant be appointed? What is the timeline in that regard?

This is a serious and urgent issue for post-transplant CF sufferers. Having a transplant is not the end of it. CF does not suddenly go away. All the other issues still go on in the person's life. If the person then experiences deteriorating lung capacity, he or she is back to the same full-blown CF he or she experienced prior to the lung transplant. Cystic Fibrosis Ireland has been campaigning on this issue for more than three years but we still do not have anyone who will prescribe Kaftrio to CF sufferers. I am seeking an update in that regard.

Deputy Kieran O'Donnell

I thank the Senator for raising this issue. I will speak on CF overall and go into the details. Is the patient to whom she referred a woman?

Senator Mary Seery Kearney

Yes.

Deputy Kieran O'Donnell

If we can do anything for that lady, I ask the Senator to provide me the details and I will follow up on it. I know many people who have CF. They are a group I admire. Many of them are highly successful. A member of my extended family who has CF is a credit to her parents and leading a very full life. I fully support the provision of any supports that are required in the context of CF.

I thank the Senator for raising this issue and giving me the opportunity to speak on it in the Seanad on behalf of my colleague,the Minister for Health, Deputy Donnelly. The Government is committed to increasing organ donation and transplantation rates in Ireland and making organ donation the norm in situations where the opportunity arises. Organ donation is among the most selfless acts people can bestow on each other. The improvement in the quality of life for organ recipients and their families cannot be overstated. We have a duty to do everything we can to ensure that as many people as possible benefit from organ donation.

The Government has taken a number of measures in recent years to improve organ donation and transplantation services in Ireland. Since 2020, an additional €2.25 million in funding has been allocated to support the ongoing development of transplant services. This funding has enabled the HSE to: develop the staffing and infrastructure of the organ donation and transplant system; prepare the online opt-out register for the upcoming system of opt-out consent to be implemented with the Human Tissue (Transplantation, Post-Mortem, Anatomical Examination and Public Display) Bill 2022; undertake a pilot potential donor audit through the National Office of Clinical Audit to better understand and improve donation rates; and enhance our ability to assess organ donors from abroad.

In addition to funding, the Government has introduced the human tissue Bill to provide a national legislative framework for operating donation and transplant services in Ireland. This Bill, which is currently progressing through the Oireachtas, will support organ donation and transplantation through the introduction of a soft opt-out organ donation system. Under this system, when a person dies consent to donation will be deemed unless the person has registered his or her wish not to become an organ donor after death. Family members will continue to be consulted prior to removing any organ. If the next-of-kin objects to the organ donation, the donation will not proceed. The Bill further legislates for living organ donation and will provide pathways for non-directed altruistic donation. The introduction of this system, together with an extensive communication and education programme, will help raise awareness of organ donation and ultimately encourage more people to donate.

I will deal specifically with the issue of the consultant physician post. This is the kernel of the matter raised by the Senator. We have been informed by the HSE that engagement is ongoing between organ donation and transplant Ireland, ODTI, and the cystic fibrosis national clinical programme regarding the structuring of this post. It is expected the post will be approved shortly and recruited, subject to suitable candidates applying, in 2023. I will follow up with the Department and get precise dates for when it will be advertised, when the recruitment will take place and when it is expected to have a consultant in place. I undertake to go back to the Minister to obtain those details for the Senator. This appointment will ensure the effective management of the transplant waiting list and minimise the requirement for post-transplant care through the provision of medical support tailored to the needs of this complex patient group of CF sufferers.

Senator Mary Seery Kearney

As a party colleague and since he took up his post as Minister of State, Deputy O'Donnell does nothing but work diligently, and he is very good at following up with his colleagues. However, the speech he has been given is three minutes of absolute piffle that has nothing to do with the question that was asked. It is an obscenity that someone in the Department of Health thought it fit to provide a Minister with a speech that goes on with a load of stuff that has nothing to do with the question I asked.

Senator Paul Gavan

Well said.

