Duncan Smith (Dublin Fingal, Labour) | Oireachtas source

I welcome the opportunity to debate this issue. It is a difficult one to discuss for a number of reasons. I found the Minister of State's opening statement to be helpful and very honest about the complexities in the epidemiology and the difficulty with calculating excess mortality. Those are very real difficulties and complexities. This issue was first introduced to many of us, including me, through online debates during the Covid pandemic, particularly in the misinformation wars in which excess mortality was weaponised as a phrase to target the Government, State and health service response to Covid-19. We could talk about that until the cows come home. Overall, however, the vaccination programme and the response at the time from our health service and front-line healthcare workers were a great source of pride.

Collectively, the country tried to do its very best. However, that is where I first came to realise the meaning of this term "excess mortality" on a regular basis and to dig down into it.

The data on excess deaths, as the Minister of State, Deputy Naughton, said in her statement, are difficult to calculate and to agree upon and there are huge sensitivities to them as well. When one is debating the different methodologies, it is not like debating methodologies in other parts of social science or anything like that. When one is dealing in relation to deaths, it cuts far deeper. There are huge sensitivities to it.

The accuracy of the data on excess deaths that come from EuroMOMO, as I said, are disputed, with Eurostat showing a 16% excess death rate in Ireland. However, the data have been partially collected from RIP.ie, which, as the Minister of State mentioned, do not include key information, such as the age of the person who has passed away or the cause of death. These are real pieces of information that are needed if one is to calculate excess mortality as it can be as a result of a number of things, including issues with the healthcare system. Where, I suppose, we want to get to if we are examining excess mortality is us asking whether we are experiencing high levels of excess mortality and whether that is due to a failure in the healthcare system or another failure in the State. We are not there yet in terms of being able to stand over any kind of methodology to rigorously examine that and the lack of accurate data tracking excess deaths is a concern because we need to get to a place where we are using these data to ensure that we are planning for the health service, we are planning for the HSE and we are planning resource allocation. Of course, in the past eight days we have been having a huge debate. We will have a big debate tomorrow, and rightly so, about resource allocation and funding for the health service. Ultimately, we want to fund the health service and it needs funding because sick people need to be made better and we have to avoid people who are very sick passing away. It is vitally important.

The lack of funding for the HSE in the coming year, as has been further copper-fastened, both yesterday and today, by the Minister for Public Expenditure, National Development Plan Delivery and Reform, who seems to be calling the shots here in a hard-headed and heavy-handed way, is an absolute disgrace. It will cause harm, as Mr. Bernard Gloster, the CEO of the HSE, says. I stated yesterday, in speaking with the press, that when one is causing harm with the health service that means sick people will get sicker and very sick people will die. That is the reality of it. As predicted by Mr. Gloster, if he is to try to protect accident and emergency and access to the healthcare system, the impact will be in the clinical strategies such as cancer strategies, diabetes strategies, sepsis, our biggest killer, and heart disease, another one of our biggest killers. These are the areas that will be impacted by the recruitment freeze and the lack of funding. This is the reality.

When we are measuring the impact of this in terms of the harm caused, we will need to be able to compute, rely on and have trust in any kind of excess mortality methodology. We are not there yet. Of course, the best way to decrease deaths and to not have excess mortality is to have a functional, properly-funded and resourced healthcare system. None of us in this House, including the Minister for Health, can say hand on heart, given this budget and given where we are and where we are going, that we have a functional, properly-funded and resourced healthcare system because it has been shown and demonstrated clearly over the past eight days that we will not have that in the next year.

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