Joan Collins (Dublin South Central, Independents 4 Change) | Oireachtas source

I support the motion. I congratulate Sinn Féin on bringing it forward on the basis that it clearly outlines the scale of the ongoing and increasing crisis in the public healthcare system. It also clearly identifies the fault lines in the latest announcement of yet anther plan to tackle waiting lists.

We have to ask why we have these outrageous waiting lists in the first place. To my mind, the answer is very simple. It is a two-tier service which offers access to those who have private health insurance, and not just access to private healthcare facilities but also to our public hospitals. Those who are above the limit for a medical card or do not have the means for private insurance are left in limbo. I note that this latest plan will have only a limited, if any, effect on the lists. Of the €350 million budgeted, €200 million will be used for the National Treatment Purchase Fund or, in other words, almost 50% of the money provided by the State will be spent in private medical facilities. As long as we maintain the two-tier system, with chronic underfunding of the public sector patched up with occasional sticking plasters from the private sector, we will have an ongoing waiting list crisis. I agree with the spirit of the amendment from People Before Profit but, of course, to move from what we have now to a single-tier service will be a transition that needs to be well planned, properly funded and resourced and carried out over time.

I also attended a webinar today organised by the Neurological Alliance of Ireland, NAI. It dealt specifically with the crisis in the Dublin hospitals, which have 28 neurological nurses when they need 85. That is a shortfall of 57 nurses to care for the people in Dublin South-Central who are living with a neurological condition. St. James's Hospital needs 14 and it only has four, so it is short ten nurses, and similar numbers were given for hospitals all over the city. There are 23,979 people waiting for neurological outpatient appointments, with 8,601 waiting more than 18 months.

It is said that neurological nurses make clinics 40% more efficient. Increasing the number of these nurses would ensure that people with neurological conditions have improved access to healthcare supports and would reduce the time they are waiting for appointments. Patients who have access to nurses have reported improved psychological well-being and an improved sense of involvement in their care, and they are more prepared for tests and investigations. Their knowledge of their condition and related issues increases and they have more confidence to self-manage their condition. To have more neurological nurses will also ensure that patients get quicker access to outpatient appointments, thereby reducing waiting lists and ensuring that any deterioration in the patient's health status can be mitigated. This will also ensure that additional hospital resources can be focused on those who need it. The NAI will be coming back again with regard to national waiting lists and what is needed at national level.

I was contacted by a constituent who attends the long Covid clinic in St. James's Hospital, which has been advised it will lose its occupational therapist for long Covid care. I contacted the hospital to ask whether this was the case because the occupational therapist there has provided a fantastic service to people with long Covid in regard to their limbs, fatigue and so on. The reply was that, in the past month, St. James's Hospital has received confirmation from T. J. Dunford, primary care, national community operations, of permanent funding resourcing for the post-acute Covid clinic programme, and occupational therapy, OT, has not been resourced. It awaits confirmation of permanent resourcing for the long Covid clinic and this is expected imminently. There are concerns that OT was not included in the HSE’s draft long Covid model of care in June 2021, although this may change in the final version. I want a commitment from the Minister that this will be changed in the final version in the second quarter of the year. OT is an integral part of any therapy in regard to long Covid services.

My final point concerns Sláintecare, which is not perfect and does not deal with section 38 and section 39 bodies, which means the State is fully funding what are in reality private hospitals, nursing homes and other healthcare groups. Sláintecare would be a good start in reforming the system and that is why I want to refer to the situation in regard to the new national maternity hospital. For me, this is a crunch issue. A private healthcare group, St. Vincent's, is demanding an operating licence for a €1 billion new hospital to be built by the State and fully funded and operated by the State. I cannot think of any other country where this could even be contemplated, yet it is becoming increasingly clear that the Government will possibly cave in and agree to the demands of St. Vincent's Holdings and, behind it, the Sisters of Charity, the Vatican and the Irish Catholic bishops. If this happens, it will be the death knell of any meaningful reform of healthcare, the killing off of Sláintecare and goodbye to any vision of a single-tier public health service funded by the State and controlled by the State, that is secular and provides all services allowed by the law and free for all at the point of use.

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