Ms Catherine Keogh:

I would like to respond on behalf of Fórsa. I do not want to go over all of the ground because I am conscious of the time but we saw the response of the health unions to the health emergency during the pandemic. What the committee is hearing from us this morning is that this is the other health emergency. It does not need to take five years. I mentioned that we have had operational engagement with the employers in respect of parts of Sláintecare but there has been no strategic involvement with all of the unions. That needs to happen and it needs to be driven and focused. The union side will not be found wanting. We were not found wanting when it came to the pandemic.

One of the key issues for Fórsa, which is a flaw at the moment, is that there is no health and social care professional adviser in the Minister's office in the Department of Health. There are 26 or 27 health and social care professional grades. The HSE has a beautiful document called HSCP Deliver 2021-2026. Much of Sláintecare will be delivered through health and social care professionals, HSCPs. One example of such a professional is the clinical measurement physiologist in a hospital. I am going to get the terminology wrong and will be murdered by my members. The work these physiologists do on echocardiograms leads to early discharges. We have been trying to get a report from 2010 implemented, which would involve looking at workforce planning in respect of these vital grades.

Health and social care professionals are years behind our nursing colleagues with regard to advanced practice. If advanced practice was introduced for physiotherapy, occupational therapy and speech and language therapy, with the right numbers and physiotherapists operating at an advanced practice level, orthopaedic waiting lists could be cut. The Minister gave a commitment to Fórsa nearly two years ago that an adviser would be brought in to advise him on health and social care professionals. How can anyone implement a system-wide reform involving a multidisciplinary approach without someone giving advice? We call on the Minister to make good on that promise as part of driving Sláintecare forward.