Colm Burke (Cork North Central, Fine Gael) | Oireachtas source

I thank the Ministers of State, Deputies Feighan and Butler, and all staff in the Department of Health for the work that has been done over the past two years. I further thank staff in our hospitals, front-line staff in our nursing homes and GPs and their staff for their work over the past two years and all of the people who have worked in vaccination centres across the country for their work over the past 12 months.

We have managed the pandemic very well. There were enormous challenges that changed by the day. We must admit that our responses were not the appropriate ones on all occasions but, in fairness, the vast majority were.

I have a concern around the opening up of services. I raised at a meeting of the Joint Committee on Health this morning the issue of the opening up of elective surgery. People want to get back to what they were doing previously and what they are good at. I am talking in that regard about nurses, staff, care assistants and all those who work in our hospitals. There still seems to be a problem in getting elective procedures back in place. There has been a restriction on that work. Where there are substantial delays, how do we fast-track procedures? Should we, for instance, be looking at opening facilities on Saturdays, especially for day procedures? Could we do such procedures on Saturdays? Could we look at outsourcing to other facilities? In Cork, for instance, there were more than 4,500 people on the gynaecology waiting list. The consultants in Cork University Hospital moved to the Mater Private Hospital and patients were seen there. Those HSE consultants went to another facility to get procedures done. Those were all day procedures. That action cut the waiting list by more than 3,500 in a short period of time.

I know the Minister of State is doing work in the home care area. Lessons relating to nursing homes have been learned. I understand that there are cases where home care is not appropriate and some people require the higher level of care available in nursing homes but many people are able to live comfortably provided there is adequate home care provided for them. An OECD report examined many countries and set out the need to look at better pay and conditions. On the basis of that report, we need comprehensive training, cultural change in the structures of our services and improvement of job design. We also need opportunities for carer advancement. All of those need to be looked at if we want to have a comprehensive home care facility. In the Cork and Kerry regions, for instance, 1,800 people were providing home care within the HSE approximately 14 months ago. That number has dropped to 1,400. There are 400 people fewer working in that area and we need to address that. How can we make working in that area attractive to people? How can we bring more people into the sector to provide that level of care?

When we talk about home care, we consider the cost. If we examine the cost of nursing home care at the moment, it is over €1,000 per bed per week. Home care is still a far cheaper option. At the same time, we must ensure the appropriate level of pay is given to those who provide that home care.

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