Ruairí Ó Murchú
Question:11. Deputy Ruairí Ó Murchú asked the Taoiseach if he will report on the work of his Department’s Covid-19 and health unit. [6481/22]
View answerWednesday, 16 February 2022
Questions (11, 12, 13, 14, 15, 16)
Richard Boyd Barrett
Question:12. Deputy Richard Boyd Barrett asked the Taoiseach if he will report on the work of his Department’s Covid-19 and health unit. [7682/22]
View answer
Paul Murphy
Question:13. Deputy Paul Murphy asked the Taoiseach if he will report on the work of his Department’s Covid-19 and health unit. [7685/22]
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Peadar Tóibín
Question:14. Deputy Peadar Tóibín asked the Taoiseach if he will report on the work of the Covid-19 and health unit of his Department. [7798/22]
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Alan Kelly
Question:15. Deputy Alan Kelly asked the Taoiseach if he will report on the work of his Department’s Covid-19 and health unit. [7920/22]
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Mick Barry
Question:16. Deputy Mick Barry asked the Taoiseach if he will report on the work of the Covid-19 and health unit of his Department. [8387/22]
View answerOral answers (7 contributions)
I propose to take Questions Nos. 11 to 16, inclusive, together.
The Covid-19 and health unit of my Department supports me and the Government in co-ordinating the Government's response to Covid-19, and in developing and implementing health policy and related matters. This includes supporting the work of the Cabinet committee on Covid-19, the Cabinet committee on health and the associated supporting senior officials' groups and structures.
The Cabinet committee on Covid-19 assesses the social and economic impacts of the potential spread of Covid-19 and oversees the cross-Government response. The Cabinet committee on health oversees the implementation of programme for Government commitments in respect of health, receives detailed reports on identified policy areas and considers the implementation of health reforms including Sláintecare.
The Covid-19 and health unit also provides me with speeches and briefing material on Covid-19 and health matters for Government meetings, Cabinet committees, Oireachtas business, attendance at events and engagements with a wide range of stakeholders, including representative bodies and members of the public. The unit forms part of the social policy and public service reform division of the Department.
There is more evidence today of the crisis in the health system. Covid shone a light on a hopelessly dysfunctional, fragmented, under-resourced and understaffed health service and brought us to the brink but all that dysfunction, fragmentation and lack of resources and staff is coming back to bite us quickly in the aftermath of the pandemic, especially in the context of emergency departments being overrun and what we saw in north Kerry child and adolescent mental health services, CAMHS, which is widespread. Why are we failing to recruit and retain the staff that are necessary in order to provide the health service that we need? One problem I would put to the Taoiseach is that when I asked the Minister for Health, Deputy Stephen Donnelly, for a review of the over-medication of children by CAMHS because of the lack of staff last April, he did not answer the question directly but bounced it on to the HSE, which then gave me a pro forma answer which stated that there would not be a review. I asked a question in April regarding a general review of the over-medication of young people by CAMHS because of the lack of staffing, which, I believe, is widespread and is not limited to north Kerry. The Minister for Health - this is standard practice when you ask the Department of Health for anything - stated that he was not going to answer the question and that he would bang it on to the HSE because it was responsible for it. This begs the question as to what the Department of Health and the Minister are responsible for. The HSE gave me a pro forma answer indicating that it would not conduct a review and now we have the scandal with regard to what happened in north Kerry. Is the lack of a proper, integrated, properly governed health service part of the reason nobody wants to work in it?
New figures have just come out on the Covid hub about the levels of hospitalisation of children due to Covid. They are very concerning. The figures cover the period up to the end of January. Hospitalisations for those between zero and four years of age number 217. That compares with the numbers throughout the course of 2021 of, on average, 25 a month. There are 217 children between the ages of zero to four years of age in hospital due to Covid right now. In the five- to 14-year-old age group, there are 172. This compares with an average of fewer than 20 during 2021. Already, we are at the point where there have been more hospital days for children due to Covid this year than throughout the entirety of 2021. That tallies with what we are hearing in terms of schools. There were 14,000 - an unprecedented number - teachers out due to Covid last month. We know the risks here in terms of admission to ICU, hospitalisation, the impact on the rest of the health service and the 10% who will suffer from long Covid. In light of all of that data, is it not correct to take a cautious approach in terms of lifting the recommendation on masks and in the context of the public health guidance that is in place to protect people?
Covid has caused a significant increase in the waiting lists and a build-up of problems which are not fully diagnosed - pardon the pun - in the health service. A new plan on hospital waiting lists is to be brought to the Government shortly. Will the Taoiseach update us on when that will happen? Is this unit that sits in the Department of the Taoiseach involved in this plan?
Reports today indicate that the 2022 plan is funded to the tune of €350 million and that it will set out actions to address backlogs and deliver further reductions. Can the Taoiseach confirm if funding for this will be reallocated money that was destined for recruitment, a matter I raised with him yesterday, or will the recruitment money be ring-fenced and separate? This is an important question.
What is being put in place to do catch-up regarding human papillomavirus, HPV, screening and other screening programmes, and also in relation to vaccinations? Finally, when will the capital plan for 2022 be announced or must the Government treat it the same way as it treated sports capital grants and make sure it gets all the information out beforehand across the country?
The National Public Health Emergency Team, NPHET, meets tomorrow to discuss its advice to Government regarding schools. I want to ask the Taoiseach whether he and his Minister for Education intend to fully consult with workers in the schools, including the teachers, before they make decisions on these issues. Covid is far from a done deal in the schools. In fact, there were 14,390 teachers absent for Covid-related reasons from the schools in the month of January, an increase of 55% on December. Those figures do not include 270 schools run by the education and training boards. Meanwhile, hundreds of student teachers currently on placement are due to finish up this week which will cause a further teacher shortfall. These are key issues for the school communities. Can the Taoiseach tell us the Government's plans with regards to proper and full consultation?
