Mary Butler (Waterford, Fianna Fail) | Oireachtas source

I thank Deputies across the House for their contributions to the debate. I wish to acknowledge the points raised regarding the challenges that our emergency departments are currently experiencing due to increased service demands. I also wish to acknowledge the invaluable work carried out by our health and social care workers in providing health services to patients. As we are here talking about challenges and the current issues affecting health services, I am conscious that all over the country tonight in our acute and community hospitals, nursing units, nursing homes and Caredoc services, nurses, doctors and healthcare workers are all working, and they will work through the night to make sure that our families and loved ones are looked after. That has to be acknowledged.

There are more than 135,000 people working in healthcare in this country. I am often conscious that when we come into the Dáil and speak about challenges, those people should be acknowledged because they are all doing the very best they can.

As Members have heard from the Minister for Health, it is clear that emergency departments are experiencing significantly increased demand. Attendances and admissions have both increased significantly above five-year averages. That is due to a combination of factors, including the circulation of RSV, flu, Covid and strep A.

To ensure that our acute and community services are supported this winter, the HSE winter plan for 2022-23 represents investment of up to €169 million and includes the recruitment of 51 emergency medicine consultants and associated support staff; full implementation of the safe staffing framework for adult emergency care settings; the recruitment of an additional 608 staff across the health service; increased community intervention teams, GP supports and out-of-hours services to reduce the need for attendances at EDs; increased community services for mental health, disability and palliative care; increased community and acute diagnostics; and expansion of ambulance services, including the introduction of nine pathfinder teams and deployment of rapid handover teams to improve ambulance turnaround times. In recognition of the volume and complexity of service demands EDs are experiencing, this winter plan adopts a bottom-up approach involving bespoke individual local plans that seek to address hospital-specific issues, in conjunction with community healthcare organisations.

The Government has delivered record funding to permanently increase capacity in our health service. There has been a significant increase in hospital bed capacity, with an additional 934 acute beds provided since 2020. An additional 82 beds were added to this plan over the course of the past two years. This includes 72 beds - 24 in Cork and 48 in the Mater - which were set out in the National Service Plan 2022, bringing the total number of beds due to open to 1,228. The winter plan has provided 934 non-ICU acute beds nationally to the hospital system over the number available on 1 January 2020.

Addressing the recruitment and retention of healthcare workers in Ireland continues to be a top priority for me as Minister of State, the Minister for Health and the Government. The total health service workforce in October 2022 was 136,092 people, which was 16,000 higher than at the beginning of 2020, representing the third highest annual growth in the workforce after the large increases achieved in 2020 and 2021. We have been working intensively to expand our recruitment capacity to ensure that ambitious workforce targets can be met and to maximise the numbers recruited. This has included the expansion of international recruitment markets, targeted recruitment campaigns and streamlined recruitment processes.

Quite a few Deputies mentioned the situation in respect of home care. Some 59,000 people received home care today. We have a waiting list of 6,200. Some 3,000 of those people are new entries on the list. Another 3,200 are people who receive home care but who might not receive the full package, especially at weekends. From January we will be recruiting outside the EU. The Minister of State, Deputy English, and I worked hard to secure 1,000 permits to encourage people outside the EU to come here and deliver home care.

The use of private capacity was also mentioned. It is true that when we recruit private companies to deliver home care the carers are paid €27 an hour. The new tender from the HSE will be in on 1 January. Included in that tender will be the provision that any of the organisations that recruit for us privately and that deliver the services will have to pay the living wage, which is currently €12.90, plus mileage. That will be written into the tender. I hope those three measures will make a significant difference. If we got even another 500 or 600 workers, it would make a significant difference to the waiting list and would have a profound effect then on the number of people in acute hospitals waiting to be transferred.

Increased efforts have been made to retain all staff, with attractive opportunities being offered for career development and progression as well as educational and development opportunities. We have already increased consultant numbers significantly but we recognise that consultant ratios remain low by international standards. The new contract will support further recruitment and retention. The HSE will also be focused on offering prospective consultants a variety of different work patterns, as mentioned in the Minister for Health's opening comments. The NCHD task force is focused on both immediate improvements in the NCHD experience and looking towards the future medical workforce. A priority area of the task force is to inform medical workforce planning and set the policy direction for the future configuration of the medical workforce. While it is important we continue to strive to improve the day-to-day experience of those delivering health services, we also need to address the challenges in our medical workforce configuration to protect future patient care and to build a sustainable clinical workforce.

Over recent years, the Department of Health has focused on supporting, strengthening and expanding the number of undergraduates and the education and training opportunities for the health workforce. The Minister for Health and I are committed to continuing to increase the number of training places into the future to ensure a sustainable workforce planning model for Ireland. We recognise that Ireland, like many other countries, is heavily reliant on international healthcare workers. We are seeking to significantly increase domestic supply of graduates across all healthcare disciplines.

By integrating general practice, primary care, community-based services and hospitals, through the enhanced community care programme, we will deliver end-to-end care, keeping people out of hospital and embracing a home first approach. People who receive home care more than likely also attend day care centres and receive meals on wheels. Those three elements together support people to age well at home. The momentum behind the enhanced community care programme recruitment and implementation is significant, with more than 2,400 staff already recruited, an achievement of 70% of the total 3,500 additional staff required.

Along with the Minister, I again thank Deputies across the House for their contributions. I reiterate the Government's commitment to improving our health service.

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