Alice-Mary Higgins (Independent) | Oireachtas source

I warmly welcome the Minister of State to the House. In her previous term in the Oireachtas, she showed real and genuine commitment to health, and mental health in particular. I was delighted to see her take up her current role.

When we started discussing these issues in March, April and May, much of the focus was on flattening the curve. I remember thinking about how I could be of assistance. I decided that as lots of people were focusing on flattening the curve, I would focus on the issue of what we do with the time we are buying. Let us be clear that flattening the curve is only the buying of time in order to increase and support capacity. I am concerned that the time gained by flattening the curve has not been well used.

It seems to me that the lowering of the level was seen as a lessening of pressure. We know that some of the social supports which I believe should have been beefed up were removed or eroded and that we did not see the scaling up that was needed in terms of ICU care. Pre-Covid, bed capacity in ICU was 225. The temporary surge capacity was approximately 350 and now our permanent capacity is just 280. A move from 225 ICU beds to just over 280 beds is not an adequate response.

One of the issues on which I focused at the time was ventilators. As the Minister of State will know, certain companies in Galway were among the key global manufacturers in terms of ventilators. They have shown great responsibility by sharing and open-sourcing some of their plans. In March, the HSE ordered 900 new ventilators.It is not clear whether they have arrived. Where are they in the system? Are they in high-dependency units, HDUs, or ICUs? Intensive care and high-dependency units do not simply comprise ventilators - there are also ICU staff.

I echo others' concerns about the failure to drive recruitment. We should never be in a situation of people walking away because they feel that they are not valued or being offered meaningful contracts in respect of their work. For example, we want to ensure that student nurses do not leave our health system because they feel undervalued through not being paid properly.

I am concerned about ICU capacity. Were other staff retrained to acquire ICU skills? It has a specific set of skills. The Minister of State referred to increasing home care hours. When will there be a statutory entitlement to, and regulation of, home care? I asked numerous questions but received unsatisfactory answers around the provision of PPE to those working in home care and in community and voluntary services that support people directly in their homes. Will the State guarantee to provide them PPE?

Regarding those who wish to transition from residential care to home care, the Minister of State mentioned step-down services. Was she referring to people who were leaving hospital or did she mean a potential route out of residential care for certain persons?

These are my key issues. Other Senators have spoken about the flu vaccine. I have asked questions of the Department about public sanitation and been told that it was a matter for local authorities. Will the Department engage with local authorities on ensuring that there is public sanitation and that, accordingly, people can access sinks, toilets and spaces? That has always been part of ensuring an appropriate response. It is an issue, and not just for those with disabilities.

Mental health matters are a key focus for the Minister of State. Waiting lists were already extraordinarily high, with 2,000 children awaiting child and adolescent mental health services, CAMHS, and 10,000 people awaiting primary care. The amount of €30 million is not enough, and the Minister of State knows that there have been demands for €80 million. What can we do to step up?

Other Senators have spoken about home care and disability services. Rehabilitation and recovery services for those with addictions are essential care and I hope that they will form part of the winter plan.

I realise that I am coming to the end of my time. I wish to address a cost-cutting issue. When we debate the HSE's winter plan, it has to be based on health and scientific advice. That is fundamental. I urge the Minister of State and her ministerial colleagues in the Department of Health to ensure that health is the driving factor. While it is not within the remit of any Minister to produce a cure or treatment for the coronavirus, we see health concerns being set against supposed concerns about poverty and so forth by those who previously in the Seanad did not show particular concern for poverty. Poverty and income, employment and business supports are issues to which we actually have the answers. The IMF is urging us to borrow. We have a large capacity. We can spend our way out of those problems,-----