Stephen Donnelly (Wicklow, Fianna Fail) | Oireachtas source

I welcome Mr. Breslin and Dr. Holohan to the Chamber and thank them both for the work they have been doing. I know they have been working flat out for several months and it is greatly appreciated. I wish them the very best with their ongoing efforts. As Mr. Breslin said, we are still very much in the emergency or acute phase.

We have ten minutes. I have five questions and I might ask both witnesses those questions, which should give them time to answer and if there is sufficient time we can go back and forth. I will start with testing and tracing. At last week's briefing, the health spokespersons from the HSE said that the median turnaround time from referral to getting a result back was five days. We heard from the Minister in the Chamber last week that the target time is three days, which still feels quite long. Mr. Breslin stated that in some instances this is now down to between one and three days. What is the current position and what is the target? Is it that we want to get a 24-hour turnaround across the board or for high-risk groups like healthcare workers, elderly people and so forth?

The second question I have is on the impact on the health system. Before the Covid virus arrived, the health system was struggling. The Covid virus has been catastrophic for healthcare facilities and ongoing work, but just as worrying are the medium-term impacts. Mr. Breslin said we could be dealing with this for months and potentially years. My understanding is that HSE hospitals used to have a bed occupancy rate of 95% but in the Covid world it will have to be no more than 80% in order that we can guard against a surge. Doctors have told me that the number of patients that can be operated on in a given theatre list is down by about half because of all the Covid hygiene and cleaning requirements. I believe it was discussed here last week, and other consultants have stated, that the number of patients that can now be seen by any given doctor and his or her team in an outpatient clinic session could be down by between 30% and 50%. On top of that, Paul Reid said an additional €1 billion would probably be required for PPE on an ongoing basis. Has an analysis been done on how diminished the HSE's healthcare capacity will be, how long is it believed that will be the case and what can be done about this extremely challenging situation?

My third question relates to private hospitals. The reason for taking over these hospitals made a lot of sense and it was a brave thing to do. We all saw the awful scenes from Italy and other places where patients who were critically ill were being treated in car parks. Clearly, the situation is not working at the moment. There seems to be a 30% occupancy rate and figures being collected by doctors suggest it has fallen since last week. Many of the operating theatres and diagnostic machines are not working as they could. About half the private consultants have signed up. It seems, at the same time, that we will use public healthcare money to treat private patients in private hospitals. This is money that would usually be provided by the insurance companies. The intention is noble on all sides in that we are trying to procure more healthcare capacity for public patients at this time, but it is clearly not working in terms of using the healthcare assets we have, nor in terms of public money. We are told the National Treatment Purchase Fund, NTPF, has identified about 5,000 public patients who could be treated in private hospitals, whereas €50 million in the pre-Covid world procured approximately 21,000 procedures.

I know a review is under way but, given that we are spending €115 million or more a month and that the assets are clearly not being used while men, women and children around the country are suffering, deteriorating and, in some cases, may lose their lives or be permanently damaged because this capacity is not being used, is it now time to quickly decide to cancel the contract while retaining an option for surge capacity in the future and to redeploy the money involved to the NTPF? This would mean that insurance companies would continue to pay for the private patients to be treated in private hospitals and that we could supercharge the NTPF, allowing us to make serious inroads into public patient waiting lists.