Sharon Keogan (Independent) | Oireachtas source

I welcome the Minister to the Chamber again. The only question that occurs to me is to ask if we are really going to do this now. As we face into our second winter with Covid-19, and when we have just kicked the reopening ball down the road again, we are revisiting a ten-year-old promise from Fine Gael and the Labour Party to solve the problems in the public health sector by eliminating the private health sector.

In November 2015, we were told that Sláintecare had been put on hold due to the Department of Health finding that universal health insurance would lead to expenditure that was approximately 11% higher than the existing system. Two years later, a committee gave us the slogan that, "A universal healthcare system will provide population, promotive, preventative, primary, curative, rehabilitative and palliative health and social care services to the entire population of Ireland, ensuring timely access to quality, effective, integrated services on the basis of clinical need". That is a lovely-sounding mission statement to be sure, but unless we can sell it for €3 billion, it brings us no closer to delivering universal healthcare.

Four years on, we are still talking about it because the head honchos finally realise that the requirements for implementing this programme are seriously lacking. It is doomed to fail and it simply will not happen. We do not need Sláintecare to get moving on the real and pressing issues with our healthcare system. Some regions are experiencing one in five permanent consultant posts being left unfilled, yet the HSE is cutting 350 junior doctor positions that were provided last year to fight the pandemic. Nursing staffing levels dropped by more than 3,000 from 2007 to 2017. However, the Nursing and Midwifery Board of Ireland accepts less than 10% of work applications from American nurses. Policies and structures in place are exacerbating these problems and not alleviating them. The Minister and the Department do not need to implement Sláintecare to fix them, yet we are discussing this pie-in-the-sky promise rather than simple and practical solutions.

What a time to resurrect it. We have just been told that Friday's D-Day has gone up in smoke and the Government has again foisted the blame and the burden on the people of this country rather than recognising its failure to prepare, adapt and react. On 16 July, the Minister told this House that, "The second-best scenario from NPHET now shows that over 200 people would be in ICU in just a few months’ time". There are now 74 cases in intensive care units, ICUs. We are not even being told how many of those patients are in ICU due to Covid-19 and how many are there for other reasons but have tested positive for Covid-19. The narrative is that ICUs and hospitals are going to be overrun if we do not continue certain Covid-19 measures. This is not exactly a new tune, is it?

It has been 16 months since it was said that we had two weeks to flatten the curve. It seems like a lifetime ago, so I will not blame people for not remembering. The deal was that the people of this country would put their lives on hold for a few weeks and, in return, the Government would put in place the necessary healthcare infrastructure and bolster the capacity necessary to accommodate those falling ill due to the virus. That never happened. Precious little was done. Lockdowns and mandates were instead used as blunt instruments to suppress case numbers. Once again, the ordinary people of Ireland were made responsible for the Government’s remit.

It is not like it could not have been done. Sweden doubled its ICU capacity to tackle the pandemic, with the number of ICU beds in its capital quadrupling. New equipment was ordered and there was a scramble to retrieve old ventilators from basements and emergency reserves. Anaesthetic machines and ventilators were borrowed from private caregivers. All non-essential administrative work was scrapped for staff so they would have more time to look after patients. Volunteers were drafted in, as were staff from other regions less affected by the outbreak of the pandemic and staff from private caregivers in Stockholm. In short, the Swedish authorities reacted accordingly and did their job. How many ICU beds did we get in the last winter plan? It was 17.

Let us be clear. This is not a Covid-19 issue. For those who can remember, the trolley crisis loomed large for some time before the pandemic.There were nearly 100,000 people on trolleys in 2017. The following year, 2018, was the worst year for hospital overcrowding according to the INMO and it was the same in 2019, long before Covid existed. Any pressure on the healthcare system is not due to a minority of people who have opted not to receive a vaccine. It is due to poor policy, stagnated decision-making and a Health Service Executive mired in bureaucracy.

Nothing exemplifies that more than these lateral flow test kits, more commonly known as antigen tests, first mentioned in this House by me in July 2020 and obstinately ignored by our NPHET overlords who refused to sanction antigen testing for staff, visitors and residents in hospitals and nursing homes even though it might have identified some of the outbreaks earlier. Now, finally, 15 months after their use first being mooted in the Seanad by me, the Government has announced it is considering using them, seven months after the UK. Antigen tests need to be used. In the UK these are handed out in pharmacies free to everyone. Today the Government is only making these available to people who are vaccinated. People who are not vaccinated cannot avail of them, which is ridiculous.