Frank Feighan (Sligo-Leitrim, Fine Gael) | Oireachtas source

I welcome this opportunity to address the House on the issue raised by Deputy Quinlivan. The health sector is facing significant challenges in providing emergency care while also managing Covid-19. I acknowledge that this is causing distress to patients, their families and front-line staff. I welcome the release of the report of the independent review of unscheduled care performance under the Freedom of Information Act 2014 following an application to the Department from the Irish Patients' Association. The terms of reference of the report were finalised by the HSE following discussion with the Department, and it was published in June 2019. The review across nine hospital sites was conducted during 2019 by an independent review team, including external management expertise from the National Health Service Scotland, the Scottish Government and National Health Service England.

The report notes that the nine hospitals accepted the inspection visits with good grace, openness and a desire to learn, and that this is a great testament to their acceptance of the huge need for learning and change. During the course of the review the team witnessed many incidents of outstanding practice and excellent patient care and was reassured by the many good things it saw happening. The team also observed many areas that it felt needed to be improved. The report contains significant findings in areas such as: patient experience times; executive leadership; and appropriate care settings. It also gives clarity on: care provision; patient flow; and the normalisation of full capacity protocol. The report makes numerous site-specific recommendations and 30 consolidated recommendations across four themes, covering: leadership and governance; emergency departments and assessment; patient flow; and operational grip. It highlighted the following: the need for better access to routine diagnostics at weekends; the need for more senior decision-makers on-site on evenings and at weekends; and the need for more health and social care professionals working at weekends. The HSE has advised that the arrival of the Covid-19 pandemic in March 2020 required it to respond to the extraordinary challenges posed and in doing so resulted in the implementation of structures and initiatives to address many of the issues and recommendations that were identified in the draft report.

The report has remained in draft format since January 2020 and close-out of the review process to include factual accuracy checks and response from the nine sites reviewed was never completed. The Government has increased health service current funding from €15.3 billion in 2018 to €19.4 billion in 2021, and €20.4 billion this year.

We permanently funded 1,146 acute hospital beds in budget 2021 and more than 800 have opened. Significant funding was provided for additional staff, home help hours, alternative care pathways and community services. It is critical that the funding is used in a manner that has a demonstrable impact on the challenges facing the healthcare system, particularly in relation to overcrowding in healthcare settings. Key to this outcome is an emphasis on alternative options to emergency department attendance and a focus on improving the patient experience in the emergency department.

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