I want to raise with the Taoiseach again the closure of the Keltoi rehabilitation unit at St. Mary's Hospital in the Phoenix Park. As the Taoiseach will be aware, this has been raised consistently by Members of the Oireachtas over the past two years and, indeed, by people working in addiction services, locally and nationally. Currently, the facility is closed and is hosting a social inclusion Covid isolation facility. I want to urge that the facility in question be moved elsewhere and that the service be reopened as a matter of urgency.
As the Taoiseach will be aware, there is an ongoing under-provision of drug rehabilitation beds. We know that one person dies as a result of addiction each day. Waiting times for residential care are very long, with people waiting months and sometimes, disgracefully, years.
Keltoi is the only trauma-informed facility of its kind in the State. It is the only residential rehabilitation facility run by the HSE. Its programme is gold standard. This is something that ought to be replicated, not hindered in any way. Its ongoing closure runs contrary to the HSE commitment to enhancing residential addiction services in the community healthcare organisation, CHO, of Dublin north city. I ask the Taoiseach to give a commitment today to investigate this matter with the explicit purpose of securing a reopening date for Keltoi as soon as possible.
Deputy Boyd Barrett raised issues in terms of health. He stated that there has been a chronic lack of resourcing and referred to difficulties recruiting. The Deputy said that nobody wants to work in the service. There are 132,000 people working in the service. Since 2022, there has been record recruitment to the health service of 12,500 net and 32,000 gross. It must be remembered that there are people leaving at different times due to retirement, etc. In order to stand still, the HSE has to recruit 9,500 staff each year. It is not true to say that nobody wants to work in the health service. The numbers are increasing every year. That is the right way to do it. The service is vast.
Likewise, the level of investment has gone up significantly. It increased by billions of euro in the past number of years, particularly in the past two years, in terms of significant funding gone into the base of the HSE to provide additional services. Reforms are happening also in respect of primary care and community care. Home care packages have gone up by 2.7 million hours. Some 55,000 families are now being provided with home care packages. That is a dramatic increase from previous years. The Deputies should acknowledge that.
There are challenges and there are pressures, particularly in emergency departments, which are a legacy of emerging from Covid - delayed diagnosis, people not presenting during Covid, elective care being cancelled during Covid and diagnostics being cancelled. Unfortunately, all that will have an impact over the next 12 months. What clinicians are saying is that over 75-year-olds who are presenting are more ill than would have been the case prior to Covid. These are challenges we have to deal with.
Clinicians are responsible for treatment in terms of prescribing. That much is clear. Where there are junior doctors in position, there should be proper clinical oversight in respect of that. That was not the case from the evidence presented by the independent review of south Kerry CAMHS. Fundamentally, clinicians have their chain of accountability too in terms of the Medical Council and they are responsible for the prescription policy and the treatment of individuals. Every individual is different, and every case can be different.
Deputy Paul Murphy raised Covid-19 and the hospitalisation of zero to four-year-olds. I spoke to the Chief Medical Officer this morning. He is very clear that as far as he is concerned, there has been a stabilisation overall in terms of hospitalisation. We did not specifically discuss children. He said the conversion is not there at the moment to ICUs or more generally in terms of hospitalisation. We are basically where NPHET was hoping to be when we lifted restrictions some weeks ago. The CMO is reasonably satisfied with the continuing progress we are making in regard to Covid-19. That will inform NPHET's decisions in terms of advice that it will give to the Government in respect of mask-wearing more generally and in schools.
I would draw a distinction between public health guidance and advice, and that which is mandatory. That is an important point. What has to be assessed is whether there is justification for a legal, mandatory framework, which makes it a legal requirement to wear masks. That is an issue on which NPHET will advise the Government in the coming days. The Government will take decisions based on that. That is the up-to-date position I have received from the Chief Medical Officer. I will revert to him on the inquiry in respect of children and ask what the position is, as outlined by Deputy Paul Murphy.
In response to Deputy Kelly's points, a new plan will be announced on waiting lists. The short-term plan prior to Christmas had an impact. It brought down the list by about 6% and then Omicron had its impact in terms of December and January. It is both a plan for 2022 and a multi-annual plan. Some €350 million is being provided this year in respect of the plan. The HSE will be funded to recruit as many staff as it possibly can. The indications are that it would be realistic to definitely be able to net 5,500 staff for 2022. If the HSE can do more, it will be provided with funding to do more.
I take Deputy Kelly's point on HPV screening and vaccination. Deputy Pádraig O'Sullivan raised HPV vaccination for young people with me yesterday. We are following that up to make sure it is as comprehensive as it can be. That is a very important piece of work.
Deputy Barry raised the issue of consultation, which I have dealt with. There has been consultation right through in respect of Covid-19 and schools. The Minister for Education has always taken public health advice on board in respect of schools. She has been very consistent on that principle and will follow that. She has always engaged with stakeholders in respect of school policies around Covid. As we saw this morning, we have different perspectives in the House on the issue.
Deputy McDonald spoke about the rehabilitation unit in the Phoenix Park that is closed. I will engage with the HSE in regard to that but, again, I do not get involved in operational decisions that the HSE takes in respect of particular facilities. I presume she has raised the issue with the HSE, and it has stated reasons for doing what it is doing but I will raise the fact that it was raised in the Dáil by the Deputy.