Keith Swanick (Fianna Fail) | Oireachtas source

I dtús báire cuirim fáilte roimh an Aire Stáit, an Teachta Jim Daly, as bheith anseo inniu. Ba mhaith liom labhairt faoin seirbhís sláinte. Tá cúpla ceisteanna simplí agam. Dhá seachtain ó shin bhí scéal dochreidte sa Sunday Business Post. People were rightly shocked to see the headline "Life or Death: Top doctors say life support now being 'rationed' " in a newspaper at the weekend. The relevant story by Susan Mitchell, which was published in The Sunday Business Post, goes on to state that doctors were forced to make "tough decisions" and prioritise some critically ill patients. It is clearly stated in the article that the crisis stems from a shortage of intensive care beds in hospitals.

I preface my concerns about the problems relating to the intensive care units by stating that the vast majority of people who use the public health system have extremely positive experiences. Let us look at what has been said about the intensive care unit, ICU care. Dr. Tom Ryan, a consultant in intensive care and anesthesia in St. James's Hospital is president of the Irish Hospital Consultants Association, IHCA. Two weeks ago, Dr. Ryan noted that we are effectively rationing life support. Dr. Ryan is a senior medical professional who knows what he is speaking about. Dr. Emily O'Connor is President of the Irish Association of Emergency Medicine and a consultant in emergency medicine in Connolly Hospital Blanchardstown. She stated that doctors were having to make "tough decisions about which critically ill patients to prioritise.". I could quote from members of the Irish Nurses and Midwives Organisation, INMO, SIPTU and other unions who are on the front line in intensive care units. The Irish Medical Organisation, IMO, and the Royal College of Surgeons in Ireland have repeatedly warned about cuts in bed capacity and the impact on patient safety. What do unnecessary risks or tough decisions actually mean?The absence of a post-operative bed in an intensive care unit, ICU, means that critical life-saving surgery is delayed, deferred or - God forbid - cancelled. No doctor ever wants to be in this position. It runs contrary to our Hippocratic oath, contrary to the guidelines of the Medical Council, and contrary to the reasons many of us decided to get into medicine and health care. Doctors routinely have to sit down with family members and loved ones and say that in their professional opinion, having reviewed and assessed all of the options, the likelihood of survival is slim. Some of us have to give this bad news thousands of time in our professional lives. I can remember the first time I had such a conversation. I assure the Minister of State that it never gets easier. I never thought that one of these reasons might be that an ICU bed was not available.

In 2018 we were told by the Government that we were the richest in Europe and had the fastest growing economy in the eurozone. There is something profoundly sick about the fact that ICU beds are being rationed. This is why the type of problems being experienced within ICUs is so alarming. The failure to provide emergency surgery because of the absence of an ICU bed is nothing short of a national scandal. There can be no surprise that there is a shortage of ICU beds. It was highlighted for the HSE in 2009, but cuts of €576 million have been made to the capital budget for acute hospital care in the last ten years. What makes it worse in the case of ICUs is that it directly impacts upon serious elective surgery, such as procedures for treating cancer, and hinders doctors from escalating really medically sick patients, for example a patient with pneumonia, from the medical ward into an ICU bed.

Knowing what I know and speaking to people on the front line I can only conclude that the medical outcomes of people have been compromised and that people are dying as a result. This is a very serious thing to say but it is unfortunately the case. People are dying as a result of the absence of ICU beds.