Sharon Keogan (Independent) | Oireachtas source

I congratulate the Cathaoirleach and the Ceann Comhairle on the presentation we received from President Zelenskyy. We stand with Ukraine.

The HSE is once again in the public eye as a result of plans to return greater decision-making abilities to regionally based authorities rather than top-level managers. The plan of the Minister, Deputy Stephen Donnelly, is to set up six regional health authorities. If this sounds familiar, it might be because we had regional health authorities 17 years ago. They were done away with and replaced by the HSE as per the design of the then Minister for Health and Children, Deputy Micheál Martin. I hope that in another 17 years, centralisation is not tabled as a brand new solution to the systemic issue of bloat and bureaucracy which plagues our health system.

More light needs to be shone on the HSE than perhaps the Department is willing to shed. Monday saw coverage of an unreleased 2019 report which showed unsafe and unacceptable treatment in emergency care departments of nine separate HSE hospitals. Some 50% or more of patients spent at least one night in the emergency department on a trolley before getting a bed or being discharged. In at least one hospital they found patients spending up to ten nights on trolleys. The report, Independent Review of Unscheduled Care Performance, was led by Professor Frank Keane, the former president of the Royal College of Surgeons in Ireland. It addressed issues of overcrowding, saying that the dignity, privacy and safety of patients on trolleys need attention. Perhaps more worrying are the findings regarding leadership, staff and the communication between them as well as pervasive negative work practices. Hospital staff did not always know who was in charge. The adequacy of executive leadership and operational groups gave rise to concern and out-of-hours executive leadership commonly relied on tight rotas, often on a goodwill basis, which could promote burnout and become unsustainable. Wards containing patients with a range of illnesses meant consultants and nurses were constantly moving around the building to find their patients. The policy is any bed, anytime, anywhere, including mixed gender wards.

Taken all together, it paints a stark picture of a healthcare service which has consistently fallen far below the standard expected of it, and whose senior management lacks any appetite for meaningful reform. I understand that the Minister, Deputy Stephen Donnelly, has had enough on his plate during the Covid pandemic, but now is the time to be proactive rather than reactive, and to create lasting change. I hope we do not stop short of seeing it through.