Alan Dillon
Question:11. Deputy Alan Dillon asked the Taoiseach when the Cabinet committee on health will next meet. [8624/23]
View answerTuesday, 28 February 2023
Questions (11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22)
Mary Lou McDonald
Question:12. Deputy Mary Lou McDonald asked the Taoiseach when the Cabinet committee on health will next meet. [9599/23]
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Ivana Bacik
Question:13. Deputy Ivana Bacik asked the Taoiseach when the Cabinet committee on health will next meet. [9672/23]
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Aindrias Moynihan
Question:14. Deputy Aindrias Moynihan asked the Taoiseach when the Cabinet committee on health will next meet. [9745/23]
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Mick Barry
Question:15. Deputy Mick Barry asked the Taoiseach when the Cabinet committee on health will next meet. [9746/23]
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Peadar Tóibín
Question:16. Deputy Peadar Tóibín asked the Taoiseach when the Cabinet committee on health will next meet. [9812/23]
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Jennifer Murnane O'Connor
Question:17. Deputy Jennifer Murnane O'Connor asked the Taoiseach when the Cabinet committee on health will next meet. [9923/23]
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Paul McAuliffe
Question:18. Deputy Paul McAuliffe asked the Taoiseach when the Cabinet committee on health will next meet. [9937/23]
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Richard Boyd Barrett
Question:19. Deputy Richard Boyd Barrett asked the Taoiseach when the Cabinet committee on health will next meet. [9959/23]
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Gino Kenny
Question:20. Deputy Gino Kenny asked the Taoiseach when the Cabinet committee on health will next meet. [9961/23]
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Bríd Smith
Question:21. Deputy Bríd Smith asked the Taoiseach when the Cabinet committee on health will next meet. [9963/23]
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Rose Conway-Walsh
Question:22. Deputy Rose Conway-Walsh asked the Taoiseach when the Cabinet committee on health will next meet. [10252/23]
View answerOral answers (24 contributions)
Tógfaidh mé Ceisteanna Uimh. 11 go 22, go huile, le chéile.
The Cabinet committee on health met on 13 February and is due to meet again on 27 March.
In addition to meetings of the full Cabinet and of Cabinet committees, I meet Ministers individually to focus on different issues. I meet regularly with the Minister for Health to discuss challenges in the area of health and the Sláintecare reform programme.
The primary aim in 2023 is to improve access, outcomes and affordability for patients, and that is what Sláintecare is all about. We are committed to expanding the core capacity of our acute hospitals with more health professionals and more acute hospital beds. Over the past three years we have added approximately 1,000 hospital beds, more if community beds are included, with further additional beds planned for this year and next. We aim to increase our public health and social care workforce by 6,000 this year. We already have 6,000 more nurses, doctors, dentists and midwives than we had three years ago.
A strong pipeline of capital projects is being developed by the HSE and the Department of Health, including several new hospital projects and significant new facilities in existing hospitals.
Budget 2023 includes €443 million in funding to treat tens of thousands of people on waiting lists and to reduce the waiting times faced by all. Our multi-annual approach to reducing and reforming waiting lists resulted in an overall reduction in the number of patients exceeding the maximum Sláintecare waiting time, that is, roughly three months, by 11% in 2022. The number of people waiting more than three months for treatment fell by 11% in 2022, at a time most countries are experiencing big increases in the number of people waiting more than three months for treatment or to see a specialist.
The enhanced community care programme continues to develop healthcare at a more local level. The programme, which is investing €240 million in community health services, is easing pressure on hospitals and more acute settings.
Work is progressing on the establishment of six new regional healthcare areas, RHAs, and elective care centres and surgical hubs in Dublin, Cork, Limerick and Galway. We are also making high-quality healthcare more affordable for people at a time the cost-of-living crisis is affecting everyone. For example, last year we removed inpatient charges for all patients under 16, and this year we will remove them for all patients over 16.
We are also widening eligibility for the GP card, which will allow many tens of thousands more people to see their doctor without having to pay.
Additional eligibility initiatives include €10 million set aside for access to IVF treatments in Ireland for the first time; the expansion of the entitlement to free contraception to women aged 26 to 30; €5 million for oral healthcare for children up to seven years of age; and a reduction in the drugs payment scheme threshold, that is, the maximum amount any household has to pay for medicine every month, to €80.
Our health service has profound challenges. That was particularly evident during the difficult winter period but we have responded and expanded capacity dramatically in recent years. We are treating more people than ever before, with better outcomes than ever before. Ireland now has one of the longest life expectancies in the European Union. It continues to increase and is well above international averages. We also continue to see reduced mortality rates for stroke and most cancers. We also see positive trends in health-maintaining behaviours.