Senator Mary Seery Kearney

There is small group of people whose lives and quality of life depend on action being taken. The advocacy group Cystic Fibrosis Ireland has spent more than three years asking for a consultant who will prescribe kaftrio for post-transplant CF sufferers but what I have got back are vague phrases like "being approved shortly" and "will be recruited". There is no urgency shown towards the people of the Republic the Department of Health is there to serve. That is its job. It is obscene that the Department is not serving the people and thinks the reply it has provided to a Member of the Oireachtas is appropriate. It is an absolute disgrace of an answer.

Deputy Kieran O'Donnell

I make the point to Senator Seery Kearney, soon to be Deputy Seery Kearney, that although it is regrettable that recruitment for a consultant respiratory and lung transplantation physician in the Mater hospital has been delayed, the HSE ODTI is working to recruit to the position as soon as possible. Once in place, this consultant physician will provide greater support to lung transplant recipients, including those with CF. I have undertaken to go to the Minister, Deputy Donnelly, and the Department to get the information the Senator is seeking, that is, ultimately, when that consultant physician will be in place in the Mater hospital and, working way back from that, when the post will be advertised, what will be the interview process and when a candidate will be recruited. I have undertaken to follow up in that regard. It is a straightforward request from the Senator and, in the circumstances, I do not intend to cover anything else. That is the heart of her question. I undertake to follow up on that and I will get the Minister to issue a direct response to her.

Senator Mary Seery Kearney

I thank the Minister of State. I do not doubt his sincerity but I doubt that of the Department.

Hospital Overcrowding

Senator Paul Gavan

I wish to put on record that I am more than disappointed that the Minister for Health is not present. He has bottled it because he knows he has no answers to the issue I will raise in respect of University Hospital Limerick, UHL. I am interested to hear the response of the Minister of State who is from Limerick. He may be aware there is considerable divergence between the official HSE figures for the number of admitted patients on trolleys and the figures as counted by the Irish Nurses and Midwives Organisation, INMO. During a debate in the Seanad on Wednesday, 1 February, the Minister, Deputy Donnelly, said there were just eight patients on trolleys in UHL that morning. He went on to say, "In the past week the average has been about six." However, figures from the INMO show there were 78 people on trolleys in UHL on the morning of 1 February. In the week before that, there were between 44 and 65 patients waiting for an in-hospital bed. Mary Fogarty, the INMO assistant director of industrial relations, told the Limerick Post that the Minister's figures have no basis in reality. She went on to say:

We were at the hospital on Thursday, February 2, and established that his figures are absolutely wrong. I have no idea where the Minister got the figures but there were 77 people on trolleys when we were there.

The Minister of State knows Mary Fogarty. I spoke to her yesterday. She described the HSE figures as bizarre and confirmed that the INMO figure is taken at 9.20 each morning. As the Minister of State will be aware, the HSE figure is taken three times a day and claimed there were eight patients on trolleys at 8 a.m. on the morning in question. It is simply not credible for the Minister, Deputy Donnelly, to state there were eight patients on trolleys at 8 a.m. on 1 February when the INMO tells us there were 78 patients on trolleys at 9.20 a.m. It should be borne in mind that Mary Fogarty spoke directly to staff in the emergency department to verify those figures.

The Minister of State need not take her word on this issue, however. Ger Kennedy of SIPTU, who represents the support staff in the emergency department, also confirmed to me that the HSE figure is nonsense. I put it to the Minister of State that 11,000 people did not take to the streets of Limerick to protest about the chronic crisis in capacity in staffing because of eight people being on trolleys.

The reason this is so serious is that implicit in the statement of the Minister, Deputy Donnelly, is a belief that there is no crisis in respect of patients on trolleys in UHL.

I would be interested in hearing the Minister of State's position. While I know he has a script to read, it is too important a matter. I want to know whether the Minister of State acknowledges that the INMO figures are correct. I want to know whether the Minister of State acknowledges there is a massive crisis with patients on trolleys in University Hospital Limerick. I ask this because, frankly, when the Minister was sitting in that seat two weeks ago, he said quite the opposite. He stuck to the figure of eight patients that the HSE gave. The Minister of State and I both know those figures are absolute nonsense. There is a difference in how the figures are calculated, but in no way do they go anywhere near closing the gap between the two figures, which are eight patients and 78 patients. By the way, if one looks at the figures over the last month, it will show that a significant gap is always there. There are gaps of 40, 50 and 60 between the INMO and the HSE figures.

