Dáil debates

Tuesday, 10 May 2022

Ceisteanna - Questions

Cabinet Committees

4:30 pm

Photo of Richard Boyd BarrettRichard Boyd Barrett (Dún Laoghaire, People Before Profit Alliance)
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8. To ask the Taoiseach when the Cabinet committee on health will next meet. [20604/22]

Photo of Paul MurphyPaul Murphy (Dublin South West, RISE)
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9. To ask the Taoiseach when the Cabinet committee on health will next meet. [20607/22]

Photo of Ivana BacikIvana Bacik (Dublin Bay South, Labour)
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10. To ask the Taoiseach when the Cabinet committee on health will next meet. [21060/22]

Photo of Cathal CroweCathal Crowe (Clare, Fianna Fail)
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11. To ask the Taoiseach when the Cabinet committee on health will next meet. [22933/22]

Photo of Mick BarryMick Barry (Cork North Central, Solidarity)
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12. To ask the Taoiseach when the Cabinet committee on health will next meet. [22945/22]

Photo of Gary GannonGary Gannon (Dublin Central, Social Democrats)
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13. To ask the Taoiseach when the Cabinet committee on health will next meet. [22980/22]

Photo of Micheál MartinMicheál Martin (Taoiseach, Department of An Taoiseach; Cork South Central, Fianna Fail)
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I propose to take Questions Nos. 8 to 13, inclusive, together.

The Cabinet committee on health oversees implementation of programme for Government commitments in health, receives detailed reports on identified policy areas and considers the implementation of health reforms, including Sláintecare. The Cabinet committee last met on Thursday, 28 April and is expected to meet again shortly. In addition to the meetings of the full Cabinet and of Cabinet committees, I meet with Ministers individually to focus on different issues. I meet regularly with the Minister for Health to discuss priorities in the area of health, including Sláintecare and the management of Covid-19.

In 2022, we will spend a record €21 billion on our health and social care services. This will allow us to reduce waiting lists, increase capacity, protect our most vulnerable, address inequalities and deliver the right care in the right place at the right time. Work is continuing to advance a number of priority programmes of work identified in the Sláintecare Implementation Strategy and Action Plan 2021-23, including progressing six new regional health areas, waiting list reduction and taking steps towards the establishment of elective care centres in Dublin, Cork and Galway.

The years 2020 and 2021 saw record increases in the health sector workforce, and a further 1,778 whole-time equivalents have been recruited to end March 2022. This growth in the workforce has enabled the delivery of services, including the establishment of 51 community health networks, 15 community specialist teams for older people, and four community specialist teams for chronic disease management. Some 21 community intervention teams are now operational with nationwide coverage. A total of 829 acute beds have opened since 1 January 2020. Baseline critical care capacity is now 305.

A range of accessibility and affordability measures are being progressed, including funding of €30 million for new medicines in budget 2022, with 24 new medicines or new uses of existing medicines approved to date this year. The drugs payment scheme monthly threshold was reduced from €114 to €100 on 1 January 2022 and was further reduced from €100 to €80 on 1 March 2022. I refer also to the abolition of public in-patient charges for children under 16, GP care without charges for six- and seven-year-olds, increases in the fees payable to contracted dentists for a number of items, including examinations and fillings, and the reintroduction of cleaning for medical card patients. A scheme for accessible contraception for women aged 17 to 25 is due to launch in August. We will continue our investment in an expanded public health service and embed the lessons learned throughout the pandemic into our health and social care services.

Photo of Richard Boyd BarrettRichard Boyd Barrett (Dún Laoghaire, People Before Profit Alliance)
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There are 2,000 medical scientists in this country. The Medical Laboratory Scientists Association, MLSA, is going on strike on Wednesday, 18 May, Tuesday, 24 May, and Tuesday, 31 May. The reason is that, way back in 2001, there was a report of the expert group on medical laboratory technician and technologist grades that recommended that medical laboratory scientists should be put on pay parity with clinical biochemists. Also, 20% of medical scientist posts in our hospitals are not filled. The MLSA has engaged with the HSE and the Department of Health through the Workplace Relations Commission. It got a ballot for industrial action, which was due to take place in March and early April. It deferred it because it wanted to try to find a resolution. All that has come to naught and it has no choice but to take industrial action.

