Matt Shanahan (Waterford, Independent) | Oireachtas source

I note the very sad passing of Detective Colm Horkan and send condolences, on behalf of the Regional Group, to his family and the families of victims of Covid.

As we appear to be exiting this crisis, we may well be heading into another. In this present respite, we have yet to address the expected winter surge and the possible re-emergence of Covid-19, mindful of the reduction in bed capacity and procedures output due to increased infection control protocols. Portiuncula University Hospital in Galway has seen a 10% reduction in its bed numbers. We are seeing a significant increase in waiting lists as a result of lost months of elective activity due to the Covid lockdown. Some of the recent deferment of patient procedures could have been avoided if full-time private consultants in private hospitals were allowed to continue to treat both public and private patients under the recent private hospitals agreement. The imposition of a type A contract during this agreement was rooted in Department of Health ideology and not in the practicality of trying to treat as many patients as possible at every opportunity.

We need a renewed sense of urgency to be brought to bear in our hospital services plan. We need clear targets to deal with the impending bed crisis. System rigidity with respect to existing custom and practice must be set aside. Collaborative, innovative thinking should be encouraged across all grades to decide new work practices. Most importantly, resources must be guaranteed to get the job done. Resources have proven not to be a problem when allocating €330 million for a three-month agreement that delivered 40% bed occupancy. Similar financial resolve is needed to properly support our front-line healthcare workers in the battle ahead and to deliver additional measures.

Among those, I propose that the Minister opens up the recruitment of additional clinical posts, that he provides additional homecare packages to free up the long-stay patient beds, and that he asks hospital management to reserve surgical bed capacity pathways, with supporting ICU and high dependency unit bed assists. We provide mandatory testing and dedicated Covid patient management in assigned group hospitals. After-hours diagnostic imaging sessions seem to be something that we can easily contemplate. I propose flexible rosters to support public consultants providing activity in private theatres. I believe that we need significant engagement and new contracts through the National Treatment Purchase Fund. Additional capacity in the private sector must be immediately negotiated through service-level agreements and contracted bed or procedures purchase through the NTPF. We must not see a repeat of employment conditions in public contracts which are designed to exclude full-time private practitioners, thereby reducing value to the public purse. Additionally, to match the latest scientific understanding, I call for mandatory temperature testing of all hospital workers, which is now commonplace in the industrial manufacturing sector.

Regarding a new ethos, I will revisit the issues at University Hospital Waterford's cardiac care centre. Despite the Minister's welcome recent assurances to me that we should see no further slippage of the second cath lab development promised from September 2018, I confirm to the Minister that the construction timeline has extended by a further three months, and construction may not begin until spring of 2021. This extension of time is wholly unacceptable. This is while we continue to operate in the south east for 39 hours per week, with just one cath lab for the whole of the south-east's population, while understanding that the mobile diagnostic cath lab facility which was on site at University Hospital Waterford since 2018 was removed in recent weeks, as the Minister knows.

The remodification of our existing cath lab, which we previously discussed, has also been suspended for many weeks. Despite the new laboratory equipment being in storage in the hospital for a considerable period, engineers required to install and commission it will not travel from abroad because of our two-week isolation requirement for travellers. Such requirements could have been dispensed with by a means of a Covid test on-site at University Hospital Waterford and a managed accommodation agreement. Where there is a will, there is a way. However, it appears that senior officials responsible for delivering this project could not demonstrate a single ounce of wit to consider how these delays could be advanced and this vital work progressed. Every day that the Waterford cardiac service operates without two laboratories means that diagnostic tests that could prevent a heart attack cannot be undertaken, with obvious implications.

It is a further source of angst to me that a commitment to future provision of a 24-7 cardiac care service for the south east is not contained in the present programme for Government. As the Minister knows, University Hospital Waterford is the only designated national cardiac centre which does not provide a 24-7 cardiac care service. I know that for the Minister, the south east's 24-7 cardiac care issue may soon be in his rear-view mirror. I highlight to the Minister, his party colleagues and those who sit on the other benches in this House that this service refusal remains a stain on the Department of Health and HSE's national planning with respect to acute clinical care. All lives matter, including those of us who live in the south east. We will not continue to be treated like serfs on our own land. The timelines proposed to deliver these two urgent cath lab projects must be given the highest priority in the Minister's Department and the ground lost must be recovered. The sad reality to date is that the urgency of NPHET has not been extended to the lives or clinical needs of cardiac patients living in the south east.

This debate mirrors the challenges facing the next Government. The problems are known and widely flagged. Solutions are possible but questions remain. What actions will those in leadership in the next Government take to address these issues? Will the commitments they espoused be forthcoming and brought to bear? Will resources be equally distributed across this country in the future?

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