We will continue to advance these reforms under Sláintecare in 2023 and 2024.
One of the most pressing projects in County Mayo is the long-awaited extension to the emergency department, ED, at Mayo University Hospital. The ED was initially built to cater for 20,000 patients. It now sees more than 40,000 annually, and that number is growing. An extension to the unit has been promised for the people of Mayo for the past ten years.
Following a recent HIQA inspection in August 2022 at Mayo University Hospital, long-term action to address the shortcomings in national standards to protect service-users from the risks of harm associated with the design and delivery of healthcare will not be taken until 2025, with a new accident and emergency department and an advanced medical assessment unit planned. I ask that the HSE and Department of Health work together to see how we can fast-track these type of projects on an accelerated programme in order to protect people’s lives, improve outcomes and deliver healthcare in a modern and fit-for-purpose facility.
The opening of the Children's Health Ireland, CHI, urgent care centre at Connolly Hospital was hailed as a major milestone in the new children's hospital project. The walk-in service providing urgent care for children with minor injuries and illnesses was a critical component of the new service, not just in providing immediate care but in taking the strain off CHI at Temple Street and CHI at Crumlin and the new children's hospital, when it finally opens. As the Taoiseach knows, CHI has inexplicably and suddenly withdrawn the walk-in service. Parents now have to log on to a website and triage their children online, after which they might get appointments at Connolly Hospital or they could be directed to CHI at Temple Street. This approach completely defeats the core purpose of the CHI service. I know that parents have been in contact with the Taoiseach about this because they are worried that they will not be able to get GP visits if their children are sick or injured and they are unlikely to go onto a website to get medical attention, which will put the ambulance service under further strain. Moving healthcare online also excludes sections of our population from accessing it, and we noticed this during Covid. Accenture's most recent digital index report found that computer use was split according to socioeconomic status, with only 39% of those in the lower socioeconomic groups using computers daily. Was the Minister for Health informed of this closure of services and will action be taken to reinstate the walk-in services in CHI at Connolly?
I thank the Taoiseach for giving his view. When the Cabinet subcommittee meets again, will it discuss medicine shortages? This is an issue that has been constantly raised with me and it is challenging for patients throughout the country. Pharmacists are finding that while there would have always been some medication shortages, the breadth and number of medications that are in short supply this year is much more unusual and significantly overwhelming. A recent survey of Irish Pharmacy Union, IPU, members found that over 60% found that there were 40 or more medications in short supply. This is not just prescription medications but also over-the-counter medications. This means that if you take a common lotion for eye care, for example, which was out of supply for several months, you are required to get an alternative by going to a GP, and that is adding to the burden on GPs. Will this be discussed and will a plan be put in place, such as the serious shortage protocol they have in the UK? What kind of measures can be put in place to deal with this?
Some 10 million people living with AIDS do not have access to lifesaving treatment. Not a single monkey pox vaccine has been sent to Nigeria or the Democratic Republic of Congo, where monkey pox has been endemic for more than 50 years. There are still huge global inequities around access to Covid vaccines. The World Health Organization pandemic treaty is being drafted to address the massive inequities in the global distribution of life-saving medicines exposed by the Covid crisis. The Government played a shameful role when it bowed to the demands of the pharmaceutical industry on the issue of the TRIPS waiver during that crisis. Will the Government play the same role or will it play a more honourable one this time? Will it prioritise the needs of vulnerable people globally over the profits of the big corporations?
In December 2022, Ireland had the highest excess mortality rate since the start of Covid. Ireland had the fourth-highest level of excess mortality in the whole of the European Union for that month. During Covid, at a time when there were fewer excess deaths than in December 2022, the Government’s response was to stop people travelling more than 2 km from their homes, close schools and stop people attending the funerals of loved ones. In that time the Government stopped people from going to work and making a living and it prevented them from being with their families, even when they were dying. We should compare and contrast that with now, when there are more deaths. I raised this with the Taoiseach in the Dáil in recent weeks and the full extent of the Government’s response was that the issue would be raised with the Chief Medical Officer. Why is the Government so silent about mortuaries filling up at this moment in time? What has it done to investigate what is happening in real time so that something can be done about it?
In April 2016 I asked an oral parliamentary question in the House about a proposed primary care centre for Tullow in County Carlow. I was told "The HSE proposes to deliver the primary care centre for the Tullow, Rathvilly and Hacketstown area using the direct/own-build mechanism." The HSE said its capital plan would fund the centre. Following several parliamentary questions in six years since, the HSE told me that Tullow was the only place identified for the centre. Last year then I was told it was to begin in the fourth quarter. I am still waiting to be told where the centre is to go and I hope the Taoiseach can tell me. Recently I met a crowd of people in Borris, County Carlow, which is also in urgent need of a primary care centre. That is a rural part of Carlow and it is so important that we have these facilities in rural areas. It would help to stop the crowds at the accident and emergency departments and people could be treated in these centres. I ask the Taoiseach to make this a priority.
