Seán Crowe (Dublin South West, Sinn Fein) | Oireachtas source

Senator Conway wishes to come in but I have a couple of comments before he does so. We started off on the right foot in terms of the apologies and thanking the staff, but also apologies to those who were on trolleys or chairs. The system is that a patient usually starts off on a chair, ends up on a trolley and then, if he or she is lucky, goes home or gets a bed within the system. We all accept that. It was helpful that the witnesses outlined the significant challenges facing the system, such as record highs, people taking longer to recover, attendances and admissions being up, the increased number of people on trolleys across all cohorts, the increase in the number of ambulance calls and so on. It is clear there was a perfect storm that many people stated was predictable. The frustration and the biggest criticism for many people who are listening to these proceedings or who had someone sick, particularly over the Christmas and January period, is that we knew Covid, flu and the other virus - the witnesses themselves mentioned them - were going to be a big challenge, yet clearly the system was not able to cope. In many cases, hospitals were reconfigured primarily on the basis of safety, yet the current system, particularly in the context of what happened on certain days in January, was not safe; it was dangerous. One of the biggest challenges we face, which the witnesses have discussed, is that people were being asked to go to their GP but many cannot access a GP. That adds to people's frustration. A Deputy made the point that one could understand a GP being short-staffed at Christmas time or on a bank holiday or a weekend and that there would be a problem in that regard. A lot of people were asking when is a good time to get sick. It is difficult to access a GP out of hours or whatever. The message from the HSE that people should go to their GP is correct in one sense but it is really frustrating for people that they cannot get access to a GP.

The next option is for people to try to get to a hospital. We know there is a problem with the ambulance services and the time people are waiting. I discussed that with the witnesses when they previously appeared before the committee. I will give an example. We should always go back to examples. I spoke to a person dealing with women in very vulnerable situations. During the period in question, the person was dealing with a woman who was suicidal. The woman came in to see the person and expressed suicidal thoughts. The person, believing that if the woman left the building she would commit suicide, rang an ambulance but was told there was a waiting list and could not get one. The woman left the building. The staff ran out after her and brought her back in.

They got a taxi and brought her to the hospital. They were in the hospital with that woman until midnight that night. Eventually she got into the system. That is just one example. I say this because I have a concern that people who are really sick will not go to the accident and emergency department. I was one of those people. I had sepsis. I did not know I had sepsis. If I had not gone to the accident and emergency department, I would not be here today. I dealt with someone who had extensive medical issues and underwent elective surgery. I do not know whether the surgery went wrong or not. However, the person's family tried to get in touch with the surgical team in the hospital but could not get through to anyone. They tried to get his doctor who said he would see him on Monday. This happened at a weekend. Eventually they called an ambulance and had to wait a long time for it. He was in agony. He eventually got into hospital and got a trolley. Last night he got a bed within the system. This is an example of what is happening to people.

I have another example concerning an elderly person who took ill. An ambulance was called. The ambulance service advised that the hospital on call was St. James's Hospital which is not a place they would want their elderly mother to go to at the moment as it is packed. The mother could pick up the 'flu or some other virus. It is a dangerous place. I sound very depressed about the system. I accept there are many positive things about it but that is a challenge. We have to convince people that if they are really sick to get the ambulance to the accident and emergency department. If they cannot get an ambulance just go there directly, as bad as the system is.

Some of the things suggested over this period included that staff should work longer hours. That was one of the solutions the Minister had. I ask the witnesses today if that is a solution. I am being told that staff are burned out because of Covid-19 and everything else. Is it viable for staff to work longer hours in this situation? That is one question for the witnesses.

In regard to the average turnover, I know this differs between hospitals. There is a huge challenge in this regard. Some people suggested cancelling elective surgery. That is terrible for anyone in that situation. If we are going to keep repeating this cycle of challenges that we face some were suggesting we should have a plan. There are plans in place but they are not working. It has to be about increasing capacity in terms of both staff and beds. In the case of hospitals that have sites I cannot understand why there is a delay in clearing the opportunities for those beds to go into the system. It is frustrating, when we know there is a shortage of beds in a particular area, that there are sites and recommendations from five years ago. University Hospital Limerick, for example, will have a number of beds put in two years from now which will still not be sufficient based on what was recommended a number of years ago. We know the population is growing. It does not make sense that we are not building sufficient bed capacity in those areas. It is playing catch-up all the time. I know this sounds like a rant but I am articulating some of the frustration of members of this committee. We tried to have a meeting earlier in the crisis but we were unable to do that.

I want to send a message out to staff that we do appreciate the work they are doing and we understand the war-zone situation in which they work in some hospitals. We want to try to resolve the situation. There are solutions.

We need to put our heads together and come up with those solutions.

The last thing is the frustration in losing key members of staff within the HSE and the Department and so on. We lost one person from the digital transformation team last night. What many of them are saying and the common theme has been frustration with the resistance to change within the organisation. That is a big problem. Will Mr. Mulvany comment on some of those issues? We are losing public confidence in the system, which is really worrying.