Seán Sherlock (Cork East, Labour) | Oireachtas source

I welcome the motion, which we support. I also acknowledge the bona fides of the Ministers opposite in trying to fix a perennial problem. I read the Minister's speech carefully but feel that there is much more that can be done to increase capacity.

The Minister refers to the investment in diagnostics and primary care in particular. It is all well and good to state that the HSE has added 90 additional primary care teams in the country but there is still an issue in that people in the constituency I represent cannot get to the GP in the first instance. The diagnostic piece does not, therefore, arise. I am told by my constituents in the town of Mitchelstown, where we have an excellent primary care centre, that they are waiting up to two or three weeks - four weeks in one instance - to see or interact with a GP in a primary care centre. I am not here to criticise GPs. They are absolutely snowed under. We know that. However, with all due respect to the Minister, until such time as people can get access to the GP in the first instance, the issue of diagnostics is moot. I need to know how we are going to fix that. That is the problem that I need to see fixed. We know what the latent effect of people not getting access to basic GP services in the first instance is. It just heaps up a pile of problems for the long term. If there is no access to diagnostics, it just shores up a pile of problems down the line. I need answers to the questions I have in respect of Mitchelstown. The situation is similar in Mallow. It is not just Mitchelstown and Mallow, but every town in the country. Why is it that people now have to wait so long to get access to the GP? I do not blame GPs. We are very quick to blame. We need to blame somebody for problems. However, where is the solution to those problems?

As a local Deputy, I, for one, have done a lot of work with some of the GP practices in my area to try to assist them with visas for GPs coming in from third countries or from outside the European Union. We have had some measure of success there. Many people are now emigrating and taking up job opportunities elsewhere. If the Government and the HSE were to take a proactive approach to recruiting from across the globe - there is precedent for this and it is being done day in and day out - we could bring in GPs from other countries, which would help alleviate the problems in places like Mitchelstown and Mallow. That is one possible solution.

With regard to out-of-hours services, throughout the Christmas period, we all received calls from people who could not get access to services such as that in my area, SouthDoc. SouthDoc is an excellent service. Once you get in the door and are seen, it is the best service in the world but there is the question of getting that initial access. I know of some very acute cases that arose over the Christmas period in particular. I do not have a degree in medicine and am not qualified to diagnose but, if I am contacted by an anxious parent who is seeking access to the service for a three-year-old, who has been waiting six, seven, eight, nine or ten hours for a call back from the out-of-hours service and who does not want to go to the emergency department because they are petrified of going to Cork University Hospital, CUH, we have a serious structural problem. Is that also about the supply of GPs? Can we get more GPs? The Minister will say that SouthDoc, Westdoc or the service in whatever part of the country one might be from operates on a co-operative basis but the HSE and the taxpayer are also big funders of these services. We have skin in the game and, as such, I am sure that we have influence at a ministerial level over how these services operate. All I want for my constituents is access to a GP when they need it because, once someone gets in the door of a primary care centre and gets access to a GP, a lot of triage can be done, reducing the need for people to present to the accident and emergency department in CUH.

Do not get me started on CUH. I was there with somebody recently and saw the ambulances backed up and the lack of beds. That is again a structural problem but it did not just arise because of RSV or Covid because the trolley numbers are now up in the months of June and July as well. There is evidence for that. It is a year-round thing. When you look at the faces of healthcare professionals, which the Minister has seen, including nurses, doctors, attendants and people working on the floors, you see that they are all stressed out to the hilt. That is not sustainable. I genuinely worry for the health of our healthcare professionals at the moment. I genuinely worry that many of them are now saying they have had enough, they cannot take any more and they are out. It is hard to blame them. We need to try to alleviate the pressure.

There is another way of alleviating the pressure. Level 2 hospitals are an untapped resource. Take Mallow General Hospital for example. The Minister spoke to issues around capital expenditure and turning bricks and mortar into wards. We have a 42-bed unit in Mallow General Hospital that is all but built.

The hospital is operating excellently. It provides a great deal of elective care for people. It is excellent in diagnostics. Many people could be triaged on an out-of-hours basis and directed into hospitals like Mallow General Hospital. I ask the Minister to fast-track the 42-bed unit. We would get it up and running for the Minister. We would take people out of Cork University Hospital, CUH, and move them into Mallow General Hospital, as well as places like Ennis and Nenagh hospitals and other hospitals. The excellent staff on the ground will do what the Minister has spoken about in terms of delivering the healthcare we need. That would alleviate the pressure on CUH and this can be done now. The bricks and mortar are there. I invite the Minister to visit Mallow to take a look at it for himself. It is an excellent hospital.

The writing was on the wall for the accident and emergency department a long time ago. We did a lot of work in respect of building out endoscopy suites, medical assessment units, a local injuries unit, an urgent care centre, etc. We now have a 42-bed unit and if the Minister will give us the money to put beds into it, we will do the business for him. That is what we want to do in Mallow. This would take a great deal of pressure, from a regional perspective, off tertiary care centres like CUH. It will not only serve the people of Mallow but also those in Tipperary, Limerick, Waterford and the whole catchment area. If we look at Mallow on the map, we will see it is right in the heart of Munster. This is what we are talking about in terms of solutions. The Minister has the capability, wherewithal and means to do this because he is the Minister. If he could take a look at Mallow General Hospital specifically, we could do a job of work there.

We also need to talk about ambulance care. We are all deeply worried about people who work in the ambulance services. They are stressed out as well. They are being asked to do double shifts and take on extra work. I fear for their health and safety. In the not-too-distant past, we had a case where somebody going home from doing a shift crashed because they were just absolutely wrecked tired, to use my local parlance and to speak in the vernacular. We just cannot have that. People need to have adequate rest between shifts. We cannot have a situation where we are trying to squeeze more and more hours of healthcare professionals because at some stage it becomes dangerous for them and the people they are treating. I ask the Minister to take a look at this aspect.

In the few seconds I have left, I will speak about pharmacies, which are yet another untapped resource. Community pharmacies have tremendous capacity to deliver, if they could be built out to deliver more at the community level. If I am not mistaken, the Minister may be doing some work in this area already. I ask him to fast-track that. Pharmacists are excellent. They provide excellent advice to people in their communities daily and they could do much more if they were given the training and resources. Increased capacity will require resources. I think the Minister is saying there is a budget of €23 billion. What we are seeking for the few small things I have mentioned would not be big money at all. The Minister could do it.

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