Gino Kenny hails vaccine success, demands detail on 10,000 hires

Thanks Cairlich and thanks for the Minister's statement. It's quite comprehensive to say the least and obviously it's welcome in relation to funding and resourcing our public health service that has the last two years has been challenged like never before and I think it has rose to the challenge particularly the frontline staff which have you know have come under a barrage of a virus that hopefully hopefully now that you know we're seeing it receding into the background and I think there's really there's a lot of positives to be taken from the last two years particularly around the vaccination program. I mean the vaccination program was probably the biggest success our health service since the foundation of state that the Irish health service has done. It was kind of a gargantuan undertaking and a huge amount of people helped in that process and you know we pulled together as a country and you know it was a fantastic kind of effort and it just shows what code can be in relation to public health minister. So just minister just a number of questions and it's it's going to be kind of centred on the recruitment of 10,000 staff and I know this has been flagged times and I've said at the moment there's probably just over half of that being recruited in relation to the 10,000 people that we need and they are public health service and there is because obviously there's many factors in trying to employ staff you know and I won't go through them all here so it's multi kind of kind of you know there's there's different spokes to actually employing staff. So I have eight questions so they may be kind of short answers if possible if possible if possible. So could you give a breakdown in relation to the improvement of them additional staff into general health and mental health areas. DEPUTY if I could just come in briefly there on the mental health so last year for example we hired 53 whole time equivalents into CAMHS and in relation to eating disorder teams there was 45 new staff recruited there I only got those figures this week. So that was to support the three outstanding teams that were already in place and 19 for the three teams that were announced for 2021 so that's very positive for both those specifics. Okay thanks minister. In relation to breakdown to medical specialties in the recruitment of them additional staff could you give a breakdown of the specialties that you know the HSE is trying to kind of focus that recruitment process into. Thanks deputy we'll we'll just look for a note on that we can give you a breakdown by different areas including say nursing midwifery clinical specialties NCHD health and social care professionals and then the management and administrative grades as well. So I'm just looking for a note on that to be able to come back to you on that. The fourth question is in relation to geographical regions and breakdown in relation to recruitment in obviously the CHOs if that's possible or even the kind of the you know the main kind of health provinces in the state. I don't know if you can give figures for that minister. We can deputy yeah what I'll get you is a note both on CHOs and then hospital groups is probably the other the best way to look at it for the for the acutes. Yeah in relation to the four quarters of this year and targets wise recruitment are we kind of a staggered approach obviously I know that there's barriers to this but is there kind of a name for which kind of which which period of the year that you're kind of aiming for or to kind of prove these stuff. There are deputy yeah the different departments hospital CHOs and clinical specialties do have timelines against when they would like all of those recruited so we'll include that in the note as well. Okay. Minister just in relation to extra capacity in relation to private hospitals and obviously you know private hospitals are an integral part of public and private healthcare so obviously we have a disagreement with that I think there's you know I think universal healthcare should be only one tiered and I think you know I think you would be of the opinion that universal healthcare is the best road to provide healthcare for the country. But in relation to private healthcare capacity this year in relation to say compared to pre-pandemic what kind of resources in relation to the overall budget is going towards like private hospitals and private healthcare. Thanks deputy there are a few areas where we'll be spending more and but it's funding public patients to be clear. So the aim of us using capacity from the private or the independent sector is purely with a view to funding or treating as many public patients as possible. So as you'll be aware deputy there are there have been several safety net agreements put in place. This is when the capacity within the HSE hospital system is put under a lot of pressure by COVID that we can activate capacity within the within the the private or the independent sector. There's a there's a fourth safety net agreement being put in place at the moment for exactly that reason and there are individual relationships that our hospitals have with individual and private hospitals that they use be it for operating theaters or bed capacity sometimes critical care capacity. For example the pediatric orthopedic so so children's health Ireland use capacity within the Blackrock clinic sometimes to make sure that the children can get treated so there there are local arrangements in place. And then the big one is the national treatment purchase fund. So last year the allocation was a hundred million euro this year the allocation is a hundred and fifty million euro. I think there's two important things to say I know that some members of the committee are uncomfortable with the money and going in and being paid out to private providers. There's just one or two things I'd say first of all actually last year the majority of the NTPF money went into went into public hospitals. So so some people I think might think that it's all spent on