I know the Taoiseach will share the frustration of many parents of children with different abilities as they wait for assessments of need and then interventions, treatments and therapies. One of the real difficulties in delivering that service is the level of vacancies for the posts. In CHO, 9, my CHO, we have a vacancy rate of 35%. It is difficult for any service to deliver if 35% of posts are empty. Will the Taoiseach outline what the Government strategy is on recruitment for posts in this sector and what we can do to ensure that parents and children get the services they are entitled to?
My question follows on neatly from Deputy McAuliffe's. The Children's Rights Alliance gave the worst mark to the Government on youth mental health. You look at the chronic understaffing of child and adolescent mental health services for assessments to provision of therapies, and it is all down to a lack of staffing. Then we make it very difficult for people who want to, for example, qualify with masters or doctorates in psychology, or in other allied health professions, to get qualified when they want to work in this area, because they are crippled with fees that are astronomical. Their representatives, myself and others have asked time and again why we are making it difficult for people who want to work in mental health or in health generally. Why are we making it difficult for them to get qualified by hammering them with fees for masters and doctorates? Why are we failing to pay our student nurses when they are on placement? It makes no sense when we need more people qualified in these vital areas.
The Irish Nurses and Midwives Organisation, INMO, will ballot its members on industrial action very soon. It is doing this in pursuance of safe staffing. It has repeatedly asked the Government to intervene to take pressure off the health system and its staff. Nurses in this environment have stated that it is very unsafe. Will the Government intervene, uphold and listen to the nurses’ union that this is not conducive to their staff or patients?
Shocking figures from the HSE today show us that 27% of all deaths during Covid were of people in nursing homes. It is a shocking reminder of how we failed the most vulnerable cohort during the pandemic.
I, along with others in this House, sat on a special Dáil committee during the Covid pandemic, which made a priority recommendation that the State should conduct a full inquiry into the deaths of these people in nursing homes during that crisis. We are still waiting to hear news of that inquiry. That committee also examined other aspects of the State's failures when it came to caring for the elderly in nursing home settings. One startling figure that stood out was that 80% of nursing homes are privatised in this country and 20% are public. The position was the reverse only 15 years ago. The reality is that many private nursing home settings could not get qualified staff, could not retain staff and did not have medical resources to care for the people who got sick. When it came to the issue of oxygen tanks and personal protective equipment, PPE, they were totally inadequately resourced. We had a race to the bottom in respect of pay and conditions for those who worked in those nursing homes.
Will lessons be learned? Will that inquiry be held? Will the Government stop the failed policies of privatising healthcare, particularly healthcare for the elderly? We have seen since large healthcare centres, which are privately owned and operated being opened with grandeur, with the Taoiseach and others presiding over the opening, cutting the ribbon and so on. A commitment was given to move to more localised, community-based, smaller residential settings to prevent this tragedy in future.
The time for this question has expired. I seek the agreement of the House to take five minutes from the next question to use here. Is that agreed? Agreed.
This evening, Sinn Féin will table a motion calling on the Government to address the deterioration of ambulance services. This is nowhere more evident than in my own county of Mayo. The National Ambulance Service has warned that unless the Government acts, it will have insufficient resources to respond to the projected demand and the response times will continue to increase. We need to look at the coverage of the ambulance fleet, the ambulance stations themselves and the rapid deployment points to ensure that equitable distribution of services happens across the region. The challenges to our ambulance services relate to the wider healthcare system.
Mayo University Hospital in Castlebar was not compliant on ambulance turnaround times. Some 90% of the ambulances that attended the emergency department did not meet the turnaround time of less than 30 minutes. Let us imagine waiting for an ambulance and driving more than 50 miles in that ambulance on the worst roads in the country, only to have to wait in the ambulance to access emergency treatment. This is caused by the lack of capacity and bad patient flow. The same HIQA report stated the lack of beds in community and district hospitals is the main reason causing the backlog. Will the Taoiseach engage with the Minister for Health to address what HIQA has described as a significant reduction in step-down beds in district and community hospitals in places such as Belmullet, Ballina and Swinford to take the pressure off hospitals such as Mayo University Hospital?
I call Deputy Ó Murchú, then Deputy Bacik. I hope they leave some time for the Taoiseach to respond.
