Simon Harris (Wicklow, Fine Gael) | Oireachtas source

I did not mean the Leas-Chathaoirleach at all. I was responding to Senator Devine's comments. In response to her query, although the HSE's primary care steering group does not include a parent representative, as part of its ongoing work around paediatric home care packages it will hold two focus groups with parents in receipt of such packages in 2018. This will be a recurring annual process to make sure that parents' voices are heard. I am sure we can engage further on that matter if the Senator wishes.

I want to thank everybody for participating in this debate. It is important that I hear Members' views. I have heard them, and they very much align with the policy programme that I am pursuing in regard to reform and capacity in our health service. It is important for those working in our health service, and it is important for our citizens to hear also.

There are several positive aspects of the Irish heath service. I think it was Senator Murnane O'Connor who pointed out that our life expectancy is increasing in this country. Our survival rates from cancer, stroke and cardiac arrest are increasing. That is due to the Irish health service, the HSE, the people working in our health service, the policies being pursued by the Department of Health and the investment Government is making.

We hear a lot of chatter about health. We hear from people representing, people working in the health service, people like me and from commentators, and it is all very important. Often, we do not hear enough of the patient's voice. This is the first year in the history of the State that we carried out a national patient experience survey, where almost 14,000 people who had spent one night or more in an acute adult hospital actually gave their views on the health service. A total of 79% of them said that they had a good or very good experience in being admitted to the hospital while 85% of them categorised their overall experience in our hospital as good or very good. I absolutely accept that there are very serious challenges, but I also accept, and I think it is very important that we all accept, that many people who go in and out of our hospitals on a daily basis have a very good experience. That is also part of the Irish health service.

Senator Swanick raised a number of matters. I will not have time to go through everybody's issue, but I will address the issue of ehealth. I fully agree about ehealth as does Sláintecare. We are obviously in conversations about our capital budgets at the moment. I want to see ehealth as a very strong component. We need to move away from a situation whereby files are stored all over the health service, and towards an electronic health record that can actually help reform the health service and improve patient outcomes.

Modular units were referred to. This is something I am looking at as a temporary solution. I have already outlined that in South Tipperary General Hospital I have provided funding and approval for that. I expect that to be in place this year. We will provide 40 beds, and I have asked the HSE to see if we could do that in other hospital sites, which is the point Senator O'Donnell raised with me. This is not just about capacity. It concerns capacity plus reform. No Senator mentioned that some hospitals actually have fewer patients on trolleys in 2017 than in any other year since the Irish Nurses and Midwives Organisation, INMO, began counting. However, that is true. Why are some hospitals doing better? There are complex reasons, and every region and hospital is different, but it is not all about capacity. Every issue in the health service is not about writing another cheque. It also involves work practice and managerial grip. It involves asking why a diagnostic facility might be closed after 5 o'clock in the evening.It is about ensuring the hospitals are appropriately staffed by senior decision makers outside of what might be perceived as more regular or routine hours. It is a multifaceted issue of which resources and investment are part of the solution, but not the only part.

The issue of the GP contract as raised by Senator Colm Burke is a priority for 2018. Senator Burke is very passionate about the issue and I take his point in respect of nursing homes. I had the pleasure of speaking at the Nursing Homes Ireland conference at his request. As the Senator said, the issue of frailty and how we differentiate between older and other patients in terms of hospital admission needs consideration. We have started pilot projects to address that issue in several hospitals and need to do more in that regard.

Senators Kieran O'Donnell and Byrne raised issues relating to Limerick and I agree there is a capacity issue in University Hospital Limerick. Beds that were promised during the boom years were never delivered. We are going to deliver extra capacity. I also take the point in respect of St. John's Hospital. The 96 acute bed unit is under consideration but a capital planning process has to be gone through in that regard. We will consider the interim solutions that were mentioned. However, it is not just about capacity. We must consider why there are sometimes very few weekend discharges in that part of the country and whether more can be done in that regard.

I will directly revert to Senator Devine in respect of the beds situation in St. James's Hospital when I have a factual answer to her question. She is correct that there is much discussion of GPs, which is important, but that nursing has a very important role to play. I will soon be meeting the Irish Nurses and Midwives Organisation, INMO, to discuss several of the items the Senator highlighted.

As regards Letterkenny University Hospital and the 19 beds in the short-stay ward, I appreciate the point raised by Senator Mac Lochlainn. I will be looking at capacity across the wider health service and we will consider the issue in Letterkenny and Donegal along with the rest of the country. I take on board the points made by the Senator in that regard.

I thank Senator Grace O'Sullivan for her points. She wants to focus on solutions, as do I. The first solution on which I wish to focus is the reversing of failed policies, such as the decision during the boom years that we had too many hospital beds, leading to some being taken out of the health service. We need to put in more beds and couple that with reform.

I thank Senator Nash for his comments regarding Our Lady of Lourdes Hospital, Drogheda. I acknowledge his role and the work he carried out in that regard during his time in government. I had the pleasure of visiting the hospital not very long ago and noticed significant improvements that had been made by the staff and management team. Senator Nash made the point that the investment, together with the work of staff and management has made a difference. I accept that a significant amount remains to be done. I am not here today to make announcements about specific projects but I appreciate what the Senator said regarding the need for new theatres and critical care beds. If I were in his position, I would be asking the same questions. We are finalising our capital planning and I am aware of the need to do more in respect of Drogheda as well.

I have tried to respond to as many issues as I can-----