Michael Harty (Clare, Independent) | Oireachtas source

Before I call to the non-members, Deputy Brassil and Senator Conway-Walsh, I have a question for Mr. Reid and Ms O'Connor on the HSE Service Plan 2019, which is the plan to which we are operating. The plan contains a strong reference to changing the model of care and reorienting the health service away from hospital-centred care. The current model of care is not capable of meeting the demands on the system. That is reflected in the service plan. There are issues regarding the level of care in the hospitals, particularly at weekends. We tend to move from a different level of care Monday to Friday to weekend care. There is a deficit in the hospital services whereby there is a lack of diagnostics and access to specialist consultant care at weekends because of the model of care we are using. We do not have a 24-7 model. We tend to have a five-day-week model at one level and then a model of care weekends that inhibits the flow of patients through the system. Perhaps Mr. Reid and Ms O'Connor might comment on that.

The national service plan also indicates that the allocation of funding this year will be challenging in the context of meeting the service level provided in 2018, particularly under the existing models of care, and that we need to innovate and have integrated models of care. Perhaps Mr. Reid and Ms O'Connor might expand on how they see that being delivered. Sláintecare is strong on that matter.

As a result of increased demand, with a 5% or 6% increase year on year in attendances at accident and emergency departments, elective beds are being flooded by emergency care patients. We will soon move to a level of care whereby we can only provide emergency care through accident and emergency departments. Emergency cancer care and elective care are being pushed out of public hospitals. I have been contacted by a number of consultants who are providing more care through the NTPF in private hospitals than they are able to deliver through their work in public hospitals, particularly in circumstances where hospitals are operating to 95% capacity. There is a reference in the service plan that the national cancer control programme allocation for 2019 will not allow the services to match referral demand in areas such as radiotherapy, rapid access cancer clinics and diagnostics. In the context of the HSE's move to remain within budget, which, of course, is absolutely correct, how can it match the demands that are being placed on the system while remaining within a budget, which, even the service plan states, will give rise to challenges in the context of delivering services?

The development of elective-only hospitals is absolutely essential. This needs to be prioritised within the capital budget and within future service plans. Unfortunately, we cannot have acute hospitals delivering acute care and also expect them to deliver elective care in a timely manner. We need to move to putting in place elective-only hospitals as rapidly as possible. Mr. Reid and Ms O'Connor might comment on those points.