Róisín Shortall (Dublin North West, Social Democrats) | Oireachtas source

From the outset, I have to say that I wonder about the motivation behind this debate. I also want to note that some of the people who were loudest in calling for this debate are not present in the Chamber for it at this point. One only has to do a cursory search of excess deaths on social media to find any number of conspiracy theories and anti-vaccine content. I am not by any means saying we should ignore the statistics for excess mortality because they are important but we should question the framing of this data by some, along with the reliability of some of the sources. When it comes to excess mortality, the two most commonly referenced sources are Eurostat and EuroMOMO. However, as Professor Anthony Staines recently pointed out, their findings and data sources are very different. For example, Eurostat, which collects data from rip.ie, has repeatedly reported high excess death rates in Ireland. For August, it reported excess deaths of 21.1%, the highest in Europe. EuroMOMO, in which the Health Protection Surveillance Centre, HPSC, participates, found that Ireland has been in the normal range, with no substantial increases in mortality since March. One issue with Eurostat is the methodology. It compares the number of people who died in a given period with a historical baseline, in this case, 2016 to 2019. This does not take account of rapid demographic changes or a population ageing faster than anywhere else in Europe. When we interpret this data, particularly around winter, we must also be cognisant of waves of Covid, flu and other respiratory illnesses. In respect of Covid and the first three months of the year, there were 307 deaths as a result of the virus. That is about 13 people a week. Between October 2022 and March 2023, influenza infection led to 170 deaths.

Another factor which must be considered when looking at the winter figures is hospital overcrowding. Analysis of HSE data by the Irish Patients' Association, IPA, found that more than 1,200 patients died last winter as a result of delays in hospital admissions. When this figure was put to Fergal Hickey of the Irish Association of Emergency Medicine, IAEM, he said these estimates were "probably conservative". Addressing these avoidable deaths must be a key priority for the health service as we enter the winter months this year. Nonetheless, I do not believe that there is evidence of any hidden or sinister reason for excess deaths in winter, aside from our health system's predictable, yet unacceptable, inability to deal with winter surges.

Unfortunately, it is difficult to envisage any improvement this year when the Government continues to underfund the health service relative to demand. It is almost as if this Government is oblivious to the changes in demographics and the impact of inflation and has given up on reforming our health service. Much of the additional funding required this year was to maintain the momentum and keep the progress going of the implementation of the reform programme, Sláintecare. The question must be asked, where does this stand now, given that funding falls so far short of what is needed. For example, what happened to reviewing our model of elder care? In April 2020, the then Minister for Health, Deputy Harris, said that the current model was not fit for purpose and that a serious conversation about elder care would be required after the pandemic. We are still waiting for that serious conversation. I accept that the commission on care is due to begin its work next year but it is still not clear if it will examine the increasing privatisation of older persons' services. This is key to the model of care. A month after the comments of the former Minister, Deputy Harris, the Taoiseach also said we needed to consider alternatives to nursing homes such as "more and better home care". Yet, we know with the home care budget provided this year and the allocation, which was due to be almost 24 million hours, is being cut back in order to meet commitments to pay staff properly. Older people needing home care are paying the price for what we should have been doing anyway, which is putting homecare workers on a proper financial footing concerning their pay and conditions.

It is extremely disappointing that those improvements in pay come within the same envelope and that older people will pay the price for that. It is very disappointing, not least following the downward revision concerning the loss of almost 2 million hours and, in addition to that, the considerable number of people on waiting lists. Why has there still been no movement on the statutory right to home care five years after the commitment to introduce a statutory scheme? We still do not even have the heads of a Bill. If we were serious about this and committed to introducing a new model of care, we would put much more energy, time and effort into ensuring that long-standing commitment was delivered upon. Unfortunately, it looks to be some way off still.

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