Stephen Donnelly (Wicklow, Fianna Fail) | Oireachtas source

I thank the Deputy for those very pertinent questions and I will do my best to go through them. I could not agree more with the Deputy on the capacity issue. Before Covid-19 arrived we did not have enough capacity. We had the lowest number of consultantsper capitain the OECD and second-lowest level of acute beds. There were non-safe staffing levels for nurses and midwives. The Deputy and I have spoken together at length about the lack of capacity and even if Covid-19 had not arrived, we would have a massive capacity challenge. That is what Sláintecare is meant to be doing. There will be 2,600 beds and various additional capacity components.

It has become infinitely more important and pressing now because we have lost significant capacity due to Covid-19. The HSE's latest estimates are that the capacity for operating theatres and outpatient appointments could be down by 30%. Our capacity for diagnostics and scopes could be down by more at up to 50%. In real terms it is like losing three in every ten of our operating theatres and half of our scoping and diagnostic ability, along with three in ten of our consultants who do outpatient appointments. This is at the same time our waiting lists have gone up and we have additional Covid-19 needs, and also while we face a domestic and global recession. The scale of this is unprecedented.

In response, one of my first actions when appointed was to sit down with representatives of the HSE and the Department to say we must put together a plan that is unlike any winter plan we have seen before. It must include many of the elements raised by the Deputy. We must ask what we will do with the temporary community facilities and how we will roll out the flu vaccine across the country. We must consider how to lock in telemedicine and ensure e-prescribing can stay with us, etc. The HSE and the Department is in the middle of putting together a comprehensive plan to address exactly what the Deputy is talking about and more, as we have a long-term capacity problem as well.

We are kicking off what Sláintecare is calling the "citizen care master plan" to consider what level of care is needed, where we are in different parts of the country and what is the gap. This leads to consideration of the workforce, capital, bed and diagnostic plan. There is a much shorter-term piece, as the Deputy quite correctly mentions, which is what we will do right now for this winter to protect people across the country.

On the matter of non-consultant hospital doctors moving to becoming consultants, I am very happy to be wrong but my understanding is there is no current legislative impediment to non-consultant hospital doctors becoming consultants. The Bill mentioned by the Deputy is on the legislative agenda and we are looking for a slot for that. That Bill not being passed is not stopping those non-consultant hospital doctors being promoted to consultant level. That is my understanding but I am very happy to be wrong on it.

There are different issues, including pay inequality, working conditions and professional progression, including missed opportunities. There are fantastic non-consultant hospital doctors but because of the countries they come from, they are barred from progressing to consultant level. That does not make any sense to me. We need to address many issues in getting to the right number of consultants and if there are legislative concerns we will deal with them. My view is that whole-of-profession issues must be addressed.

With regard to face coverings, I will revert to the Deputy in writing with more detail. I know I am out of time but I completely agree with her that there can be no financial burden to anyone accessing face coverings. I will take that message back to the Department today and we will revert to the Deputy on it. I will revert to her in writing on the other issues if she agrees.

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