Róisín Shortall (Dublin North West, Social Democrats) | Oireachtas source

I welcome the Minister's announcement that the review of A Vision for Change will be published next week. The next step is to urgently establish the implementation group so that action can be commenced in regard to existing challenges and the very substantial Covid-related mental health challenges that are emerging. I urge the Minister to make an early announcement in that regard.

On Tuesday, the IMO appeared before the Special Committee on Covid-19 Response, where it made a very strong case for urgent attention to be paid to where we go from here. We were reminded that our hospitals have been overwhelmed and operating at dangerous levels of capacity for many years and that this is the result of the neglect of successive Governments of the public health service. The IMO made a number of proposals on the basis that it is untenable that we would continue with the historic deficits in manpower and bed capacity in the context of the growing waiting lists. The point was made that between inpatient and outpatient lists there are now 800,000 on the public waiting lists. The point was also made that while there is much talk about a surge in regard to Covid, which thankfully we have not experienced, there is a surge that is the norm in our hospitals every winter. At this point in the year, we need to start preparing for the regular surge that takes place in our hospitals at winter time, when, hopefully, we will not also be catering for, or preparing for, a surge in regard to Covid.

The IMO also spoke about the roadmap and expressed regret that the arrangement with the private hospitals is to end. It also expressed the view that for the remaining period we need to ensure that private and public services open in tandem based on patient clinical need. I have also made the point to the Minister that for the remaining period of the agreement there should be a single list, with every bed in the private sector being utilised every day until the deal ends to progress through that waiting list. The point was also made by the IMO that it was hoping that when the current deal ends whatever arrangement is reached with the private hospitals it would not include the National Treatment Purchase Fund, NTPF, because the IMO is of the view, as am I, that this would deprive the public system of investment and enable the continued neglect of public services. That is a very strong point, one that those involved in negotiations for government should take on board.

The IMO is calling for a different approach. There are possibilities for the UK model in which some targeted purchasing is negotiated.

I regret that the Government is going to end the deal at the end of June. The Minister admits it is a political decision, but it is the wrong decision. A deal could have been renegotiated that would serve the interests of public patients. Given that a single list operated for Covid patients, we should now be operating a single list for non-Covid patients as well. The situation is regrettable because there was potential for doing something worthwhile by continuing with a form of agreement. Let us hope that, whatever new arrangement the Government enters into, it is not one like the National Treatment Purchase Fund, NTPF, but something fairer and more meaningful.

Regarding the underprovision of hospital beds, it has been recognised that we need at least 2,000 additional public hospital beds. Let us start moving on that now. Much can be done with temporary modular builds, as was done in Tallaght and elsewhere. The IMO called for this Government and the incoming Government to really start moving on modular builds. It is fine to talk about big plans for the future but we need action now and we urgently need additional hospital beds in the public system.

Manpower is another issue which was raised by the IMO. There are now 500 vacancies among consultants and much can be done in improving and increasing manpower at that very important level. The IMO said we should acknowledge, in particular, our non-consultant hospital doctors, NCHDs, who have been at the front line of care for Covid-19 patients. Our public health specialists also play an invaluable role in health protection and should be awarded consultant status, in line with the recommendations of Dr. Scally. That is a really important point and an awful lot could be done about that matter now. NCHDs who were due to finish various contracts in July have not been guaranteed any post to stay in the Irish system. It is crazy at this point, given all we know about the shortcomings in the public health service, to see another generation of Irish-trained doctors leaving the country. They are available now and many of them came back to help in a time of crisis, so contracts should be offered to them. NCHDs going through the training system who are due to finish in July should also be offered acting-up contracts. Those are very practical proposals from the IMO and I hope the Minister will take them on board. Let us not go back to where we were before. Let us build on what has been done in recent months and embed some of those changes into our public health system.

Strong points were also made by the Intensive Care Society of Ireland. As the Minister knows, the baseline critical care capacity in this country is very low by international standards, with only 5.2 ICU beds per 100,000 people. It is the lowest per capitalevel in Europe and that must be addressed as a matter of urgency.

Finally, the issue of screening programmes is really urgent. There has been a lot of slippage in the production of the roadmap, but the whole screening area must be given absolute priority.

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