Thursday, 21 May 2020
Covid-19 (Health): Statements
Róisín Shortall (Dublin North West, Social Democrats)
By way of clarification, the Oireachtas did not ask someone to come in on Monday. It was written advice that was given that is completely new advice. Previously a consultant on workplace health and safety was asked to come in and gave the original advice that we have been operating to up to this week. The other was just a particular medical person who was asked.
I have four questions. I read in today's edition of The Irish Timesthat the Health Information and Quality Authority, HIQA, has said that immediate action is needed to mitigate the risk of infection spreading throughout our public hospitals. I want to bring a matter to the Minister's attention, although I understand he has already received a letter about it. This is about the packed waiting room at Beaumont Hospital last weekend, where large numbers of people were sitting side-by-side, many of them waiting there up to 12 hours. Photographs of the situation have been sent to the Minister. I hope he can respond to us about that high-risk situation. My concern is that that high-risk situation is being repeated every day and every night in emergency department waiting rooms throughout the country. What guidance is being given to public hospitals in terms of the safe management of people waiting for services in emergency departments? This is an urgent issue. On the one hand hospitals are providing services to Covid patients and on the other hand the non-Covid patients would seem to be placed at risk as a result of the failure to segregate and provide sufficient space for social distancing. If that situation was to arise in a shop the numbers would be reduced drastically. There would be control on the numbers but there does not appear to be any control on the numbers in emergency department waiting rooms and we need a response on that urgently.
My second question concerns private hospitals.
We have been told by the Minister for a number of weeks that there would be a road map and that there is unused capacity that needs to be brought into use for non-Covid conditions. That needs to happen quickly. I read the briefing we got from the HSE the other day. We are still talking about two weeks before that is finalised and the services are up and running. There are empty beds in hospitals. We are paying quite a lot for them and they should be brought into use as soon as possible. For example, we have talked before about the advisability of having elective-only hospitals. If we look at the Sports Surgery Clinic in Santry as an example, why are we not using it to its maximum capacity and putting large numbers of people through it for hip and knee procedures and all the other orthopaedic work that needs to be done? I do not see why there is a need for a delay in ramping that up. It is really important that we use that capacity to the absolute maximum and I hope the Minister will retain it for the foreseeable future. It is really important that he does so.
Regarding Covid services in public hospitals, there is a single list. When people come in with Covid, they are not asked whether they have health insurance, and that is absolutely right. All patients are being treated for Covid in public hospitals. By the same token, all patients should be treated for non-Covid conditions in private or public hospitals where there is spare capacity. There should be no question about that and we should be embedding that principle into our health services generally.
My next question relates to home care services. There are indications of delays in home care provision in terms of, say, somebody being discharged from hospital and needing home supports, as well as delays in testing before the home care service is put in place. Equally, where a person in receipt of home care has suspected Covid, there are delays in getting the test and delays in getting a new team of carers into that situation. Another concern is that at the beginning of this pandemic, a lot of families were nervous about home care workers coming in and asked for the service to be suspended. Now, several weeks down the road, those families cannot cope any longer and want the service reinstated, and there seems to be delays with that. Some action is needed there fairly quickly.
My fourth question is how we identify high-risk groups and respond to them appropriately. There is a stand-out example of delays in responding. It was early days and all of that kind of thing and it happened in other countries, but there undoubtedly were delays in identifying and responding to the high-risk situation that people in nursing homes were in. There were tragic results because of that. There are a whole lot other high-risk situations. People in direct provision - the Minister is just getting to that now - and Travellers are examples. There are also meat packers and construction workers who are living and working in very high-risk situations. There is no point in coming along a week or two after the event when there is an outbreak or several clusters. Is there a system in place to identify those high-risk groups and is there a hit squad to ensure there is a speedy response to outbreaks in those circumstances?