Seán Canney (Galway East, Independent) | Oireachtas source

I move:

That Dáil Éireann: acknowledges that:

— the most recent waiting list figures available from the National Treatment Purchase Fund show over 79,000 patients are waiting for an inpatient or day case procedure, and a further 625,000 are awaiting an outpatient appointment;

— the Irish College of General Practitioners has indicated that only one-in-five general practitioner (GP) practices can take on new patients from the General Medical Services Scheme as they are at full capacity, and only one-in-four can take on new private patients as they are unable to employ another GP or replace a retiring GP;

— according to the Irish Nurses and Midwives Organisation, 10,679 patients who were admitted to hospitals in October spent time on a trolley before securing a bed, which was more than a 25 per cent increase on last October; and

— more than 27,000 people left Ireland's emergency departments before being seen by a doctor during the three-month period from July to September this year;

recognises that:

— the World Health Organization has defined the post Covid-19 condition, also known as long Covid, as a condition which occurs in individuals with a history of probable or confirmed SARS-CoV-2 infection, usually three months from the onset of Covid-19, with symptoms lasting for at least two months that cannot be explained by an alternative diagnosis;

— while there are some 200 conditions associated with long Covid, common symptoms include profound fatigue, shortness of breath, post exertional malaise, dysautonomia, neurological and cognitive dysfunction, as well as others that have an impact on everyday functioning, with symptoms appearing following initial recovery from an acute Covid-19 episode, or persisting from the initial SARS-CoV-2 infection;

— research highlights the real burden long Covid represents to the Irish population and an already overwhelmed health service, highlighting the importance of finding scientific solutions which can tackle the underlying mechanisms that are causing such diverse and debilitating symptoms;

— while there is a lack of knowledge associated with the management and treatment of long Covid conditions, this is not the first infection-associated chronic illness triggered by a viral infection, with many long Covid patients meeting the diagnostic criteria for myalgic encephalomyelitis and chronic fatigue syndrome;

— the duration of illness can be variable, with some patients who developed long Covid after contracting Covid-19 in the first wave in March-April 2020 having made little or no recovery to date;

— due to the heterogenous nature of long Covid there is currently no one universal diagnosis or treatment, however, medical evidence indicates that symptom management can improve quality of life;

— research published by the Health Protection Surveillance Centre on Irish blood donors indicates that 69 per cent of adults in Ireland have been infected by the virus;

— there are likely to be 336,451 adults nationally who are suffering from or have suffered from medical conditions associated with long Covid, based on an extrapolation of Netherlands-based research published in The Lancet in August 2022 which attributed long Covid symptoms to 12.7 per cent of patients infected with the SARS-CoV-2 virus;

— patients with long Covid, many of whom are young with no underlying conditions, have presented with prolonged multisystem symptoms which can impact quality of life, affect ability to work and cause significant disability for some;

— long Covid is having a significant impact on our labour force, and an Australian study on long Covid indicates that even low rates of Covid-related permanent illness or disability could still lead to a significant future societal burden from the disease;

— some 0.81 per cent of Enhanced Illness Benefit claimants were certified unfit to return to work at least 12 weeks after their initial infection, meeting the emerging scientific criteria for long Covid;

— on a population basis over 21,000 people may be unfit to work due to long Covid, which excludes those who have relapsed after initial recovery from SARS-CoV-2 infection or the tens of thousands more experiencing less severe forms of long Covid who have reduced participation while in employment;

— just 22.5 whole-time equivalents of the 70 health service staff to be appointed by the Health Service Executive (HSE) to work with long and post Covid patients were recruited up to last month, with patients waiting up to 10 months for initial assessment before joining record waiting lists to see other specialists;

— long Covid services do not exist for children;

— the clinic in the Mater Misericordiae University Hospital Dublin treating neurological conditions, such as brain fog associated with long Covid, has been forced to reduce its service due to a lack of funding;

— many Irish patients have been forced to seek costly treatment overseas due to a lack of clear referral and treatment pathways being developed in Ireland; and

— the primary mechanism to prevent long Covid is to minimise the incidence of Covid-19 infection, by ensuring that all practical measures to reduce the transmission of the virus are introduced and maintained in a time appropriate manner, including the provision of Evusheld to those who are immunocompromised or where vaccination is not recommended; and

calls on the Government to:

— address chronic workforce issues within our GP practices, primary care, and acute hospital services;

— fully staff long and post Covid clinics as committed to on foot of the HSE plan of September 2021, which must be updated to reflect the changing skill set required to support the emerging evidence on the treatment of conditions associated with long Covid, such as direct access to neurological clinicians;

