Mr. Bernard Gloster:

There are two parts to that. In the context of winter plans, it may be a necessity for 2023, given the period of time that I have arrived into the system. My preference is that we have an all-year round capacity management plan. Winter plans have perhaps passed their usefulness in that context, and that is because we experience pressures right throughout the year in the system. The acute hospital system operated at full tilt in periods last summer. If one looks at the evidence, one would find it hard to distinguish between parts of the summer and parts of the winter.

Whether or not there will be a winter plan for 2023 is something I want to discuss with the board of the HSE, the Minister for Health, Deputy Stephen Donnelly, and the Secretary General of the Department of Health. My preference would be that by the time we get to 2024, if not sooner, we would have a capacity plan for the year as part of the service plan, and that we all know from the start of the year what we are doing about capacity, be it in May, August or December. Enough of a period can be allowed in that plan for fluctuations to happen. That is just a general comment on plans.

With regard to private hospital capacity specifically, we are in a phase where we can anticipate, with pressure, for the next period of time that we have to use what capacity is available to us to use in the best way that we can. Personally, I think there is more capacity benefit from the private hospital system in the context of elective work, responding to waiting list initiatives, and picking up some of the pressure and slack there. The use of the private hospital system for what we might call more general medicine, which is a predominant part of the pressure in emergency departments, is much harder. It is not necessarily the core work of a lot of private hospitals.

I could not agree with Senator Kyne more, however. If we are going to use capacity in the private sector - and I need to look at what that will be for the balance of this year, with the Department - for the rest of the year, then that is better dealt with, and dealt with well in advance as distinct from short notice engagements, and trying to buy capacity at short notice. We either have capacity to be bought and used for the public interest while we are building and developing for the public capacity, or we do not. It is not beyond all of us to identify and call out what that is, and nail it down more quickly.