the private sector. It's not actually the majority of it last year. I'll check but I have the figure of sixty percent in my head and was used to they call it in sourcing so longer hours and so forth in the in the public hospitals. And finally deputy what I would agree with your opening comment in that the the goal and why we're investing so much money in the public health service is that the public health service can handle in time all of the requirements for our population. Universal health care as an ideology remains neutral as to which hospital you get your care in. It's about the patient rather than the provider. So Ireland the UK the Germans the Canadians all of different models for providing this and some largely public some a mix some independent nonprofit trusts there's various different ways of of doing it. But in Ireland I think what we are all committed to certainly this government is is committed to is a public health service that has sufficient capacity to treat all patients in the Republic. Just my two final questions is in relation to recruitment of additional neurological nurses and I mean there's 57 extra nurses neurological nurses needed in Dublin alone and 100 extra nationally. I think that's including 57 and then obviously 43 additional outside Dublin. Is there kind of in relation to the overall plan is there in relation to recruitment of them particular particularly that that's a specialty in neurological and the discipline in neurological nursing? I'll get you a detailed note on that Deputy. I'll get you a detailed note on that Deputy. OK. And just the final question, Minister, in relation to retention of staff. And this I think is one of the most important things Health Service faces. I just have a stat here, and it says in the last couple of years in relation to doctors graduating from the state, in the last three years there's been a 44% increase in relation to doctors leaving the state. So obviously they've been graduating and then leaving the state, and obviously that's very, very concerned. And people leave the state after graduating for all sorts of reasons, but one of the reasons that they leave is particularly around conditions and pay, because what you don't want is that somebody that has been graduated has graduated and feels that they can't go back, even though they want to go back into the Irish Health Service, but they feel like it's borne out time, it's really, really borne out, and that's very, very, very concerning. How can you address that kind of leakage? You can't address it all, because I said it's kind of a multi kind of reasons why that happens. How can you keep Irish doctors that have been graduated in this country, educated in a very, very high standard, leaving the state? One of the things we have to do is we have to treat our non consultant hospital doctors much better than we currently do. I don't believe that the current training path that they are asked to pursue on their way to being consultants. I don't think it's appropriate. And I think it needs to be completely changed. I met recently with a group of NCHDs. And quite frankly, I was shocked by what they told me about their reality, having to travel around the country every year, not supported in doing so over potentially 10 years, working far too long in their week, not having some basic supports in place that they should have. On the back of that, I contacted the IMO. I've invited the IMO in for talks. I've asked the department to put me together an approach for how we do this. We need to start by listening very carefully to the doctors themselves. I heard a lot of things last week that simply are not acceptable. We've already done some things, deputy. So you may be aware that last year I removed the restriction on non EU NCHDs training as specialists. Right. We need to keep moving with that. We need to significantly increase the number of training posts as well. We don't have enough. And now that's tied in with an increased consultant body as well. We've got one of, if not the lowest ratio of specialists to per population in the EU. It's not acceptable. We need a very significant increase in our consultant workforce. But I think you're referencing mainly the NCHDs, deputy. And I need, we need to see some very serious change in how they are treated in their conditions of work, in the training opportunities they have, so that they can lead a decent and reasonable life in the six or eight or ten years that they're training to be specialists. Because certainly too many of them do not have that opportunity based on what's asked of them. And what ministers, what one thing from your kind of your engagements with kind of junior doctors and graduate doctors, what one thing would you change after hearing some of the testimony from them graduates? Well, a few of the things I would change and we will be talking to the NCHDs and the representative bodies about this idea that they can be moved around the country with very little notice to any part of the country and have to have to relocate themselves, sometimes their children, their partners every year for 10 years. That's not acceptable. That is simply not an acceptable thing for us to ask. I'm also very uncomfortable at some of the reports of the working hours. We have European working time directives in place. They need to be followed. There may be some exemptions there, but they need to be followed. So really, it's around giving them a bit of stability in their lives and allowing them to do more than just be in the hospitals working and training 60, 70, 80 hours a week. I just don't think that's a reasonable ask, particularly in the modern world. I want to see a gender analysis done as well. We have a lot of women going in and training as NCHDs, but the conversion rate to specialists should be maintained and it's not being maintained. Now, in some specialties it is, but on average across the consultant population, it's not. I think we need to, as I said, Deputy, the first thing I want to do is listen carefully to the doctors themselves. Thank you.