Michael Healy-Rae (Kerry, Independent)
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I thank the Ceann Comhairle and his office for selecting this matter. I also thank the Minister of State, Deputy Feighan, for being here, but I must ask where the Minister for Health, Deputy Stephen Donnelly, is. Where is he and could he please come out? He came to County Kerry like a thief in the night. He stood in for a couple of quick pictures and then disappeared. He did nothing for University Hospital Kerry, UHK, when he came and did nothing for it when he left.

Why is it acceptable in Ireland that if a cow, a bullock or a dog has an injury, it can be quite safe to assume that, within two hours, a vet, a qualified person, will be giving care to that animal and providing treatment, and rightly so? Why does it seem acceptable in the Ireland of today that older people can break hips or sustain other fractures or that children can suffer injuries and have to go to accident and emergency departments, but that they might not be seen that day, never mind within the hour? It could be the following morning or the day after that they would be seen. Why have we come to this state of affairs in respect of healthcare? It is not an exaggeration to say that the family pet can get quicker and more immediate healthcare treatment than a grandparent, a mother, a father, a son or a daughter. This is not acceptable and it is not right.

In his absence, I would like to direct a question to the Minister for Health. I thank the Minister of State, and I respect him very much, as he knows I do, but he will see why I am pointing out these facts. Yesterday, the Minister was notified that University Hospital Kerry was going to be discussed on the floor of Dáil Éireann. He failed to turn up here today to answer questions, but he has failed to turn up for that hospital since he became a Minister. Therefore, I am not surprised that he is not here, because he is not interested in his portfolio. He is not interested in our hospital. He is not interested in our community hospitals. He is not interested in the GP network that is crumbling in County Kerry because we cannot recruit staff. I wish to raise these issues with the Minister.

We need a recruitment drive for nurses and incentives for them to come back to work in County Kerry. I would like to ask the Minister why it was that 16 were waiting for beds last night and why was there no capacity in the relevant department. Why was it the case yesterday that there was no orthopaedic bed for a person who fractured his or her hip in County Kerry? It has been proven that a direct result and consequence of prolonged trolley waits is an increase in mortality and morbidity rates, and, consequently, also longer average lengths of stay in hospital. We need more GP access in County Kerry to try to steer people away from having to go to our accident and emergency department. We need two new candidate advanced nurse practitioners as a matter of urgency. We need a new acute floor model and surgical assessment system in County Kerry. We need to advertise for two new consultant microbiologists, posts in which there seems to be no interest in at present. What is the plan for new management in our university hospital in County Kerry if the current management regime is changing?

Turning to our ambulance service, the men and women there provide an excellent service and do their jobs to the best of their ability, but we need more ambulances in County Kerry because of the geography and size of the county. We seem to be relying more and more on private ambulances and taxis. This is not the proper way to run a healthcare service. Again, we need to incentivise the recruitment of nurses and of other staff for our hospital. I appreciate so much the maintenance people, the catering people, the nurses on the wards and all the people who diligently go about their work. Shame, shame, shame on the Minister for not turning up for our hospital and for not turning up here today.

Catherine Connolly (Galway West, Independent)
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Regarding personal comments and robust debate, I do not know why the Minister is not here.

Michael Healy-Rae (Kerry, Independent)
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Because he is both ashamed and a disgrace.

Catherine Connolly (Galway West, Independent)
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I do not know why he is not here, but we will avoid personal comments.

Michael Healy-Rae (Kerry, Independent)
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Tell that to the people waiting in-----

Catherine Connolly (Galway West, Independent)
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I am sorry, we are over time. I call the Minister of State.

Frank Feighan (Sligo-Leitrim, Fine Gael)
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I thank Deputy Healy-Rae, on behalf of the Minister, Deputy Stephen Donnelly, for the opportunity to update the House on this very important matter.

First, I want to acknowledge the hard work and commitment of the staff of University Hospital Kerry, UHK, in the provision of services during the Covid-19 emergency and in managing many difficult cases presenting in very challenging circumstances. These challenges have continued to hamper UHK’s efforts to provide safe, timely and effective care for its patients. At certain periods, elective surgeries have had to be cancelled, high numbers of patients have been recorded on trolleys and staff shortages have been ongoing.

