Jennifer Murnane O'Connor (Carlow-Kilkenny, Fianna Fail) | Oireachtas source

I welcome the Minister. The winter plan seeks, in part, to protect services and patient care delivery. I am concerned about the lack of services in the community for those in need of palliative care. Palliative care teams are fantastic but there is not enough of them. People could die without this care because of under-resourced services. This winter more people will die but we cannot allow their families to spend precious last days fighting for care for their loved ones. It is imperative that the Minister properly staffs this resource. We cannot have a family sharing a palliative care team with another family and have one patient die while the team is attending the other patient. This happened in my constituency this week. The family concerned was devastated. I have been working with them since. No family should have that experience because of a lack of resources.

Today marks the beginning of breast cancer awareness month. When will breast screening services resume? I have been told that there is a waiting list of 12 to 14 weeks. While cancer can in some cases be slow to move, anxiety is not. Patients were not able to access screening because of Covid and in some cases they were too afraid to discuss their symptoms with their GPs or they could not access a GP because of Covid. Adding to their anxiety by extending waiting times is not acceptable. I know that this is a priority area for the Minister and I ask that he provide me with an update on it.

I want to comment on the current restrictions in Dublin and Donegal. I think restrictions might be imposed on more counties soon on the basis of the current figures. As things stand today, will restrictions have an impact on services in counties? In other words, if restrictions are imposed on more counties will services be affected? Will people be told to not attend services?

I also want to speak about the impact of Covid-19 on our mental health services. It concerns me that this pandemic exposes the huge gaps in our services. Many more people are seeking to access supports during this difficult time. We know that our mental health system was under serious pressure prior to the pandemic and it is even more stretched now. Our communities are in dire need of funding to support them through this tough time. Mental Health Reform, the national coalition of 70 plus different organisations, launched its pre-budget submission seeking an increase in staffed mental health services, the development of an out-of-hours crisis service to give people quick and easy access to services, investment in primary care mental health and talk therapy to enable prevention and early intervention, support for the community and voluntary sector to continue providing essential mental services , investment in individual placements and support to help people get back to work. We need to resource these services.

Earlier, the Minister spoke about the excellent work being done by our paramedics. I compliment the service in Carlow. We have excellent paramedics who are going to houses to carry out testing. We are two or three days behind. I raised the following issue at the recent meeting of the Covid committee but it is important to raise it again now. For three years now, I have been raising the Department's promised investment of €350,000 for a building to house this service. Currently, it is housed in a prefab with one shower to cater for a number of paramedics. It is important that funding is provided.

My other concern is in regard to staffing in general. It is brilliant to have ambition for the plan. I believe this winter plan is ambitious but I have concerns. Who will staff these beds? How will those staff be paid? Will our student nurses be paid, as our student doctors are paid? How will we pay for these resources in the middle of the pandemic? Are we represented on the national doctors training and planning, NDTP, medical workforce speciality review specific to each area of medicine in Ireland? I am conscious of glaring gaps in our medical workforce. For example, in the south west for a population of over 500,000 there are only 2.4 public health specialists, which is not near enough. I welcome the announcement yesterday that 250 more specialists are to come on stream nationwide. Is the HSE actively recruiting and to what areas will staff be deployed? It is important we know this.

I welcome the €138 million for home care supports and additional hours. I know the Minister of State, Deputy Butler, has been working hard on this provision. I welcome that provision. It is so important. When will the funding be made available and will the Minister of State provide a breakdown of the allocations, in particular for CHO5, which is my area? I also welcome the ten new dementia advisers. When will these jobs be taken up and, again, will any of them be deployed to CHO5?

This is a €600 million plan. We have to welcome it. How we use that money is important. I know from interactions with the Ministers of State, Deputies Butler and Rabbitte, in regard to disability services that a lot of services will get funding, although I note it was mentioned earlier there is nothing much in the plan in regard to disability services.

The flu vaccine was mentioned. We will be living with Covid for a long time and we are heading into the winter, which will be a difficult time for young and old. We are living in a different world. We will probably never see anything like this again in terms of the recession and the changing times. Families are trying to watch out for each other and people are afraid to go outside in case they catch the virus and pass it on to someone else. We have to be careful. Do we have enough flu vaccine and, if not, do we have a plan if we run out of it?

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