Dáil debates

Tuesday, 28 September 2021

Hospital Waiting Lists: Motion [Private Members]


9:05 pm

Photo of Mary ButlerMary Butler (Waterford, Fianna Fail) | Oireachtas source

I move amendment No. 1:

To delete all words after “Dáil Éireann” and substitute the following: “notes that:
— the population aged 65 and over has increased by 35 per cent since 2009, with the result that there have been increasing levels of demand for health and social care services;

— arising from the Covid-19 pandemic, which broke out in March 2020, routine scheduled acute hospital care had been severely curtailed during the periods when surges occurred, and capacity reduced generally for reasons of social distancing and infection control measures;

— arising from the Health Service Executive (HSE) ransomware cyber attack, which occurred in May of this year, these services were further seriously disrupted as hospitals endeavoured to maintain emergency and urgent time-critical services;

— other jurisdictions have experienced increased pressures on waiting lists due to the Covid-19 pandemic; and

— notwithstanding the enormous challenges facing the health care system, it is projected that acute waiting lists will be reduced, from a peak of 740,000 in May, at the end of the year through the implementation of a waiting list recovery plan, which is being finalised;
— the commitment in the Programme for Government: Our Shared Future to the implementation of the Sláintecare Plan;

— the major investment made this year to tackle waiting lists through the establishment of the Access to Care Fund of €240 million;

— the increase of permanent bed capacity of 795 beds to date, with a target of 938 by the year-end;

— the increase of 44 Intensive Care Unit (ICU) beds to date, with a target of 66 ICU beds by the end of the year, a 25 per cent increase over the level at the beginning of 2020;

— that the National Development Plan provides for health capital projects, including 2,600 acute hospital beds and 4,500 social care beds;

— the measures taken to ensure national coverage of community intervention teams and structured general practitioner access to diagnostic programmes;

— the additional allocation of €50 million to commence implementation of the recommendations of Sharing the Vision - A Mental Health Policy for Everyone, and €15 million once-off funding to combat Covid-19 related issues in mental health services;

— the implementation of a new standard operating procedure to ensure that children with disabilities have timely access to assessments of need and interventions;

— the progress made in relation to the Individual Health Identifier;

— the increased investment in the health services, including an increase of 6,000 more whole-time equivalent staff, with 2020 and 2021 seeing the biggest annual growth in staff since the HSE was established;

— that a multiannual plan to reduce waiting lists and bring waiting times in line with Sláintecare targets is being developed; and

— the publication of the Sláintecare Implementation Strategy & Action Plan 2021 — 2023: Progress Report January – June 2021, which shows that the Government is largely on track with its implementation; and
agrees to:
— the continued implementation of the Sláintecare Implementation Strategy & Action Plan 2021 — 2023, to which the Government is committed and has the support of all parties; and

— support the Government’s measures in relation to the waiting list recovery plan for this year and the finalisation of the multiannual waiting list plan.”

I welcome this debate. We are all acutely aware of the waiting list challenges. The Government is acutely aware of them as well. We discuss them every day of the week.

In response to the pandemic, the broad range of mental health services and supports provided by the HSE and its partner organisations have been significantly expanded to meet existing and new and emerging need. There has been progress in respect of certain initiatives and I will go through them now. This has been achieved through developments in the national mental health clinical programmes and models of care. These programmes will not only promote standardisation of evidence-based care but also improve access to supports when and where they are needed.

Deputy Ward stated that he was concerned that of the €23 million that was allocated for Sharing the Vision, only €2.77 million has been spent to date. As of this week, we are up to €9 million, and recruitment is under way. Most of the money will be spent in quarter 4 of this year, and I can guarantee that none of that money will be repurposed. Take eating disorders, for example. The three existing eating disorder teams will be completed by the end of the year in addition to the establishment of three new teams. This will have a significant impact on improving access to these vital services.

The perinatal model of care has progressed significantly, with funding made available this year for the recruitment of outstanding staff. All six main hub sites are in operation and all 13 spoke sites now have mental health midwives in place. I know everybody will welcome the fact that we have 19 perinatal mental health midwives in place. Progress has also been made on the development of CAMHS telehubs, which will enhance access to mental health supports out of hours.

Other initiatives include the selection of Waterford, Dungarvan and south Kilkenny for provision of a crisis resolution team and the opening of a community café in Galway. Some €13.5 million was allocated this year to increase surge capacity for mental health beds during the pandemic.

Many speakers touched on the primary care psychology list. It is something I wanted to work on, so last month I announced the approval of €4 million to reduce the number of children and young people waiting over 12 months to access primary care psychology. That €4 million is for the spend between September and December of this year.

Work is progressing across all the CHOs on regional, local-based initiatives, including the recruitment of new staff. They are using public capacity, private capacity and locums at the weekends and doing overtime on Tuesday and Thursday evenings to try to tackle this. We are acutely aware of these challenges but we must also have a sustainable future for primary care psychology. That will be addressed in the Estimates process.

I was delighted to announce earlier today that I had cleared a historic deficit in mental health funding, which had grown to €53 million by the end of 2020. This achievement is critical to ensuring that our mental health services can operate effectively and efficiently from a stable funding base and enable enhanced development going forward. This includes improved access and reduced waiting lists across a broad spectrum of mental health supports. It will, on a separate basis, enable the HSE to allocate €49 million to new developments in mental health. This includes the €23 million we have already spoken about from budget 2021 and €26 million in historical development funding. More than 400 new mental health staff are at various stages of recruitment as part of these developments. There are huge issues and challenges in recruiting staff. I am not happy about the fact that it takes 50 weeks to recruit somebody and that sometimes the post has to be backfilled. That is where we are seeing the challenges, but I am working really hard with my colleagues to see how we can tackle these problems.

To conclude, I will touch on the waiting list hours that were referred to earlier. Overall, the number of home support hours has increased, with the number of people now waiting reduced to 1,460. It was at a high last May of 7,295. The one point I wish to raise is that because we delivered in excess of 1.5 million additional home care hours up to July of this year, 1,200 people did not have to enter a nursing home. That is an important point to put on the record.


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