Mattie McGrath (Tipperary, Independent) | Oireachtas source

I am glad to see the Ceann Comhairle is in great form this evening. He is very lenient.

I will begin by complimenting our medical staff and all those research specialists who are working tirelessly to meet the challenges that are being presented by the coronavirus, Covid-19. Containment remains the top priority for all countries. The situation is serious and very worrying. According to the World Health Organization, management of Covid-19 globally is not a one-size-fits-all approach and must be tailored to the transmission scenario faced in each country.

Early robust measures, which are key to saving lives and halting transmission, need to be implemented here in Ireland. It will only be possible to measure their effectiveness in time. It is absolutely vital that we do all we can to interrupt human-to-human transmission including reducing secondary infections among close contacts and health care workers, preventing transmission events, and preventing further international spread.

Many of the concerns that have been raised with me, and no doubt with most other Members of this House, other politicians and with health care professionals, centre on the capacity of the HSE and our wider health systems to cope with this virus should it become more widespread among the public. There is general concern and a feeling of hopelessness on this. The sub-committee and the agencies are doing their best but people are worried. They do not have great faith in the HSE on many things. We wish the HSE well in its endeavours but people are concerned and rightly so. As Deputy Verona Murphy noted some moments ago, the Government was not listening to the people and has a habit of not doing so. It needs to bí ag éisteacht le cluas oscailte i gcónaí.

We already know that before this outbreak, the state of our preparedness was not exactly world class. That is acknowledged by all. We have heard more concerns about the mid-west by Deputy Connolly. If anything, Covid-19 has exposed the extent to which the chronic capacity issues within our hospitals can lead them to become easily overwhelmed. We see that on a daily basis with the trolley crisis. People are not even on trolleys any more but are on chairs, stools and anything they can sit on. South Tipperary General Hospital and Limerick University Hospital are the worst affected in the country with regard to trolleys. Parts of Limerick University Hospital are fairly modern but Clonmel is an older hospital and does not have space. There is a league comparing the worst hospitals for trolleys and there is a trolley watch. The situation is much worse in Clonmel, which is an old building with narrow corridors and the Minster himself has accepted that.

The Minister visited the hospital in Cashel and admitted he was quite taken aback by the extensive range of facilities which are unused there. I have suggested locally that in light of the ongoing capacity issues facing South Tipperary General Hospital, it might be more prudent for the HSE to consider locating its coronavirus isolation units at Our Lady's Hospital, Cashel. The Minister has visited it with colleagues and myself when he saw that its top floors were empty. There is activity on the ground, which we appreciate and which cannot be interrupted, but it would be ideally located for the purpose of isolation. It is a relatively modern building. The HSE has confirmed that it has identified isolation units in all acute hospitals, including South Tipperary General Hospital, where specific multidisciplinary virus preparedness committees also will be created, which we welcome.

The priority here has to be about maintaining patient safety and minimising the risk to the general population should a case of coronavirus be identified in Tipperary, while ensuring the safety and protection of all the healthcare workers, including nurses and doctors and the general team from the porters to the consultants. It must also be about maximising the best use of existing resources in such a way that will not cause greater levels of disruption than are warranted in an already overstretched health system. That cannot be said strongly enough. We are overstretched and we do not want to make the existing trauma and stress worse. This is why the HSE should at least explore the possibility of locating the isolation units in a hospital facility such as Our Lady's Hospital, where there are no inpatients and where the impact on patient care can be minimised. I acknowledge that there are day cases and child and special needs facilities there but they can be relocated if necessary.

South Tipperary General Hospital is already at absolute capacity and under enormous pressures to maintain normal services, as is University Hospital Limerick. It makes sense therefore to see if we can make positive use of Cashel hospital, especially as most people would accept that it has the potential to offer a wider range of services. If it turns out on foot of expert advice that locating the isolation units in Our Lady’s Hospital, Cashel are not appropriate, then that advice must of course be deferred to in the interests of patient safety. I do not want the usual excuse rolled out that there is no lift and it is not accessible. There is something wrong there. Some €22.5 million was spent on that complex and it is outrageous that it is left empty.

Much more needs to be done on advice to workers and employers. The OECD has already warned that the virus presents the global economy with its greatest danger since the last financial crash. That is a stark warning. Meanwhile the Minister for Finance has said that he will review the economic effect and see if a policy action by the Government is necessary. This seems totally absurd; surely this must be examined now, rather than waiting for what will happen and trying to deal with it afterwards. Why are we still having this wait-and-see approach from the Minister and the Government when as we speak businesses, schools and tourism is being negatively affected?

While I accept we need a proportionate response, that kind of measured response will only come if the public and the business community are convinced that the appropriate protective measures are in place. During the severe acute respiratory syndrome, SARS, epidemic in 2003, the House debated a motion aimed at assessing the adequacy of the State’s response. It centred on the actions of the then Minister for Health, Deputy Micheál Martin. It was felt that there had been a serious erosion of confidence in the public health service arising from the mishandling of the SARS threat by the Minister and the issuing of inadequate, confusing and contradictory communications. The motion also noted that these failures were symptomatic of a more general failure by Government to effectively and efficiently manage the health service at a time of unprecedented spending. The HSE was set up under the Minister’s watch. Bedlam, confusion and distress ensued among the public, which we are supposed to serve as Teachtaí Dála sa Teach seo. We are meant to serve the public which we have not been doing. There are parts of that motion which could have been written yesterday because in many ways, we do not seem to have learned many lessons 17 years on. That is very sad. We experienced the SARS outbreak and should have learned from the mistakes in order that we can be ready.

There is still a need to deliver a more comprehensive public information campaign.

The public feel they are in the dark. When that happens, rumour and panic can spread, as we all know. We must do all we can to prevent that, while ensuring we hold those responsible for effective public health and safety to account. I am very concerned, as many people are. I am aware of the efforts of the churches, schools and people in other areas of public life to minimise any risk. However, the Minister saw the hospital in Cashel. It is a shame and scandal in 2020 to have that lying empty after €12.5 million has been spent on the building, with the rest spent on the complex, some of which does very valuable work in regard to services for the elderly and so on. It is a shame to see it empty. It could be fortuitous if this unfortunate epidemic forced it to be opened, given there has been resistance in the HSE to opening it. People are on chairs and on trolleys in Limerick, Waterford and elsewhere. The Minister and his officials have seen it and I ask him to examine the issue.

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