Mary Seery Kearney (Fine Gael)
Link to this: Individually | In context | Oireachtas source

I thank the Minister of State, Deputy Feighan, for being here to take this Commencement Matter. The Dáil constituency of Dublin South Central is my home constituency. It has a population of nearly 136,000 people, according to the most recent census. When those constituents were asked their views regarding their state of health, fewer than the national average reported being in good health and more than the national average reported their health as being only "fair". The usual categories synonymous with increased hardship and financial challenge are shown across the board in Dublin South Central, whether that is one-parent families, renters in local authority properties or the private rental sector and lower-paid employment categories. The constituency repeatedly shows figures below average in categories that tend to imply financial advantage, such as the numbers of professionals employed. As a consequence, there is a greater likelihood of reliance on public health in the area and, as such, it is essential that primary care centres are working to their optimal capacity.

The former Minister for Health, Deputy Harris, and his predecessors built primary care centres in the heart of this community. There are such centres in Ballyfermot, Crumlin and Inchicore and at the old Meath hospital in Rialto. These were put in place both through good and bad financial economic times and it is acknowledged that they have been a vital resource to the community in terms of promoting healthcare, quick access to diagnosis and care in the community. There should be a sixth primary care centre in the constituency, that being the Drimnagh primary care centre. It was announced by the predecessor of the Minister of State, former Deputy Catherine Byrne, and the former Minister, Deputy Harris, in November 2019, with a view, albeit in a pre-Covid world, to there being sufficient movement and delivery of that in 2020 and 2021. It should be ongoing at present. I take this opportunity to press on the Minister of State, Deputy Feighan, the importance of delivering that primary care centre for the people of Drimnagh who have been waiting for it for a long time.I ask the Minister of State to make that a priority in the post-Covid actions.

I fully acknowledge that we are in the midst of the most difficult crisis for our country. Throughout the crisis we have seen extraordinary work on the part of our healthcare professionals and the administrative staff within the HSE. We know that the administrative staff have been redeployed to carry out contact tracing. Some nursing staff were redeployed for swabbing and testing. Others have been part of what is colloquially termed the nursing hit squad. They have been redeployed into private nursing home facilities where severe staff shortages are exhibited. They do that repeatedly, moving from crisis to crisis, to support the care of patients. They are extraordinary workers and, as a nation, we are extraordinarily indebted to them.

We know that our population is experiencing hesitancy in coming forward when they have symptoms, fearful of getting Covid, and that the delays in the identification of illnesses may be fatal where an opportunity for early detection in diseases such as cancer may be lost. I am also conscious that the schools vaccination programme has been moved into the GP primary care setting due to its obvious inability to be delivered within the schools when the children are not there. This has a knock-on effect of children not accessing the vaccination programme for various reasons, including Covid fears when going out, lack of knowledge or information and delays due to redeployments. I am hearing complaints of a lack of access to physiotherapy and delays in speech and occupational therapy referrals and services. Of very serious concern to me are reports of delays in accessing the mental health teams.

I am concerned to know how the primary care centres are operating in Dublin South-Central in particular, how they are impacted by the redeployments and what mitigating factors are being put in place to ensure healthcare services for the population and those who so rely on them. I am mindful that next week we will see the commencement of the over-70s vaccination programme. That will be a great boost to the population at large. There are nearly 16,500 people over the age of 70 in Dublin South-Central, so I am anxious to ensure that that will be a smooth roll-out and will not be affected by any redeployments. I thank the Minister of State for his time and I look forward to his reply.

Frank Feighan (Sligo-Leitrim, Fine Gael)
Link to this: Individually | In context | Oireachtas source

I welcome the opportunity to provide an update to the House on this matter. Covid-19, as the Senator will be aware, has had a significant impact on the primary care sector, including the redeployment of staff from their core roles to aid in direct response to the pandemic. Those staff who have been redeployed have taken on essential duties, including Covid tracking and testing and providing additional support to long-term residential facilities for older persons, disability services and mental health services. Significant progress was made in returning staff from Covid services to their core roles between June and October, reflected at least in part in the HSE's recruitment of a dedicated workforce for community swabbing and contact tracing. Figures from the latest staff census available show that the number of redeployed staff has fallen from a peak of 3,555 in April 2020 to 815 at the end of November, a reduction of approximately 77%. Regrettably, the surge in positive Covid cases in recent months has increased pressure on our health service and has meant that we have again needed to turn to primary care staff to support the wider response to Covid.

Turning to the specific question the Senator raised, I can inform her that as of 4 February 2021 the number of whole-time equivalent staff redeployed in the primary care centres she has identified is as follows: Ballyfermot primary care centre, 8.5 staff members redeployed; Crumlin primary care centre, three dental staff redeployed; Inchicore primary care centre, one dental staff redeployed; Meath primary care centre, five staff members redeployed; and, Rialto primary care centre, 0.5 staff redeployed. I stress that the HSE has advised that this level of redeployment is associated for the most part with only a small reduction in services. Further, I can assure the Senator that a number of actions are being taken to mitigate any negative impact of the redeployment. This includes the prioritisation of service delivery based on need as well as the use of tele-health and video calls to maximise service provision. In addition, to enable cross-cover of cases, staff have been relocated to assist in areas where staff have been redeployed.Where services are curtailed or reduced, this is being done in line with clinical advice, a shared national position with appropriate risk assessment and communication with providers, service users and families.

The global pandemic has undoubtedly disrupted our primary care services. I know the distress this can cause to those who need to access these services and supports. I assure the Senator that staff will return to their substantive posts as soon as it is possible for them to do so and that the focus will continue to be on ensuring those with the greatest need can continue to access services.

Mary Seery Kearney (Fine Gael)
Link to this: Individually | In context | Oireachtas source

My thanks to the Minister of State for the accuracy of the numbers. I really appreciate the investigation that went into that.

From next Monday we are going to see a major uplift throughout the country. People, including the likes of my father, would be queueing up already if they could with their deckchairs. My father is hoping for and looking forward to his vaccination. As we see people like that getting the vaccinations, there will be a good lift, belief and hope for the future, because we will see vaccination in the community as opposed to behind the closed door of healthcare or residential settings.

My concern is that the minute that starts rolling out, the focus will turn to the other health issues. It will be important that we have the plan of getting back to full health. I appreciate that there are mitigating measures in place and I am thankful for that, but I believe we need to focus on getting everything back on track. Once vaccinations are rolling out, then we will need to get the appropriate focus back on all the rest of healthcare.

Frank Feighan (Sligo-Leitrim, Fine Gael)
Link to this: Individually | In context | Oireachtas source

I thank the Senator for raising this matter. The health service has faced an unprecedented challenge in the past 11 months. In some ways, redeployment of primary care staff can be thought of as the community sector turning to its own surge capacity to respond to the needs for testing and tracing services and, crucially, to provide additional supports to the residents of nursing homes and other long-term residential facilities, whether private or public.

The focus in the months ahead will be on the following: continuing to deliver Covid-19 and non-Covid care side by side safely; maximising the volume of non-covid care and catching up, where possible, on any shortfalls; and bedding in reform of the delivery of services. This will be supported by the significant investment in the health service in 2021, including €150 million in new development funding to deliver an enhanced community care programme.

The Department of Health and the HSE are working closely together to ensure continued access to services to our most vulnerable people and those with the greatest need. As part of these efforts, staff who have been redeployed will return to their core roles as soon as it is possible and safe to do so.