Dr. Gabrielle Colleran:

There are very high levels of Covid-19 among mental health workers and consultants. Services are under extreme pressure because of the number of acute presentations and the lack of beds. It is essential that they are prioritised.

I want to take this opportunity to emphasise something that is key for us to talk about, that is, our public health specialists and infrastructure. People sometimes get confused between the acute public hospitals and the public health infrastructure and the staff who provide it. As the IHCA does not represent public health specialists, I cannot be accused of having a vested interest in this matter, other than the same vested interest that we should all have in having a public health system that works. We do not give consultant status to public health specialists in this country. We are an outlier in that regard and it massively impacts our ability to manage pandemics and to plan healthcare. It is essential for that to be addressed and all of the outbreak management and contact tracing falls under the auspices of, and is led by, public health consultants.

The elephant in the room is that vaccine roll-out is hampered by the fact that we do not have a universal health identifier for people. We do not have public health IT that is fit for purpose, compared with the UK and other countries. Those other countries are well able to prioritise people and have back-up lists because they have a universal health identifier and the required IT infrastructure. We have the specialists. Public health specialists are trained to consultant level in public health. If we actually pay them properly, give them the tools that consultants have in terms of teams and software resources, they will optimise our response and we will reap those benefits, societally and economically. It is incredible to me, as an individual watching this, that 11 months into the pandemic, there are only 60 public health specialists in the country, as Mr. Owens earlier outlined. In Scotland, which has a similar population, there are 180. That we have not addressed that and upped the numbers of public health trainees, given them proleptic appointments with consultant status at the end of it, is incredible and must be addressed. This is not the last pandemic. We may not even be experiencing the last surge of this one. Until we tackle climate change, we are going to have more and more pandemics and our ability to respond to them without locking down our society is dependent on having the public health infrastructure, including the people, IT and structures. If this committee takes just one lesson from this meeting, that is it. It is essential. It is what has hampered us and is a part of why we are rolling from one lockdown to another. We do not have the public health capacity.