It is worth exploring this topic. We know if that if a patient is in a cubicle in the emergency department in UHL, and he or she is still on a trolley, mind, that person will not be included in the HSE figure. Is the Minister of State happy with the exclusion of those people from those numbers? We know the INMO also counts patients placed on wards, corridors or chairs elsewhere in the hospital who are waiting for admission to a bed. However, the HSE figures the Minister quotes excludes those people again. What is the Minister of State's opinion on that? Does he think people who are on trolleys who are not in the emergency department should be excluded? Clearly, the Minister for Health does. I remind the Minister of State that previous Ministers for Health, such as the Minister of State's colleague, James Reilly, were happy to accept those INMO figures. Indeed, when Deputy Stephen Donnelly was in opposition, he was happy to quote the INMO figures. However, he has been in constant denial here on not just one but two occasions in the past month. To be frank, I believe that is why the Minister for Health is not present this morning, because he would have no answers in relation to this crisis. The people of Limerick want to know at the very least whether the Minister for Health understands there is a chronic crisis in UHL. He was in denial here two weeks ago. I hope the Minister of State will give me a positive answer and that he will be very clear that he accepts those INMO figures.

Deputy Kieran O'Donnell

I am taking this Commencement matter on behalf of the Minister for Health, Deputy Stephen Donnelly. The Senator and I are colleagues in Limerick and I am fully aware of this issue. Senator Gavan will know that I, along with colleagues, have looked to highlight the issues at UHL with overcrowding. I intend to explain the difference and then I will deal with the more local, substantive issues.

I welcome the opportunity to address the House on this important issue, which has been raised by Senator Gavan. Although both the HSE's TrolleyGAR and the INMO's trolley watch counts provide daily reports on the number of patients waiting on trolleys for admission in acute hospitals, there are notable differences in their inclusion criteria. The HSE's TrolleyGAR is a count of all emergency department patients who are waiting to be admitted to an inpatient bed and for whom an appropriate bed space is not yet available. The definition of an appropriate bed space agreed between the HSE and the INMO is that it must have a bed, curtains, access to bathroom facilities and oxygen and suction facilities, must have a named consultant and nursing team assigned and the patient must be on a documented pathway of care. As such, TrolleyGAR includes patients waiting on trolleys in the emergency department and in wards but does not include patients in designated surge capacity beds, which are recorded and reported separately by the HSE. It is my understanding that it does not include people in cubicles. It is our understanding that the INMO may include some surge capacity beds within their trolley counts. There is a definition. I likewise had a look at the figures. In the last two days, the TrolleyGAR recorded Limerick at the figures of 26 and 18. respectively. I do not know what the INMO's figure was this morning because it was not up, but it was 90 yesterday, it was 80 on Tuesday and it was 77 on Monday.

For me, it is a matter of how they are counted, as well as about treatment. I would prefer for someone to be treated in a cubicle than for them to be on a trolley, but it is about dealing with overcrowding in UHL. Whatever metric is used, there is still overcrowding. We have looked to address it through the new emergency department. Some 98 additional acute beds have gone on-site in the last two years. In last three years, there has been a 60-bed acute ward, plus an additional 38 units have been put in during Covid-19. There is a 89-bed acute bed ward that is under construction at the moment. We are looking to get another 96 beds. There is a new consultants' contract coming in.

The numbers went up by a great deal between January and February. That is because electives were restarted and we need to do electives. What I would like to see and what we need to look at - and I hope this will happen under the new contract - is for there to be consultants on duty. There are now 11 consultants in the emergency department. Can we have a mechanism where there is a consultant who is on duty at later times, perhaps up to 12 midnight? Furthermore, will there be discharges over the weekend?

