Alan Kelly (Tipperary, Labour)
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I thank the delegates for their attendance. We have been down this road several times. I am well aware of the issues and recommendations. I support all of the recommendations. I hope to tease out through my questions where we are in practical terms. Every day, I deal with the issues raised by Ms Ní Sheaghdha. The two hospitals with which I deal most are University Hospital Limerick, UHL, and South Tipperary General Hospital. It is like a perfect storm or Bismarck's nightmare. They are two of the worst hospitals in Ireland for overcrowding.

Many people have contacted me regarding the recruitment freeze. I tabled multiple parliamentary questions on the matter and asked questions directly and indirectly of Ministers and the chief executive of the HSE . The answers I have received have all been rubbish. One gets a standard reply stating that there is no recruitment freeze but, rather, a process through which the HSE is managing its funds. That is rubbish. It is a recruitment freeze aligned with a lack of retention planning and other matters on top of administrative burdens that have been put in place to slow down recruitment. That is what is happening. Nobody can tell me otherwise. So many people have contacted me on this issue that I could probably take out my phone and get the details of 15 or 20 cases without having to check too hard. The issue of those returning after leave is incredible. I have had to contact hospital managers regarding cases where they stated they lacked nursing specialists in certain areas and I had people who were returning and wanted to go back to work. In some cases, I had to embarrass the managers or argue that the staff needed to be taken on to fill the vacancies the hospitals are publicly stating exist. In some cases, they were taken on. It is a significant issue. A modular unit in South Tipperary General Hospital will have to open in two tranches because the management cannot recruit sufficiently to staff it. If the hospital manages to stick to its plan, 20 beds will be opened in January and another 20 will be opened five or six months later.

I have carried out a comparative analysis of statistics for two hospitals that are of the same scale and model, namely, UHL and Beaumont Hospital. The Chair is well aware of my work on this issue. There are 1,294 nursing and midwifery staff in Beaumont and 1,016 in UHL. UHL has 349 health professionals compared with 527 in Beaumont and 228 support staff compared with 459 in Beaumont. This matter is of such seriousness that it goes beyond politics. I have never seen a situation like that in the hospital in Limerick this November. I have no idea what it will be like there in January and February. Several members of my family who have recently been in the hospital were left on trolleys for days or weekends. Very elderly people have been left on trolleys. Infection control is a significant issue there. Patients have been moved to Nenagh Hospital to avoid infection. That is not on.

The recruitment freeze must be lifted. We need to deal with this issue immediately. It has gone on for too long. We need to address the recruitment freeze, the administrative burden and the lack of planning and so on. I know the HSE and the Department of Health are watching these proceedings. I am begging Mr. Paul Reid to deal with this issue. I have written to him, spoken to him and questioned him. My pleas have fallen on deaf ears. I acknowledge he must try to meet his targets and do what he must do, but there must be other ways to reach those targets. People are suffering badly. The situation in Cork hospitals has escalated. It was not too bad in previous years but the situation has been aggravated by a lack of specialist nurses in certain areas, in addition to other issues.

I have significant understanding of the issues and sympathy for those involved,. My questions relate to details that could help us to formulate the necessary arguments. I agree with the remarks of Ms Ní Sheaghda. Does she have statistics regarding geographical areas and specific hospitals that have the biggest issues? She referred a slight increase in retention of graduates, which is to be welcomed. What is behind that increase? Is there a specific reason for it that we could push on a little more? Does she have more information on the lack of places in step-down care? Are there areas where particular issues have arisen? It is definitely a problem in my area. Has the INMO been consulted on the winter plan that is meant to be announced this week? I have no idea what magic the Minister will come up with, but it will need to be magic. If the INMO has been consulted on the plan, what is its opinion thereof? Ms Ní Shealghdha referred to a decrease in palliative care services, which is very disturbing and disheartening. Have specific areas been affected in that regard? I referred to the fact that beds in South Tipperary General Hospital cannot be opened because of a lack of nursing capacity. The new modular unit should open in the first week of January but that seems doubtful. I hope it will. Are there similar situations elsewhere? The workforce planning strategy was published in 2017. Who initiated it? Was it of benefit in the grand scheme of things? I presume it was. What has changed such that it has not been carried out in the past two years? Is Ms Ní Shealghdha aware of an example of its being of assistance? I presume it was of assistance. Why has it not been carried out since?

My hope is that the more we can focus on the areas, hospitals and policies that are not working and how they are affecting people, the more political traction we can get to deal with them. Given where we are headed early next year, we need to deal with them urgently. I am not being dramatic. The statistics back me up. This will be one of the worst periods in Irish healthcare. A hospital clinical lead told me that the trajectory of overcrowding is such that he or she expects catastrophic events this winter.

What they mean by that is that people are going to die unnecessarily. Would Ms Ní Sheaghdha agree with that statement?