Mr. Liam Woods:

That is a real concern for us.

In some of the submissions we have made to the committee the Deputy will see we have identified that there is a challenge. As the committee will be aware, what has happened over the last number of months is that we have seen a significant fall-off in attendance at hospitals. We have seen that recover substantively in the emergency care and emergency flow areas. We saw a significant fall-off in scheduled care. We compensated to some extent in the private system for that three-month period. We are entering into further arrangements with a view to extending that.

The challenge identified is a correct one. The Deputy mentioned facilities and there is a challenge there. We are currently pulling together a lot of proposals to expand capacity physically. That challenge is most apparent in areas like outpatients and emergency departments. Some measures are already in place around that. As part of our winter planning process, which has accelerated this year, we are identifying further requirements. Indeed, the new Minister has instructed us to do so on an urgent basis. From our point of view there is definitely a facilities challenge.

In terms of staffing, it is correct to say this whole pandemic experience and what it has meant to the health environment and to the wider public has been extremely difficult. That has been the case for staff also. It has really only been through the Herculean efforts of staff we have gotten to where we are. Staff numbers within the overall health system in this period have risen by over 3,200. There has been a significant increase but, of course, there has also been significant absence associated with Covid-19. Growing that staff and growing key service areas, like intensive care, acute beds, community homecare and other supports, is a key priority for us. They are all falling into being considered as part of our winter planning process.

I agree that the challenge will lie more in identifying issues. Our task is to grapple with that and put in place the best arrangements we can now for what the Deputy rightly identifies will be both a potential return of Covid-19, depending upon the trend in the pandemic, and also the emergence of winter.