Hildegarde Naughton (Galway West, Fine Gael) | Oireachtas source

The planning, management and allocation of health resources has been particularly challenging over the last year, due to the arrival in Ireland of over 80,000 refugees in 2022, the majority of whom are from Ukraine. Refugees arriving in Ireland have different health needs from the rest of the population. Furthermore, being a refugee is a social determinant of health, which is associated with considerable trauma and vulnerability. We need to recognise that refugees and migrants are a population group that has to be catered for in line with the Sláintecare reform programme and the HSE national intercultural health strategy.

The HSE national intercultural health strategy provides a comprehensive and integrated approach to addressing the many unique health and support needs experienced by refugees and other migrant groups. To address the distinct health needs of refugees, the Department of Health works closely with the HSE's national Ukraine health response planning and co-ordination group to plan, co-ordinate and support the delivery of healthcare services for the growing refugee population. Delivery of health services to incoming Ukrainian refugees and international protection applicants has necessitated the rapid mobilisation of dedicated staffing and services which heretofore did not exist. In this context, the HSE has developed an integrated refugee health service delivery model to provide healthcare services for refugees. The model includes a health assessment model for Ukrainian refugees in the national transit centre in Citywest, which identifies individual health needs.

The HSE has established area crisis management teams in all community healthcare areas, which complement existing community services. The crisis management teams are co-ordinating with local service responses and they work closely with the community response forums to co-ordinate interagency services at the local level. Community healthcare services include multidisciplinary teams that are providing in-reach services to assess urgent health needs and are referring refugees to the appropriate services. The teams conduct risk assessments on Covid and other health issues, including infectious diseases.

GP capacity to deliver services to the arriving refugee population remains a significant issue. There is a finite resource of GPs and capacity challenges already existed prior to the arrival of refugees from Ukraine. The accommodation model that is being used to house refugees adds to the increasingly challenged capacity. The uneven geographic spread of refugees, which is concentrated in communities along the Atlantic coast, is causing a significant strain on GP capacity in many areas. There are more than 1,100 dispersed facilities accommodating Ukrainians and other refugees across the country. Demand for GP services among the refugee population is surpassing the demand from the existing population. The HSE, in conjunction with the Irish Medical Organisation, IMO, has prepared bespoke options to deliver GP services to refugees accommodated in hotels and other temporary settings. The exact model varies depending on the number and geographical distribution. However, all have access to GP out-of-hours services. Temporary sessional GP clinics are provided on a weekly basis to deliver regular services, increasing the number of sessional clinics across the country to 40 per week. This is a HSE priority for 2023.

Another HSE priority is providing vaccinations and immunisations to refugee populations. All refugees have access to Covid-19 vaccinations. They can be requested from their chosen GP or pharmacist and accessed through the HSE vaccination centres. All community healthcare organisations, CHOs, are advising on how to access vaccination services, while on-site clinics have been provided in a number of settings. However, the uptake of vaccinations in migrant populations is low. The risk of spread of airborne diseases is greater for beneficiaries of temporary protection and international protection applicants due to the congregated living arrangements. To mitigate these risks, the HSE established a catch-up immunisation programme for migrant children and young adults. The roll-out of the catch-up programme is under way and will have commenced in all CHOs before the end of February. In addition, targeted public health communications are delivered to refugee populations, advising them of how to keep themselves or their families safe from respiratory illnesses across the winter period and how to access Covid and flu vaccinations. The "keep well in winter" message resources are available on the Health Protection and Surveillance Centre website. As I am conscious that I am sharing my time with Deputy Troy, I will let him in.

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