The point is, however, that whatever metric is used, there is overcrowding in UHL. I am conscious of that for the patients and their families who come in. It is something I acknowledge. I am committed to working with the Government, with the Minister for Health, Deputy Stephen Donnelly, and the Taoiseach in order that we get the numbers of trolleys down. Whatever count that is being used, the numbers are too high.

Senator Paul Gavan

I thank the Minister of State. The point is that the divergence between these figures is such that the HSE figure is simply incredible. I have a huge concern that twice in this Chamber over the past month, the Minister for Health rejected the INMO figures. He insisted there were just eight people on trolleys on 1 February when he was here and he told me that I did not have my homework done. It turns out that he has just written a note to say that he cannot attend school today. The fact he is not here is an absolute disgrace and he has bottled it. I feel sorry for the Minister of State because the fact is that everyone in Limerick knows the INMO figures are correct. Everyone knows there are more than 100 patients on hospital trolleys. Members of all parties have acknowledged it over the last couple of weeks in this Chamber. Yet, the Minister for Health is in absolute denial in relation to this issue. It is hugely disrespectful to the INMO. It is hugely disrespectful to SIPTU, to the front-line workers there in the hospital and at the very least, the Minister needs to come into this Chamber and correct the record and acknowledge that he is fundamentally wrong when it comes to the numbers of people on trolleys in UHL.

Deputy Kieran O'Donnell

I acknowledge the phenomenal work being done by front-line workers. I acknowledge the difficulties being experienced by patients who are presenting in UHL. Staff are doing their utmost. We have a capacity issue and we all accept that. The Minister for Health, Deputy Donnelly, is fully aware. These are two different metrics. If someone presents to UHL, I would prefer for them to be in a cubicle to be treated than to being on a trolley or waiting. That, by definition, makes sense.

I have spoken to the Minister for Health many times on UHL. He is fully aware of this and he is fully committed to getting the trolley numbers down, by whatever metric is used. The issue for us in Limerick and in the mid-west is that the hospital requires additional bed capacity. Equally, we need to look at other ways we can improve the patient flow through the hospital itself. I will take the point the Senator has raised back to the Minister, Deputy Donnelly. However, I utterly refute any question that the Minister is not committed to UHL, because at this stage I have spoken to him on countless occasions about the issues in UHL. He has visited it and he is fully committed, as is this Government, to getting the additional capacity into UHL in order that we can reduce the numbers of people on trolleys who present at the emergency department.

Senator Paul Gavan

There have been 12 years of failure from Fine Gael on this issue.

Health Services Staff

Senator Martin Conway

The Minister of State, Deputy O'Donnell, is very welcome to the House. This is a straightforward, simple Commencement matter. I am looking to learn when the Minister for Health, Deputy Donnelly, will appoint a chief pharmaceutical officer in the Department of Health. This is commonplace throughout the world and in practically every other European country. Yet, in this country we do not have one. We have a Chief Medical Officer and we saw the great work her predecessor did during the pandemic, and indeed the great work she is doing now. We have a chief nursing officer, who brings together all strategies to do with nursing and nursing care in this country. We have a chief veterinary officer in the Department of Agriculture, Food and the Marine, who brings together all those various issues.

In the Department of Health, there is a chief dental officer, who brings together all policies on dental care. A chief pharmaceutical officer would push forward the role pharmacists play in this country. Pharmacists are totally underutilised in relieving the pressures on the front line, particularly in general practice. Of all the flu vaccines administered last year, 30% were given in pharmacies. That percentage could be much higher and, in addition, there are many other vaccines and tests pharmacists could administer. A report launched last week on cardiovascular care in Ireland referred to a simple, straightforward screening programme. Such a programme could easily be carried out by the network of pharmacists throughout the country. It should be done.