The Department and the HSE should meet their demands, give them the parity that was recommended back in 2001 and fill those posts. They point out in their briefing on this that all the problems of CervicalCheck, which increased the demands on these laboratories, resulted in them warning way back in 2006 against the decision to outsource screening to American laboratories and that it would cause problems because we did not have the capacity or the ability to retain laboratory scientists. These matters have very serious implications. I urge the Government to meet the demands of the medical laboratory scientists.

Photo of Paul MurphyPaul Murphy (Dublin South West, RISE)
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I want to raise with the Taoiseach the very serious issue of long Covid, which I fear will be a pressing issue for our health service and our society in the coming years. Figures suggest that, worldwide, well over 10% of people who get Covid suffer some form of long Covid, and that a minority of them suffer a very severe form of long Covid that can continue for many months and even potentially years, with quite severe symptoms. I met a man, for example, in campaigning to save the Tallaght long Covid clinic, which was thankfully saved, called Pete Brennan, who was suffering from very severe fatigue, memory loss and shortness of breath. It was having a massive impact on his life. There are many other people similarly affected. We are going to need to invest in long Covid clinics throughout the country.

A month ago, I asked the Minister for Health through a parliamentary question how many people in Ireland have long Covid. The question was referred to the HSE which answered that it does not currently hold information centrally on the numbers of patients affected by long Covid. I found it quite astounding. We cannot manage what we do not measure. If we do not know how many people have long Covid, how does the State know where to put the resources, how much resources to put in and so on? It does not make any sense. Does the Taoiseach agree that we need to start collecting those data centrally?

Photo of Ivana BacikIvana Bacik (Dublin Bay South, Labour)
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I would like to raise the issue of the long delays in the roll-out of free GP care for children. In 2015, funding was secured for the extension of free GP care to all children under 12 but this was not rolled out. Again in 2020, the then Minister, Deputy Harris, announced free GP care for children aged 12 and under on a phased basis, with six- and seven-year-olds first. In the most recent budget, the current Minister for Health, Deputy Donnelly, confirmed again that funding would be put in place for the extension of free GP care to six- and seven-year-olds.

We are being told that consultations are under way with the IMO on the introduction of this service. While parents and households generally are in the middle of a cost-of-living crisis, with costs rising for all sorts of basic services, food, rent and fuel, it is long past time for us to see the roll-out of free GP care, at least with the cohort of children in question. It should be rolled out for all children thereafter. Can the Taoiseach give us the date on which this will actually happen? It is now approaching seven years since funding was first put in place for the extension and there does not seem to be any credible excuse for further delays, particularly when there is a cost-of-living crisis and when Ireland is the only country in western Europe without such free care.

4:40 pm

Photo of Cathal CroweCathal Crowe (Clare, Fianna Fail)
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With regard to the health aspect of this agenda, I wish to raise the incessant overcrowding and trolley usage at University Hospital Limerick, UHL, week in, week out. There is yet another inquiry, and I expect its outcome will again indicate that far too many people are funnelled through the same hospital system. When the Minister for Health, Deputy Stephen Donnelly, visited the hospital on 17 February last, he stated UHL was doing too much heavy lifting in the mid-west. Surely, the answer to this is not just within the curtilage of UHL; the solution to the healthcare crisis in the mid-west lies with Ennis, Nenagh and St. John’s hospitals. These hospitals need to have the capacity to discharge out of hours. I am aware of a scenario in which a patient who was feeling quite well, and whom the nurses said was feeling quite well, on a Friday evening could not be discharged until Monday. That is bed blocking. It is blocking by policy and the mechanics of the hospital institution. We need to have the capacity to let people go home, if they are well enough to do so, on an out-of-hours basis.

