Jim Daly (Cork South West, Fine Gael) | Oireachtas source

Most of the statements mentioned by the Deputy have been readily agreed and I concur that the community is the basis of the reform of our healthcare system. Whether seeking efficiencies, better outcomes or an increase in the number of people being treated, the answer lies in community-led services. Interesting initiatives, such as that for pharmacies, provide normal rather than distorted incentives for good, common efficiencies in the prescribing and administration of drugs. There is a significant issue of older people taking too many drugs or taking the wrong drugs. There have been problems with poly-prescribing, where different sources prescribe different drugs for the same issue. We should streamline that, which would lead to better outcomes for older people.

The Deputy asked about initiatives for older people this winter. The winter initiative has older people at its heart. We are trying to provide local clinics and extending GP hours. The Minister has spoken about this regularly in the past couple of weeks. The measures are being taken with a view to helping older and more vulnerable people.

The Deputy mentioned the flu vaccine. I also spoke about it earlier in the debate. We have to make sure more health workers are taking the vaccine to prevent outbreaks. I referenced the fact that in some hospitals in New York, healthcare workers at any level who have not had the flu vaccine have to wear a mask when coming into contact with older people in an acute hospital setting. We are also increasing home care packages. The Deputy will be aware of the announcement that we have added a further 550 intensive care packages. We are also examining the problem of late discharges and will take initiatives in that area, including a public communications policy which will advise people, in particular, older people, that the least safe place to be when one does not have to be there is an acute hospital setting. That is a challenge to normal thinking and is a culture shock to some people, but we must raise awareness of the fact. There are many hospital-acquired infections with which one might come into contact to which older and more vulnerable people can be susceptible. Most of us think that the best and safest place for our loved ones aged over 70 is in a hospital. We are about to start a communications policy advising that it is not; if one does not need to be there, it is the least safe place. We are also taking other initiatives which seek to prevent people from having to go to accident and emergency services. We are working with Nursing Homes Ireland to try to build awareness about nursing homes. Admissions to accident and emergency services should be a last resort and should not be the first option people take, given that it is not the safest place to be unless one absolutely has to be there.