Direct action has been taken since September to address these issues. As an immediate response, the South/South West Hospital Group interim chief operations officer has been onsite at the hospital directly supporting management and clinicians, initially on a two days a week commitment. This process has focused on identifying delays as well as solutions within UHK patient flow streams. Furthermore, the HSE has confirmed that the South/South West Hospital Group management team are also providing support to the various members of the UHK management team on an ongoing basis. The national director for acute operations and members of the South/South West Hospital Group management team also met with the executive management board of UHK, clinical directors, representatives of the consultant group and other key stakeholders in November 2021 in UHK to discuss the challenges facing the hospital.

A HSE review team was established comprising members from HSE acute operations, the special delivery unit, the national integrated care programme for older persons and representatives from the South/South West Hospital Group, and it has been asked to report on its findings. As part of its work, the HSE review team was on site in UHK and engaged with stakeholders in the hospital. I am pleased to confirm that the report, which is to set out the priorities and related critical dependencies, has been completed and its recommendations are being considered at a local level.

Two further measures being undertaken by the South/South West Hospital Group are also worth noting at this point. First, a health planning process, which is being overseen by a steering group comprising key stakeholders, is nearing completion. This report examines current and future infrastructural capacity requirements over the next 15 years and will align future investment with evidence of demand factors. Second, the South/South West Hospital Group has also engaged the expertise of an external consultancy group to assist with the development of a strategic plan. All staff have had the opportunity to have their say and I look forward to watching these developments.

The Deputy also raised several other issues and I will bring them back directly to the Minister today.

Michael Healy-Rae (Kerry, Independent)
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I thank the Minister of State. I again ask what the Minister has done for the hospital since the day of his visit, when he came to stand for silly, stupid picture. What actions has he taken to improve the situation for people in accident and emergency? I will ask and ask until this stops. Why is it acceptable for people to say to a person who has gone to accident and emergency: “How many hours or days were you there waiting to be admitted?” That is wrong. That is not the fault of the staff who work so diligently and hard, late into the night and in the early morning, and who are worn to a thread from trying their best. Management is the problem. HSE management is the problem. The Minister is the problem. If University Hospital Kerry was a private company and he was the CEO, he would have been sacked long ago and he would be gone down the road with a P45 in his pocket having been told “We no longer require your services.” If you are not fit for a job, if you are not fit for purpose, you should move left and get off the stage because you are either able to do your function, you are either able to do your job, or you are not.

Again, when the vets of County Kerry can give more direct and immediate attention to animals than we can give to people, something has to stop. The buck stops with the Government. It does not stop with a nurse or a doctor. It is the people in charge. The taxpayers of Ireland are putting so much money into the healthcare service and it is failing despite this.

I again highlight the fact that we need to encourage more GPs into our rural communities. We need more ambulances, more nurses, more help and we need a positive recruitment campaign. However, if someone was a young nurse in England or Australia, when they hear what is happening in University Hospital Kerry, why would they want to come there? How could it be attractive for them? It is a shame and a disgrace to think that this Topical Issue debate went on today in the absence of the Minister for Health. Shame on him. He is leaving the people of County Kerry down.

Frank Feighan (Sligo-Leitrim, Fine Gael)
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I again thank the Deputy for raising this issue. I want to reassure the Deputy that the Health Service Executive has confirmed that every effort is being taken to support, stabilise and urgently address identified risks at the hospital. To provide that reassurance, a number of actions have been taken by the South/South West Hospital Group and the group's interim chief operations officer has been onsite at the hospital, as I said, directly supporting management and clinicians on a two days a week basis. A HSE review team has been established to identify priorities and related critical dependencies, as well as to provide recommendations to be considered at a local level. The hospital group, in conjunction with HSE Estates, has also commissioned a planning process to strategically examine current and future infrastructural capacity requirements. The HSE is committed to strengthening the governance, leadership and management arrangement at UHK and it is confident that implementing the findings from the review team, as well as new actions, such as initiating a health planning process, will all help to provide the necessary direction and supports required.

There have been huge challenges since the Covid-19 pandemic. I again thank the hard-working and committed staff of UHK and all staff around the country for the provision of services during the Covid-19 pandemic. I hope the findings of this review team that was established comprising all of the various stakeholders will be addressed.