Mary Butler (Waterford, Fianna Fail) | Oireachtas source

I welcome the opportunity to discuss long Covid health services and I thank the Deputies for tabling the motion, especially Deputy Naughten who has raised this issue continuously in the House for the past 12 months. A Private Members' Bill was tabled last night on home care, which I was delighted to attend and speak on, and I am here again to discuss long Covid. These debates are important and we have to have them. I welcome the tabling of this motion.

Long Covid is a challenging condition for those who experience it and for service planning and delivery. There has been progress in establishing a national service and the Government will allocate additional resources in 2023 to ensure the full implementation of the service. The budget will facilitate an overall investment of an additional €6.6 million next year for the further development of long Covid services to ensure a full national service is in place, which is an important point. We are moving away from the postcode lottery to a national service and no matter where a person is living, he or she will get support.

There is probably not one family or extended family in Ireland that does not contain a person who feels they have symptoms of long Covid. They are experiencing symptoms they did not have prior to getting Covid. I know a person in my extended family who has been dealing with multiple issues for the past 12 months. There may be some Deputies who previously leaned towards being Covid deniers and are now talking about long Covid in the Dáil today. It is important that we accept and realise it is a real thing. I know it is a real thing judging by the interaction I have had with people who have long Covid.

We have to talk about this as knowledge develops internationally. Two and a half or three years ago we did not know anything about Covid and now we are experiencing the effects of long Covid. As knowledge develops internationally, it is important that the HSE’s interim model of care is adapted to ensure it will be in line with the most up-to-date evidence. We have to adapt, be flexible and nimble to make sure we can support the best national approach to supporting those with long Covid.

The HSE will continue to monitor demand for services and to model the numbers of people affected by long Covid based on national and international data. In this regard, an epidemiological survey is planned that will provide insight into the prevalence of long Covid in the Irish population and risk factors for developing long Covid. This study will inform further service development. I am informed by the HSE that this study is in phase 1, which involves testing the design of the study and recruiting the personnel required.

The HSE has also commissioned HIQA to conduct an international review to further inform the development of the service to ensure it is in line with international best practice. The review is expected to be completed later this month. HIQA has carried out several very useful evidence-based reviews over the duration of the Covid pandemic, many at the request of the National Public Health Emergency Team, that have helped to provide an evidence base for various public health measures implemented over the past two and a half years.

As with all aspects of our national public health response to Covid-19, it is essential that the most updated evidence continues to be used. The HSE and the Department of Health continue to monitor international data and research to ensure all available evidence is used to improve service planning and delivery. The Department, through its lead funding agency, the Health Research Board, HRB, currently supports a number of studies into long Covid. The HRB will continue to promote long Covid as a critical area where evidence is required to inform clinical practice and policy development. With the support of the Department of Health and HRB, Ireland continues to participate in international research studies on Covid-19, including the WHO Solidarity PLUS trial and the EU SolidAct. As Members have heard, providing care for those experience long Covid requires a multidisciplinary response, particularly as symptoms and their impact can be so variable. I have been struck by how varied the symptoms are for different people.

General practice plays a key role in the delivery of a national long Covid service with the initial role of GPs being to exclude acute or life-threatening complications and other unrelated diagnoses. As part of the implementation of the model of care, the HSE has engaged with the Irish College of General Practitioners, ICGP, and other professional bodies. Through this engagement, it has identified the opportunity to provide further education and training in the management of long Covid, including when and how to refer patients to specialist services. The HSE is liaising with the ICGP on how future training and education can be optimally designed and delivered. I understand the HSE is also engaging with patient groups, such as Long Covid Ireland, on service development, which is important.

Fortunately, evidence to date continues to indicate that most children recover quickly from long Covid and the incidence of long Covid in children and young adults is low. The best available evidence supports the provision of care to children by their GPs and, if necessary, by general paediatricians, who work in multidisciplinary teams and have specialist terms to refer to, including paediatric respiratory and neurology teams as needed. The national clinical programme for paediatrics and the national clinical advisors and group lead for children and young people continue to work closely with the HSE long Covid team to review evidence and support access to care.

The motion speaks to the need to ensure services are in place for those with care needs as a result of long Covid. I assure colleagues that addressing Covid-19 is something all Government partners have prioritised in the programme for Government. The Strategic Approach for the Management of Covid-19: Preparedness for Autumn/Winter 2022/2023, which was published last month, acknowledges the need to ensure provision of a national service for those suffering from post-acute Covid and long Covid. It also emphasises how the clinical understanding of this condition will continue to evolve through the review of expert guidance to reflect best practice and ensure an effective service, with a health workforce suitable upskilled in the recognition and management of both post-acute Covid and long Covid.

Five new post-acute Covid clinics have been established, which manage patients between four and 12 weeks after the initial onset of infection. Long Covid clinics manage patients 12 weeks post onset. Five new long Covid clinics have also been established. Patients are referred by their GP to these clinics as needed and more clinics are due to open in the near future in Cork, Letterkenny and Limerick. To care for those experiencing long Covid, clinical input is provided as needed, depending on symptoms, by a range of health care professionals, including those working in respiratory medicine, infectious diseases, neurology, mental health, allied health professions, general practice and other community services.

These interdisciplinary teams guide and support patients through all aspects of recovery, support and care for a range of primary symptoms. This, coupled with the HSE's planned service developments, will ensure that all necessary supports will be put in place.

I reiterate that those affected by long Covid will continue to be cared for through our health services. The Government and the Minister have committed to continued investment in ensuring a national service is in place. The service is evolving as international and national evidence becomes available to help us better understand the illness and its consequences. It will continue to evolve as needed to ensure those in need of care due to long Covid can access it. I again thank Deputies for raising this important issue. I was happy to come to the House and speak to it. As different statistics emerge, I believe we will deal with long Covid for some time to come.

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