Matt Shanahan Urges Action on Long COVID and HSE Failings
Matt Shanahan addressed ministers about transitioning out of COVID and urged urgent learning and action on testing, care and health-service failings. He called for review and measures on antigen testing, vitamin D, HSE procurement, hospital plans including University Hospital Waterford, and the establishment of long COVID clinics.
Transition and testing
He welcomed public health advice signalling a move out of COVID and asked what lessons will be learned. He criticised the failure to implement antigen testing for 15 months despite its value in the last three months and urged renewed attention to vitamin D as part of health strategy.
HSE procurement and contractors
He raised concerns about dysfunction in HSE procurement and said the HSE is now imposing new terms on indigenous contractors as the pandemic appears to pass. He also noted companies with antiviral drugs approved by the EPA were not engaged by the Department of Health.
Hospital capacity and local plans
He pointed to significant waiting lists nationwide and asked for a new strategy in relation to the NTPF. He queried the status of SlaunchiCare and said National Community Care is not visible in the acute hospital sector. He sought a forward development and capital plan for University Hospital Waterford, highlighting gaps in neurology, diabetes, trauma, diagnostics and 24-7 cardiac cover.
Workforce, residential care and immigration
He warned of recruitment problems in residential care and cited long delays for work permits of "up to 24 other weeks". He proposed exploring initiatives to employ qualified people in direct provision centres, shadowed by public health staff, with potential points towards asylum applications.
Drugs, bonuses, mental health and long COVID
He urged support for the drug strategy, particularly in Dublin, and warned of the scale of opioid abuse seen in the United States and the need for education on recreational drug use. He asked that the frontline healthcare bonus be revisited because many Section 38 and 39 workers are excluded and queried recognition for family carers. He welcomed a national CAMS review, stressed the need for multidisciplinary teams and investment, called for long COVID clinics around the country, and asked that any national COVID review include outside voices rather than only insiders.
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Minister, like everyone else in the House, we welcome the public health advice that is now signalling, hopefully, transitioning out of COVID and we will be asking the questions of what have we learned and a couple of things I would like to bring to that point. Antigen testing, we are going to have to figure out how we could not implement a public health measure for 15 months which has shown its value in the last three months. Vitamin D, how we have ignored it and I think a lot of science is going to point again a great health mission. Beyond that, the issue of HSE procurement, some of the dysfunctionality at this stage, but also some of, I would call it at this stage, really forcing down on Indigenous contractors who engage with the HSE, where now HSE are trying to derogate new terms because they see the COVID pandemic as passing. This also includes companies who had antiviral drugs approved by the EPA and were not engaged with by the Department of Health at all. In terms of the hospital situation, we know we have significant waiting lists around the country and I would ask you Ministers, you need to come up with a new strategy vis-a-vis the NTPF. I would also ask you, where is SlaunchiCare at the moment? We know that National Community Care is trying to organise but there is not a bit of evidence of it in the acute hospital sector. When are we going to start to see that happen? In terms of my own hospital, Minister Butler has left the chamber but she is well aware we have significant deficiencies at UHW in terms of neurology, diabetes, dealing with trauma and dealing with general diagnostics, let alone trying to advance our 24-7 cardiac issue. So what I am looking for is a forward development plan for University Hospital Waterford, a capital development plan and I think that should be published for each of the other hospitals as well. So we try and see what is the plan that we are going forward with. In relation to residential care homes, we have a significant issue in recruitment as you know, and in work permits and the Tarnished that this morning advised that work permits could take up to 24 other weeks. And I would ask you, could we look at an initiative, maybe there are people who are qualified in direct provision centres and potentially there is an opportunity to get them out of there, to get them working for a short time and to try and give them some points towards their asylum application based on that. They can be shadowed by other public health people. I heard you mention earlier in your opening address about the drug strategy and I would ask you again to look at the support of drug strategy particularly in Dublin. We will either pay now or we will pay later. It is as simple as that. I would also ask you just to have a look at what is happening with opioid abuse in America. I am sure you are well aware of it, but it is rampant now in American universities and therefore it begs the question of where is education in terms of people actually using recreational drugs. I would like to also reference the frontline healthcare bonus and as we know there is a significant number of Section 38 and 39 workers who are excluded from this recognition bonus. I think that is a mistake and I would ask you to revisit that. I would also ask you how are family carers and those that are looking after disabled in the home, how are they being demonstrated the social cohesion in terms of what they have had to do in terms of recognition of this bonus? I welcome the future national mental health CAMS review. We cannot operate hospital care without multidisciplinary teams and we most definitely cannot do this for CAMS either and I am sure a new review will show that. We need significant investment there. In relation to long COVID, I think we are going to have to start looking at setting up clinics around the country. There is ample evidence now of the effects of long COVID similar to other post-viral syndromes. People are going to have to be looked at and we have to see if we are giving them the best care possible. The last point I would make to you, Ministers, is in terms of our proposed national COVID, be it a public inquiry or an expert review or whatever it is going to be. I would ask you two things. One, is it going to be insiders or is it going to be outsiders who are going to lead this? What lessons are we going to discuss? I think there has been a significant number of voices who have been left outside in terms of public health policy over the last two years. If we want to have a full, frank and open discussion that is going to teach us anything, we have to allow other voices to be heard. Thank you.
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