Neasa on the HSE's Winter Plan

Fri, Oct 2, 2020

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Neasa spoke in the Dáil on the HSE's Winter Plan including: supports for people requiring services on a long-standing basis; transparency and accountability around the spend; and the need for a timeline on the introduction of Sláintecare


I will make a number of points with respect to the winter plan. First, I welcome the additional funding across a number of areas. The reality is that this must, out of necessity, be a dynamic process as it is responding to a situation that is changing almost daily. However, there are a number of challenges that come with that uncertainty and the need to respond quickly.

I draw attention to those requiring services on a long-standing basis who have found the last number of months incredibly difficult. It is very encouraging that extra funds for homeless supports have been included in the measures. This is an issue that impacts the whole country but is keenly felt in my own constituency. Services were already under pressure from increased numbers in 2019. Dublin Simon Community saw an 18% increase in demand for homeless healthcare services last year and provided access to treatment for more than 1,200 people. There was also an increase in waiting times for access to related services over the previous year. For example, for access to detox services the wait time increased by 84%.

The same organisation has now also warned of a health crisis in the homeless population in the capital due to the pressure on funding and a shortage of suitable accommodation. Covid has brought the entire system for homelessness and addiction supports to the very brink of capacity. I am aware in my own constituency that the constraints of the pandemic mean that many service providers need additional space. They need more sanitation facilities in particular. A lack of facilities has not only impacted the people who need this most basic human right but it also has a knock-on impact in the local community as service providers spill out. I would urge the Minister for Health to consider capital funding and confirmed multi-annual funding for the provision or lease of buildings to those groups to accommodate the increase in need along with the constraints that Covid represents in terms of delivering those services.

Similarly, I very much welcome the inclusion of considerable funding for home care, for community health networks and for GP diagnostics. I am very aware though that Covid has put immense pressure on people’s mental health and has had a huge impact on persons with disabilities and their families. I would urge the Minister for Health to consider the long term impact of poor mental health and a lack of disability services within the community and to bear this in mind when making decisions around the budget in the next few days, as the sector needs far more than has been announced or included in the winter plan.

Second, I draw the Minister’s attention to the report this week from the Parliamentary Budget Office on expenditure undertaken this year and its concerns around transparency and accountability. Again, I am aware from my own constituency that private hospitals in many cases provided absolutely vital capacity to the public sector during the Covid-19 crisis and they facilitated the continuation of care in other medical specialties. This was really important and worthwhile. However, the winter plan document outlines that almost 10% of the total winter plan spend of €604 million is going to go to private hospitals. There is, however, scant detail provided on what we are getting for this other than that some of it will be used for elective procedures, which is not in itself a bad idea if it increases capacity in public hospitals, but again we do not really have enough detail. None of it is being used for surge capacity and this would need to be provided separately. If we were going to spend taxpayers’ money with private hospital operators, we need to be clear right now on what exactly we are getting for the amount we are spending and what outcomes we are expecting as a result of that spend.

Covid has changed us and our communities irrevocably, and no winter plan will paper over the cracks of a system that needs reform. The pandemic has been a shock and awe event for our health service. The leadership of clinicians and front-line staff has never been more meaningful or more impactful, and the reality is that our health service for years has focused on servicing the needs of organisations, not always the needs of patients. Covid has allowed us to cut through some of that. We need Sláintecare and we should seize this moment because we need it now. Let us allow our time of adversity also be our moment of clarity. Let us begin the active implementation of Sláintecare. Let us give ourselves a deadline. I think it should be spring 2023. That is 30 months. Let us be ambitious. The NHS in the United Kingdom was established in 1948 at a time when their public finances were in total disarray and the future seemed incredibly challenging and very uncertain. That sounds very familiar to all of us right now but they pushed forward towards their vision of universal health care for everybody and we should push forward with ours.