Michael Lowry (Tipperary, Independent) | Oireachtas source

I congratulate the Minister on his elevation to high office. As Opposition spokesman, he showed a command and a deep understanding of the health brief. He has the ability to be a reforming and performing Minister for Health. In his political transfer, he showed political shrewdness and awareness and I am glad his courage and political agility has been rewarded with ministerial office. I look forward to supporting his best endeavours in his Department.

The country was riveted to the television last night as "RTÉ Investigates" took us inside the intensive care unit at St. James's Hospital at the height of the Covid-19 crisis. The scenes were heartbreaking. We saw the suffering of patients, the anguish of relatives unable to visit or be with loved ones in their final hours and the sheer loneliness at the graveside of a patient who sadly passed away. It was a difficult programme to watch. It was human pain at its most raw and people at their most vulnerable. Seldom has a programme given such an insight into what love and dedication truly means. The staff in this busy unit in St. James's went way beyond the call of duty in caring for their patients and the stress this call of duty caused them was etched on their faces. They gave haunting accounts of putting people they had cared for into double body bags and hearing the sounds of the zips being closed. They recounted calling families with the last news they ever wanted to hear and described the effort of going to work knowing that the events of the previous day could recur. The scenes we saw from St. James's Hospital last night were replicated in hospitals throughout the country. Although many patients died without their families at their bedsides, they did not leave this world without love and care in their final moments.

Throughout this Covid-19 crisis, Irish hospitals have provided exemplary care to the patients struck by the virus and our response to this epic health crisis is the envy of other countries. We have set a high standard and continue to do so. Ireland can be justifiably proud of the performance of our health service in handling the virus since it swept across our country. I pay heartfelt tribute to our doctors, nurses and all the front-line staff for everything they have done. However, just a few short months ago, before we ever heard of Covid-19, every Member of this House was getting complaint after complaint about the health service. There were issues with trolleys, waiting lists, cancer procedures, long delays in getting test results and early discharges from hospitals. The health service was one of the top two major concerns in the run-up to the general election. Could this be the same health service that rose above and beyond all expectations during the pandemic? What lessons can we learn from our handling of the crisis that we can apply to the health service as we move forward? As we enter a new era in politics, with the lessons learned from the pandemic and knowing where the cracks are in the system, it is now over to the Minister. The direction he is going to lead us in is at his discretion. What is the roadmap? What is the strategy and what is the main objective and timeframe for delivery of that strategy?

While the proper and adequate funding of our health service is vital, I do not share the view of many that lack of funding is the sole reason it is rated so badly. We have a serious problem with the management of facilities and personnel in our healthcare system. We are also not utilising our acute hospitals to their maximum potential. We have made major investments in world-class theatres and diagnostic and laboratory units around the country and it does not make sense for those facilities to be closed or curtailed at weekends. Our first-class delivery care units should function on a 24-7 basis, thereby increasing the throughput and reducing the waiting lists.

The successful handling of the Covid-19 crisis in our health system required substantial money. Additional staff were brought on board quickly. It took money to do that, but it also took expert management of the situation. The driving force behind our excellent handling of the crisis was the way we managed it. The speed and urgency of the required response to the crisis demanded that it be managed with almost military precision. Even before the first case occurred, our hospitals were ready and intensive care beds, critical care beds and step-down beds were made available at rapid pace. Testing centres were also quickly established. The one major glitch in the system was the failure of the HSE to support the nursing home sector in a timely fashion, and we were also slow to roll out testing and contact tracing. That needs continuous upgrading as it is the principal strategy for coping with a virus that is going to remain with us.

If we are to take any lesson from our handling of the Covid-19 crisis, it has to be that strong management is the key to both implementing efficiency and maintaining high standards. The health service we aspire to provide to our people through the introduction of Sláintecare will not be delivered to its full potential unless it is run like a high precision machine or a top performing business. The overall management of the health service must be the very first thing that is examined, and examined rigorously. Areas that are fragmented and sections that are top-heavy with administration or where there is duplicity of tasks should be eliminated. When direction from the top is strong and provided by a single expert group of advisers, the rest will flow with much greater ease. It has never been more clear that a strong management core will be the key to the success of Sláintecare.

Indeed, without it the best of plans can rapidly spiral out of control. Our health service can be greatly improved. However, with all we have learned over the past number of months and all we have proven ourselves to be capable of, we know now with certainty that we can get it right if we do it right. Covid-19 has changed our lives irrevocably in many negative ways, but it has also shown us the path that could change our health service for the better for every man, woman and child in the country. We must build on the lessons we have learned.

I also wish to raise the non-payment of subsistence for theatre nurses who were deployed from Nenagh and Ennis to University Hospital Limerick. This is more a matter of principle than of money. Some 16 theatre nurses answered the emergency call for deployment from Nenagh to Limerick to assist in the fight against Covid-19. They did so, without hesitation, for the public good. Their work schedule expanded to working 12-hour days, weekends and night duty, where previously they had worked eight hours a day, Monday to Friday. The redeployment involved longer travel and an earlier starting time. Many of these nurses left home at 5 a.m. and did not return until 10 p.m. This involved a major change to their daily routine, massive inconvenience, additional childcare expenses and the onset of undue stress and anxiety. It is astounding to learn that these nurses were refused a subsistence allowance. This refusal is mean-spirited and harsh. While nurses welcome the public clapping of approval, it should not be too much to expect the HSE to give practical recognition to their heroic efforts. I ask the Minister to seek clarification of why these nurses were refused a meal subsistence allowance.

Finally, Our Lady's Hospital in Cashel is a long-standing saga in the underutilisation of accommodation. It is shameful to see so much high-standard accommodation not availed of and not in use. The Minister's predecessor, Deputy Harris, visited the hospital two years ago. He was surprised and disappointed that the facility was not put into service. He undertook to instruct the HSE to examine the obvious potential for step-down beds. Recently, as a consequence of the coronavirus, patients from St. Patrick's Hospital in Cashel were relocated down the road to Our Lady's Hospital. This was understandable on health and safety grounds. It was the first tangible acknowledgement by the HSE that Our Lady's Hospital was suitable to accept patients. I hope this temporary arrangement does not become permanent. St. Patrick's Hospital in Cashel is included in the capital programme for a new 50-bed unit. I hope this new unit continues to advance and I urge the Minister to ensure a long-term plan is put in place by the HSE to provide step-down and convalescent beds in Our Lady's Hospital in Cashel for use by the local community of Cashel and the district.

I have not given the Minister time to respond so I ask him to communicate with me in writing.

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