Photo of Mick BarryMick Barry (Cork North Central, Solidarity)
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Last week, more than 200 parents marched down St. Patrick's Street in Cork chanting, "We are marching through our town 'cos Micheál Martin let us down." They were parents of children with disabilities who are not getting access to disability services, particularly in the schools. Under pressure from the parents’ campaign, the Minister of State responsible for disabilities, Deputy Rabbitte, has committed to restoring therapist allocations to Cork special schools to pre-pandemic levels. According to school principals, this equates to 60 therapists. The Minister of State told The Echothat the HSE could validate the allocations in less than two months. Does the Taoiseach understand that the parents are now watching for action on that promise like hawks and that the failure to deliver on it will inevitably — and shockingly, because it should not have to happen — lead to an escalation of their campaign? Will he act on this issue now?

Photo of Micheál MartinMicheál Martin (Taoiseach, Department of An Taoiseach; Cork South Central, Fianna Fail)
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I believe Deputy Boyd Barrett was the first to contribute on this group of questions, and he raised the issue of medical laboratory scientists. There are a number of labour relations mechanisms to deal with outstanding issues related to industrial relations pay claims and pay and conditions. It is not an issue that gets resolved in the Dáil Chamber. I appeal to both sides to engage with a view to resolving it. From experience, I believe these are never simple issues. There is always the potential for relativities to be involved in addition to other factors and implications; that said, it is an issue that we want and need to have resolved. I appeal to people on all sides to get around the table at the appropriate forum, avoid strike action and resolve the issues.

On Deputy Paul Murphy’s comments on long Covid, he made a fair point that the information is not held centrally, although we have to bear in mind the intense pressure on health services during Covid and, even worse, after it, because as it receded many people presented with a range of conditions and were affected by delayed diagnosis. There has been a lot of pressure on emergency departments but also on basic services since the ending of the emergency phase of the pandemic. We need a clear focus on long Covid in time to get a central register of people who have the condition, because that would inform better practice and protocols on its treatment and also enable more informed allocation of resources to the health service and a better focus. I will engage with the Minister for Health on this.

Deputy Bacik raised the issue of the roll-out of free GP care. I do not believe funding was provided in 2017; I think the policy was announced then. Negotiations and discussions are ongoing or beginning with the IMO in respect of the extension to six- and seven-year-olds. We need to change the way we announce and deal with this because it becomes an annual negotiation once it is announced at budget time. Very often, the leverage of the State or taxpayer in the negotiations is weakened by the prior announcement. There needs to be common sense and perspective regarding this among all parties. In our view, we want to increase eligibility. There has been very significant engagement with GPs throughout Covid, and there was a beneficial co-operative agreement, but essential additional resources were provided as well. It is in that context that I hope we can get the six- to seven-year-olds dealt with relatively quickly and then assess how to deal with our collective aspiration to increase universal access to GP care, in particular.

Deputy Crowe raised the issue of University Hospital Limerick. There is no doubt that it has been the scene of far too much overcrowding. Notwithstanding the very significant investment in the hospital in recent times, the Minister has sent down a specialist team to determine how the hospital can develop an optimal model for governance and dealing with the issues and the pressure on it. In the medium term, there is a need for more inpatient beds and capacity in the hospital group covering the region. The hospitals in the group, namely Ennis, Nenagh and St. John’s, have a role to play in alleviating the pressure. Sometimes that means some hospitals must take on specific roles or develop additional services that do not need to be provided in the tertiary hospital. The Beaumont group of hospitals comprises a good example of how services are spread. However, there are particular pressure points in Limerick that have to be acknowledged.

Deputy Barry raised the issue of disability services. Progressing Disability Services took therapists out of the special schools. More latterly, that has been alerted to the public representatives in terms of the diminution of provision within the special schools themselves. The figure of 60 therapists, which the Deputy mentioned, is not one I have heard from the Minister of State, Deputy Rabbitte, or the HSE-----

Photo of Mick BarryMick Barry (Cork North Central, Solidarity)
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School principals have raised this.

Photo of Micheál MartinMicheál Martin (Taoiseach, Department of An Taoiseach; Cork South Central, Fianna Fail)
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The Minister of State has met the school principals. There was a meeting with them recently in Limerick. It depends on how long one goes back. The programme for progressing disability services has been going on for ten years. I raised it with the disability organisations seven or eight years ago. Not too many of them raised this with the HSE at the time. Those are the facts. However, the matter has to be dealt with now. I am certainly keen to deal with it to make sure we can help special schools in the first instance with multidisciplinary teams and the provision of therapists.