The failure to deliver assessments of need and intervention therapies for families has been discussed. If we got workforce planning correct today, though I do not think we have, we would be talking about four or five years before we are able to deliver the numbers that are required. A meeting of the Joint Committee on Autism earlier was attended by representatives of the Psychological Society of Ireland, the Association of Occupational Therapists of Ireland and the Irish Association of Speech and Language Therapists. They spoke about a need for themselves and all the stakeholders in the HSE to be involved in a forum or discussion to review both the assessment and the means of intervention to provide best practice as best we can at this point. I know the Chair is going to request that the Taoiseach meet with these three groups. What does the Government propose to deal with these specific issues and what does the Department of the Taoiseach intend to do?
Yesterday, I had the pleasure of visiting Sligo to meet our local representatives, Nessa Cosgrove in County Sligo and Bernie Linnane in County Leitrim. As part of our meetings, we met staff and management in Sligo University Hospital. Some of the issues they raised with us are common throughout the health service and are a concern to all those working in front-line healthcare provision. They include issues with waiting lists and delays in the delivery of the necessary infrastructure, which includes a new unit to provide more beds in Sligo, which I understand will not come onstream until 2025, despite having been promised for a long time. We also heard of issues with staff recruitment and retention and difficulties for staff recruited from overseas in finding accommodation locally in Sligo and in other towns and cities around the country.
I will table a parliamentary question on another matter that was raised with me concerning healthcare, which is the need for a review of the use of data collected in hospital laboratories around Ireland and what safeguards are put in place relating to data protection.
The Taoiseach has little time for a response but can reply as best he can.
I appreciate that a great number of Deputies have asked important questions. I jotted them down as quickly as I could. Eighteen Deputies asking three questions each comes to nearly 60 questions. I will try to answer as many as I can as best I can in the time available. Deputy Dillon raised the issue of the emergency department in Castlebar, which needs to be extended. I agree with his remarks on that. I am not sure if it can be fast-tracked but I am working with the Ministers, Deputies Donnelly and Donohoe, to see if there are particular health projects that we could fast-track, especially those involving expanding EDs or additional bed capacity. There are a number of similar projects in the west region. On Friday, I was in Portiuncula University Hospital in Ballinasloe. I visited the hospital and the emergency department. It is a good ED but it is really small for one that takes 30,000 patients every year. It also needs an expansion. It is good to see the additional 50-bed block and 12-bed additional isolation ward are under construction.
On the urgent care centre in Connolly, Deputy Paul Donnelly and I share a constituency. He will know, as I do, that it is a really good facility and has been a big addition to paediatric healthcare in the area. It has dramatically improved the experience of urgent care for children in west Dublin, Meath and north Kildare. The same goes for the centre in Tallaght. There is a new online booking system. It has been brought in because of a very significant increase in the number of attendances, way beyond what was ever intended. It is for a trial period. I do not know if it will work or not. I did not particularly like it when I heard about it. It is a decision it has taken for a trial period. It may work for some people. They might have a kid with a high temperature or minor injury and they would rather get an appointment in three hours than sit in the waiting room for three hours. It might work for some people but I take the point that the Deputy made about people who are digitally excluded and who might not be used to using computers. It may have the perverse or unintended effect of just increasing attendances in Temple Street down the road, which we want to avoid. We will see how it goes. If it works, it works, and if it does not, it does not.
Should I continue?
The Taoiseach might as well. We will take the time from the next group.
Deputy Aindrias Moynihan asked about shortages of medicines. He acknowledged that these are not unique to Ireland and have happened in the past but it is worse than I have ever seen it, anyway. I am told that alternative treatments are available for every product that is currently in short supply. Shortages of certain paracetamol, Amoxicillin or penicillin products relate to individual line items and do not represent an entire portfolio. Unexpected surges in demand such as we have seen take time to resolve as the industry increases production to bring the supply chain back to normal. Medicine supply continues to improve.
The Department of Health is engaging closely with all stakeholders in working to mitigate the current immediate shortages. The Department has analysed products currently listed as short and can confirm that the reimbursement price is not the root cause of the shortage for any of these products. The increased notifications of shortages in recent months directly relate to the increased demand due to the winter surge. The Health Products Regulatory Authority, HPRA, is working with all marketing authorisation holders to increase supply. It will continue to offer regulatory flexibility to suppliers where possible. The HPRA has secured additional stock for many items that are in short supply. The HSE has issued several memos to prescribers and pharmacists, including clinical advice and up-to-date information on available products. A dedicated web page has been developed to allow prescribers to check what is available to supply at the moment.
We have ten minutes for the next group of questions. I will stop the clock for a minute. There is a problem when so many questions are grouped with facilitating Members who want to make lengthy statements. I might ask the Committee on Standing Orders and Dáil Reform to look at this and see how we could make it more efficient.
I think I or my office may be partially to blame as we are the ones who do the grouping.
Yes.
In fairness to Deputies, on this occasion the questions were on topic but sometimes they are totally unrelated to the group.