Matt Shanahan (Waterford, Independent) | Oireachtas source

I begin by expressing my condolences to all families who have been recently bereaved because of Covid-19. A heavy price continues to be exacted on our population. Also, on behalf of the Regional Group of Independents, I applaud the efforts of our national medical and clinical care staff and wish a full and speedy recovery to those diagnosed in hospital or home care settings at present.

I wish to highlight some areas of innovation and potential in ongoing Covid-19 management which I hope the Department of Health will acknowledge and support. PPE in development in Ireland at present has no expedited access or pathway to gain certification or standards approval so that it can be formally supplied to public, community and national health services. I am aware of two projects in Waterford attempting to navigate the standards approval process. The first is a barrier face mask, the design of which has already been approved for use in France by means of a standards reclassification, but as yet in Ireland we have been unable to accelerate standards consideration. The second is a new clinical full-face mask being developed by the South Eastern Applied Materials, SEAM, research centre at Waterford Institute of Technology, WIT, one of our 15 national technology gateways. Development is in conjunction with University Hospital Waterford's ICU consultants, Boston Scientific, Consort Packaging and Jabil Healthcare. This mask may prove a significant development for clinical care lead protection and I ask for the support of the Minister's office in the coming weeks to assist in the certification of this product. The SEAM technology gateway at WIT is assisting some of the foremost names in medical device design and manufacture in the country. Its 3D printing facility has been manufacturing face visors for local healthcare concerns since the Covid-19 outbreak began. I urge the Department of Health to support the release of approved funding granted in 2018 for the purchase of a CT scanner for industrial X-ray. This apparatus is needed to support the innovation and problem solving that has been second nature to many businesses in Waterford and the south east for many years.

I will now move on to the issues in our nursing and residential care homes. The situation regarding PPE has been well flagged, but there are broader issues which have not been flagged as yet. Some social and political commentary has inferred that we have substandard nursing care prevalent in our community and residential care settings, but I know this to be untrue in my county of Waterford. What is puzzling to me and many others is why the Department of Health and the HSE have not prioritised senior care staff to handle the testing requirements within nursing homes. Testing kits could be made available to nursing staff along with the provision of short training courses to allow for the in-house swabbing of residents and staff as required. These swabs could be sent to local laboratories for analysis. This could deliver a 24-hour test turnaround, the gold standard that we are currently failing to deliver. Beyond this, we have vulnerable patients with dementia, and it is clear that having familiar care attendants conduct swabbing would be far more appropriate to their needs. The Minister has directed HIQA to conduct inspections into Covid-19 activity in residential care settings.

Many nursing homes have already drawn up Covid-19 management strategies in collaboration with HIQA and any further reviews should be minimised to a desktop exercise to prevent individuals accessing care homes and potentially introducing infection.

The Department of Health's announcement of funding to the sector was positive but some of the actions of the NTPF, which the Minister appointed to administer the moneys, have been less positive. Many care homes have expended significant resources in the purchase of PPE, increased staff numbers, creating Covid-19 isolation areas and protocols and bonus staff payments to cover enforced absence of colleagues and the increased workload. The NTPF applications to support funding are onerous in the extreme. The decision by the NTPF that significant preparatory purchases and expenditure in the month of March cannot be supported is unjust. Capitation money is payable for fair deal residents only and not those privately funded. Bonus moneys that have been agreed or paid cannot be supported.

For many care workers the Covid-19 pandemic unemployment payment, PUP, would return more money than their weekly take home pay. The State is prepared to support this cost but is not prepared to support an incentive to allow staff to work extended hours in these most difficult conditions. The Government is not adequately compensating residential care homes for the financial hardship which Covid-19 management has caused and, at this juncture, neither is it providing the extra personnel resources promised that could be switched from hospital settings.

Significant progress has been made in securing additional test kits through the efforts of Dr. Paddy Mallon, Dr. Paul O'Brien and Dr. Oisin O'Connell. I ask the Minister for a status update in this regard. A national training scheme for PPE donning and disrobing would be of immense help in reducing Covid-19 cross contamination in hospital and community settings where the virus exists. Does the Minister or his Department have plans to address this issue? Pulse oximeters have been shown to have significant diagnostic value in identifying the early signs of Covid-19 infection and signalling treatment. I applaud the leadership the Department of Health and the HSE have taken in this area which, as profiled in an article in The New York Times this week, may significantly assist Covid-19 diagnosis and early treatment.

The cath lab at University Hospital Waterford, UHW, was scheduled for refurbishment this year. It has been closed since 14 February to allow for a refurbishment programme scheduled to take 15 weeks. In Waterford, the main cath lab and the temporary contract diagnostic cath lab are closed to service, while a reduced offering is available at UMPC Whitfield private hospital. Will the Minister commit to authorising works on the existing cath lab at UHW to be expedited as an essential service? The UHW cath lab configuration delivered over 4,000 patient procedures last year. Will the Minister also indicate a final recommissioning date and the recommencement of fixed and modular cath lab activity at UHW? In addition, the construction of a second permanent lab at UHW announced by the Department of Health in September 2018 has still not gone to build-tender-approval. There will be companies interested in this Government contract. Will the Minister confirm that moneys are ring-fenced to support this capital project and that his Department is committed to advancing it as soon as possible to construction-tender-award? I ask that the Minister deal first in his response with the issues of the cardiac service.

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