Oireachtas Joint and Select Committees
Wednesday, 11 November 2020
Joint Oireachtas Committee on Health
HSE Winter Plan: HSE
I welcome Mr. Reid and his colleagues. I thank them for their attendance and for their ongoing work in this very important area. I just want to talk for a few moments about one of those few positives that came out of Covid, and that is the acceleration of some elements of Sláintecare. Earlier in the year, Mr. Reid referred to what was happening as "Sláintecare on speed". It is a very welcome development that there is a significant shift of activity away from hospitals to the community, which is what we should be aiming for anyway.
I want to make one point and then ask a question. The point I would make about it is that part and parcel of Sláintecare is the restructuring of the HSE combined with regional management and greater levels of accountability. I understand why the HSE had to park that earlier in the year and all of the focus was on responding to Covid. That is absolutely understandable. However, I made this point to the Minister last week and I want to make it to the witnesses today that I would strongly urge them to resume that restructuring reform programme relating to the structure of the HSE, and to do that as early as possible in the new year.
My next question relates to all of that work that is going on in shifting activity to the community, which is very welcome work. My concern is, though, about those areas, in my own constituency, as I wrote to Mr. Reid last week, but also in many other parts of urban and rural Ireland, where there is a poor level of GP provision. We know from various research that has been done that areas with the greatest level of health need are very often those areas with the poorest provision because of our two-tier system. Given the shift that is taking place, what work, if any, is being done to ensure that those areas which are very poorly served by general practice, with low numbers of GPs and other primary care staff, have sufficient numbers of GPs?
Related to that, obviously, was an earlier commitment to introduce salaried GPs. It seems that there has been no progress made on that at all. Related to that as well is the whole question of ensuring the fair allocation of resources. How does the HSE ensure that that takes place where there is poor provision at the moment?
My second question relates to the budget. An extra €3.5 billion is provided for the service plan this year. I do not want the details now but will the CEO send us the schedule of the breakdown of that €3.5 billion in terms of what element is going to Covid and what element is going to increased service provision?
My third question relates to the flu vaccine and shortages. I have been raising this with Mr. Reid since last July. I was assured at the time that the 1.4 million vaccines order was sufficient to get us up to 90% coverage. I doubted the figure at the time because it did not make any provision for additional groups or cohorts of people to avail of the vaccine as a health prevention measure. Why is it that only 1.4 million vaccines were ordered? Is the HSE now saying to people who are not in the at-risk groups that they cannot have access to the vaccine? That would be a retrograde step. Does the CEO accept that insufficient quantities were ordered initially?