Ms Laura Magahy:

That is a great series of questions and it is blue sky thinking. The Senator is correct, in that even when Sláintecare is done, it will require continuous improvement on an ongoing basis because nothing is ever finished. If we can manage to put in place the structures, systems, staffing, training and e-health, then the architecture of Sláintecare will be complete and it can continue iterating and improving thereafter.

The Senator is correct to say that there must be burnout in the system after Covid-19. It has been an incredible onslaught for people working in the system, both those working on the front line and those managing the pandemic. Colleagues in the HSE and the Department have been at the forefront of this in recent months and have been working unbelievable hours to try to deal with something they had not expected and do not fully understand, as nobody does. They have shown incredible resilience in doing so. I must say that people need hope that a better system is coming, that it is funded, that there is a plan for it and that they can see that things will get better. An indication of the need to fund that is that there is money in the budget for well-being for staff, and a particular programme of activity will be implemented in this area by the HSE. Therefore, there is recognition that there is an issue in terms of burnout and people being worried, as well as a programme being implemented in that respect.

The Senator also raised the issue of the wider societal impact of Covid-19, and the unknowns that exist. Some very good planning has been done through the clinical care programmes within the HSE and the Department in trying to anticipate and put in place specialist hubs in the community for people who have been impacted by Covid-19, particularly in the areas of respiratory and mental health. This will entail putting place more mental health supports for young people, older people and the staff of the health services and systems. Therefore, a good bit of anticipatory work has been done and has been factored into the community healthcare planning. When we started, we talked about community healthcare networks linking with primary care teams and specialist hubs for older people but now, there are also specialist hubs that will be focusing on the downstream effects of Covid. We do not know what will happen until we have a vaccine and things get better next year at some point, but people need hope that the system is going to change and that they will be a part of that. It is a recognition of all the work that people have put in.