— establish a multidisciplinary public health team incorporating patient advocates to review and manage long Covid care within the population;

— establish a dedicated and specialist-led long Covid clinic for children who are without a dedicated centre at present;

— deliver in tandem with, instead of consequential on, the establishment of long and post Covid clinics, fully resourced long Covid services across GP practices and community services to ensure a national service is in place for all who need it;

— ensure that services and supports adapt and expand based on learnings from implementation, emerging evidence in relation to long Covid and current and projected demand for all specialists and services;

— develop a public awareness campaign on what long Covid is, highlighting the risks posed to the entire population, including the young and healthy, and how to minimise the risk by reducing the transmission of the SARS-CoV-2 virus;

— urgently complete an analysis of existing waiting lists to establish the incidence of long Covid and the scale of the challenge facing the heath service;

— establish a long Covid electronic patient register to provide a secure database to store and analyse detailed information in relation to the number of patients presenting to long Covid clinics, the symptoms they are presenting with and their treatment outcomes;

— ensure that all healthcare and frontline workers who are unfit to work due to long Covid are entitled to special leave with the removal of the arbitrary eligibility date of 7th February, 2022, for healthcare workers and further ensure that the current scheme does not abruptly cease in June 2023;

— recognise long Covid as an occupational illness for all healthcare and frontline workers;

— commence an information campaign providing the best available current advice in the management of conditions associated with long Covid and other post viral chronic conditions to GPs, the medical profession and those experiencing long Covid conditions; and

— develop an innovative rehabilitative and recovery programme that is designed to meet the needs of those experiencing long Covid and other post viral chronic conditions, ensuring a return to as full and active a life as possible.

I am delighted to move the motion on behalf of the Regional Group. This is the first major parliamentary debate on the impact of long Covid. I am delighted the Regional Group has seen fit to table the motion. It simply seeks the roll-out of specialist services to support those who have failed to make a full recovery after being affected with the SARS-COV2 virus.

While most people will make a full and quick recovery from Covid some adults and children continue to experience ongoing symptoms or can have a relapse after the initial recovery. These symptoms can persist for several months or even years. Long Covid is an umbrella name given to a broad range of some 200 post-Covid symptoms which can include conditions such as chronic fatigue and brain fog which are experienced at least three months after the initial infection and for significant periods of time and in some cases for over two years. According to analysis based on research conducted in Ireland and the Netherlands, some 336,451 adults nationally are likely to be or have suffered some form of long Covid and an estimated 21,000 people are so unwell that they are unfit for work. Even with a small portion of these long Covid patients presenting to our health service with complex health conditions in an already overcrowded emergency department and GP surgeries, they will overwhelm our health service as we face into a serious winter of overcrowding.

The Regional Group believes that unless we address this challenge of long Covid in a comprehensive way and in tandem with measures to reduce the spread of Covid-19 we will just sleepwalk our health service into a crisis of chronic illness. This would put people waiting on treatments since before the pandemic further down the already horrendous waiting lists. We also want to see long Covid recognised as an occupational illness and comprehensive special leave with a pay scheme for front-line healthcare workers as well as the expansion of services for other similar illnesses such as ME and chronic fatigue syndrome.

I thank my colleagues in the Regional Group for putting forward this very important motion. In particular I acknowledge the work of Deputy Denis Naughten for his great work in drafting this motion together with our administrator, Cáit Nic Amhlaoibh. It is important that we take this very seriously. The motion calls on the Government to address the chronic workforce issue in our GP, primary care and acute hospital services and to fully staff post-Covid and long Covid clinics, which I think is the most important thing. This has been committed to on foot of the HSE plan of September 2021. It must be updated to reflect the changing skillset required to support the emerging evidence on the treatment of conditions associated with long Covid such as direct access to neurological clinicians. We also need to establish a multidisciplinary public health team incorporating patient advice to review and manage long Covid within the population. We need to establish a dedicated and specialist-led long Covid clinic for children who are currently without a dedicated centre. That is a vital cog in ensuring that children are treated for this illness and that it is recognised that children have this illness.

It is important that we deliver in tandem with, instead of consequential on, the establishment of post-Covid and long Covid clinics fully resourced, long Covid services across GP and community services to ensure a national service is in place for all those who need it. I understand the Government is not opposing this motion which I welcome but it is important not just that it does not oppose it. We need to take action now to ensure that long Covid is treated in the way that it has been promised to be treated, as a very serious issue for the people who are not able to work and are suffering.

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