Elisha McCallion (Sinn Fein) | Oireachtas source

I welcome the Minister of State. She is here to present the plan but it is a little late in the year to be doing so. She is aware that Sinn Féin made proposals in August and there are many people wondering why months were allowed to elapse over the summer when this work could have been done. The plan has some good points but it appears that these are mostly aspirational rather than being part of an effective strategy. It lacks detail and, in some ways, it is a little underwhelming.

The plan is full of temporary measures. I am sure the Minister of State would agree that our health service has been in crisis for many years and that this plan needs to be about more permanent solutions, capacity and expansion. I am sure she agrees that we need beds but the announcements in this plan simply replace the capacity that existed before the Covid-19 pandemic. I am sure everyone agrees that we are heading towards a potentially catastrophic winter for our health service and that we desperately need greater bed capacity, particularly critical care and ICU beds.

It is somewhat a scandal that we are in the middle of this global pandemic with a health service that in any given year during winter is already bursting at its seams and yet we still only have half the number of critical care beds as compared to the European average. In 2009, there were 289 critical care beds and we were told then that we needed 579. Move forward 11 years and, in the middle of a global pandemic - the biggest health crisis this generation has faced - we have nine fewer critical care beds.

We also desperately need staff, including doctors, nurses, consultants, medical scientists and other health and social care professionals. Those people need investment. The plan does not go far enough in respect of any of that.

I welcome the ambitious targets for community beds but, again, there is a lack of detail. The broad suite of community and home supports is welcome but there is also a lack of detail in this regard.The plan does not go far enough to address outpatient waiting lists or funding to fully resume disability and mental health services.

Since the beginning of the pandemic, Sinn Féin has been calling for an all-Ireland approach to dealing with Covid. We do so not to make a political point but because it makes perfect sense when trying to deal with a virus such as this. It was very encouraging in the early days of the pandemic when we saw the signing of a memorandum of understanding between the two states. Unfortunately, however, there have been significant gaps in implementing it. There is, without a doubt, far more work that could be done.

I wish to raise a very serious and concerning situation which I have raised previously in the Chamber and with the Minister, Deputy Donnelly, and which my party has raised with the Northern Ireland Minister of Health, Mr. Robin Swann, and that is the serious concerns around the lack of cross-Border contact tracing. My party also raised this issue last week at the North-South Ministerial Council. However, I have been less than impressed with the length of time it has taken for this issue to be considered, let alone addressed, because, as far as I am aware, it still has not been fixed. Time is of the essence. It is no coincidence that the number of cases in Border constituencies are the highest on the island. People need to wake up and smell the coffee. We need to get this issue addressed now. What have the Minister, Deputy Donnelly, and the Northern Ireland health Minister, Mr. Swann, agreed in terms of a way to get the issue of contact tracing in Border constituencies addressed once and for all?

In the middle of the pandemic, with the worst winter that we will face in a long time to come, I am underwhelmed by the plan presented to the House. It is obvious that NPHET has concerns around bed capacity, and ICU capacity in particular. That is clear from the recommendations it made this week. However, much as the Minister of State's colleague, the Tánaiste, Deputy Varadkar, tried his best to portray otherwise, NPHET is not to blame for a broken health system that will struggle to cope if hospitalisations go up. That is on the Tánaiste and the Minister for Health, Deputy Donnelly, as well as the Government and previous Governments. If this plan is anything to go by, there is no political will to be part of the solution in the health crisis we all face. We had a broken health service before the virus. The problems did not stem from the virus but, rather, from decades of bad government, bad decisions and poorly equipped winter plans such as this one. I wish I could be more positive about the plan that has been announced.