Mary Butler (Waterford, Fianna Fail) | Oireachtas source

Eighty minutes would be more what I need.

I thank the 16 Senators who spoke for their contributions. Some strayed outside the remit of the winter plan but I will confine myself in my reply to addressing the questions that related to specific aspects of the plan.

An issue raised by several speakers was the availability of the flu vaccine. I was in the Seanad on two occasions last week to address matters raised by Senators Keogan and Paul Daly in the Commencement debate. We had a very good debate in both instances. I am happy to restate the situation in regard to the flu vaccine because I know there are worries in that regard. Last year, 1.35 million vaccines arrived in Ireland, compared with a figure this year of close to 2 million. A total of 600,000 of the vaccines are for children aged two to 12. They will be administered free of charge and inserted through the nose, with no requirement for an injection. That is very welcome and we hope it will be rolled out through the schools. The remaining 1.35 million doses are of the quadrivalent vaccine, which is the one any of us will be administered. I encourage everybody to avail of it. Following a delay in delivery from the manufacturers, almost half of the vaccine doses have now been received. By 18 October, 75% will have been distributed throughout the country. The flu virus is not only in Ireland but worldwide and there is a huge demand for the vaccine. We are on target to have 75% of our delivery distributed by 18 October. That will make a huge difference.

There were many questions on the disability sector. I was in the Dáil Chamber last night with my colleague, the Minister of State, Deputy Rabbitte, for a two-hour debate on disability services. As Senator Cassells noted, sometimes good initiatives can be lost in the business of the everyday. Senators will all be aware that the disability sector was in line for a 1% cost-cutting measure, which would have reduced its budget by €20 million. That decision was reversed since the Government came into office three months ago. In addition, extra provisions of €10 million and €7.8 million were allocated in recent weeks for the delivery of disability services.

Those services all stopped during the pandemic and it has been extremely hard on parents, carers and the people in receipt of care. I am the first to admit that the situation for many people has been awful. I held a round-table discussion with carers three weeks ago. It had to be done online and the number of participants had to be reduced but it was a good opportunity to speak with carers. Many of them told me that they had been housebound during the Covid crisis and had found it really hard. To date, 40% of all disability supports are now back in place. Most people who avail of those supports are getting two days one week and three days the following week. There is a plan to increase that provision from October to December and another plan from January to March. A huge amount of work is going on in this area.That will also be addressed in the Estimates.

Many Senators raised critical care capacity. It is a huge factor. ICU beds do not grow on trees. Every ICU bed has a cost of €750,000 and needs six qualified nurses with specific skills. It is very important to recognise that. The HSE advises that between 280 and 285 critical care beds are fully staffed and open with the precise number on any given day fluctuating due to staffing or other operational factors. We should note that our critical care units have coped well so far largely because the curve was successfully flattened at early stages, which meant they were not overwhelmed, and because of the incredible work carried out by critical care staff. As a result, outcomes for Covid patients in ICU here compare well with other jurisdictions including the UK. Mortality for Covid patients in Ireland's ICUs is reported at 21.5% whereas the figure in the UK is 41%. We are very aware of the importance of ICU acute beds. It is not simply a matter of putting the beds in tomorrow, however, because they must be accompanied by staff with a specific set of skills. That is why it is quite difficult.

Many Members spoke about recruitment and retention. Many doctors and nurses move onto other countries when they qualify, as they are entitled to do, where they hone their skills. There will not be a movement of staff this year and we are hopeful that will help us to fill some of the issues.

I sat on the other side of the House for four and a half years. Just one Senator referred to the inclusion in the winter plan of ten additional dementia advisers. That is a very important feature of the plan. When I was first elected to the Oireachtas, there were eight dementia advisers in Ireland. As a result of pushing really hard with others on the all-party Oireachtas group on dementia, where members left politics at the door and worked really hard to secure more supports, we got ten posts in last year's budget. I was very happy to speak at the launch of the winter plan two weeks ago when we announced ten more dementia advisers. There are 65,000 people living with dementia here, with 11 people diagnosed every day. It is very important to acknowledge there are many positives in the winter plan.

When I sat on the Opposition side of the House for four years, I criticised other winter plans that had a spend of €30 million. This year's spend is 20 times bigger. That shows how seriously the Government is taking the need to keep our older people out of hospital this year, and to keep our older people at home with the correct wrap-around supports. We need to ensure the people who need re-ablement can get it at home and can get the respite they refquire. That is why €139 million was spent on home care hours alone, with 4.7 million extra hours. I have spoken to some of the private companies and the HSE and it will be a challenge but it is already happening. Before the election, there were 7,900 people waiting on home care supports. Yesterday, I was briefed that this number is now down to 4,300. That is hugely significant. We are already rolling out the hours. I was told this by the person in charge of older person services in the south east. It is a significant reduction, although it is not enough and I will not be happy until no one is waiting.

Diagnostics were raised by several Senators, who asked who will provide them. Some of the details are yet to evolve, but GPs will be able to access 79,000 diagnostics, some of which will be acquired through the NTPF because we will be able to buy diagnostics for the first time ever. Previously, it was possible to do this only in the case of treatments such as hip or cataract operations. Primary legislation will be required to enable the purchase of diagnostics under the NTPF. That will be very important.

I was surprised we did not hear much about nursing homes today. It is a matter close to my heart. Members will have heard in the last week or so that there has been a surge in Covid cases and clusters in nursing homes. Every single nursing home has a sufficient quantity of PPE. There have been challenges about staff moving to other areas, as Senator Keogan observed, but I have spoken to the HSE and we have asked the homes actively not to do that.

I wish to reassure people that the temporary assistance payment scheme, which supports nursing and residential homes, will be continued until next April. That is significant.

I am sorry if I did not answer everything. I could stay here for an hour and answer questions. I thank Senators for their respect and their constructive approach this afternoon. I hope they will all support the plan. All we want to do is keep our people safe as we face the winter.