There is no strategic plan for pharmacy services. We need such a plan, driven by a chief pharmaceutical officer in the Department of Health. Representatives of the Irish Pharmacy Union, IPU, attended a meeting of the Oireachtas health committee yesterday. They have been calling for years for the appointment of a chief pharmaceutical officer. They have also been long calling for the establishment of a strategic plan for the delivery of pharmacy services. They want to do more to help the front line. They want to undertake the screening programmes and play a much greater role in the administration of vaccines. They are willing and ready to do it. They have a network of shops in every town and village in the country. They know their customers and, in many cases, they know those customers' medical needs. They are well placed to do much more of the work being done by general practitioners, particularly screening and vaccinations. There are many other areas in which they could play a vital role.

The creation of a more formalised structure for the delivery of pharmacy services requires the appointment of a chief pharmaceutical officer and the creation of a strategic plan. That should be done. It makes sense and is in line with best international practice. I would like to know why it has not happened before now and what timeline we are looking at for such an appointment.

Deputy Kieran O'Donnell

I thank the Senator for raising this important matter. The Department of Health recognises the key role of pharmacy services in the community and the ongoing significant contribution made by the sector to patients and the public, particularly during the pandemic. The potential role pharmacy services can play in the development and implementation of future healthcare reform, especially in regard to the aims and vision of Sláintecare, is under consideration.

Medicines are the most common healthcare intervention within the health system and the use and complexity of medicines are increasing. Pharmacists are the healthcare professionals optimally placed, by virtue of their training, to deliver a critical role within the health system to ensure the rational use of medicines by maximising the benefits and minimising the potential for patient harm. The focus of Sláintecare is to develop primary and community care and make it possible for people to stay healthy in their homes and communities for as long as possible. The underpinning objective of, and rationale for, enhanced services delivered in community pharmacy practice is to realise enhanced patient care and access. The Department is open to exploring any evidence-based and appropriately governed services, delivered by appropriately trained professionals, that supports this aim. In this regard, a number of proposals and ways to progress the potential extension of the scope of practice of community pharmacists in the short, medium and longer term are currently being considered.

The Senator asked specifically about the appointment of a chief pharmaceutical officer. At this time, there are no active proposals to develop such a role in the Department of Health. There are professionally qualified pharmacists among the Department's staff. Furthermore, a number of units within the Department have responsibility for advancing policy in key areas of our health system. They are cognisant of potential deliverables that can be realised by and through pharmacists and pharmacy services to deliver patient-centred care in line with the vision of Sláintecare. I note the points raised by the Senator but I have outlined the up-to-date position on the matter.

Senator Martin Conway

I thank the Minister of State for his reply. It is very disappointing that the Department has no plans to appoint a chief pharmaceutical officer. The Minister, Deputy Stephen Donnelly, is wrong not to do so. Having such an officer in place would help to pull all the various strands together. It would facilitate the drawing up of comprehensive strategies for the short, medium and long term for the delivery of pharmacy services. Pharmacists want this to be done and they have empirical evidence to suggest it will work. It would follow international practice, with every other country seeming already to have a chief pharmaceutical officer. Some of the largest pharmaceutical companies in the world have their European head offices in Dublin. The Minister and the Government are out of step with best international practice in this matter.

The Minister of State's response is not acceptable. It will cause grave disappointment to pharmacists the length and breadth of the country who have done so much to help communities. The Oireachtas health committee will be writing formally to the Minister to make a strong recommendation in this regard. If that communication has not already been sent, it will be done in the coming days.

Deputy Kieran O'Donnell

I thank the Senator again for speaking on this topic. The Department of Health appreciates the expertise of pharmacists and the valuable contribution they make, both in working collaboratively with other healthcare professionals as part of a team and working independently. By leveraging their knowledge, they make a significant contribution that adds benefits to patient outcomes. I acknowledge the Senator's indication that the health committee intends to write to the Minister. Perhaps the committee might consider undertaking a substantive body of work around this issue. I will take the matters raised by the Senator today directly to the Minister.

Senator Martin Conway

I thank the Minister of State.

Cuireadh an Seanad ar fionraí ar 10.17 a.m. agus cuireadh tús leis arís ar 10.32 a.m.

Sitting suspended at 10.17 a.m. and resumed at 10.32 a.m.