115. Deputy David Cullinane asked the Minister for Health the steps she will take to avert industrial action among ambulance workers, the steps she is taking to meet the ambition of the ambulance service's strategic workforce plan and if she will make a statement on the matter. [28517/26]
Sentiment score: -0.05
My question concerns potential industrial action by ambulance paramedics, particularly pre-hospital care professionals, which would include emergency medical technicians, EMTs, paramedics and others. They voted overwhelmingly to take industrial action, as the Minister knows, on 12, 19 and 26 May. I imagine that the last thing paramedics and EMTs want is to be on strike. A number of votes were taken in recent times, including one last year, on the roles and responsibilities changes that paramedics voted against, so clearly there are issues. These are votes of no confidence in the system and no confidence in action that should be taken being taken, so what is next? What action will the Minister take to avert industrial action?
Sentiment score: 0.16
The problem is that the National Ambulance Service is massively understaffed. I put down a parliamentary question to which the Minister's office responded a number of weeks ago. In 2025, the HSE target was to have 4,162 whole-time-equivalent paramedics working in the National Ambulance Service. The number for this year is 2,657. By 2026, the target was to have 4,780. The number is estimated to be 2,920 by the end of the year. By 2028, it is meant to be over 6,000. At best, we are going to hit 3,500. We are somewhere between 2,000 and 2,500 paramedics short of what we need. That is leading to burnout and fatigue, which is why there has been vote after vote where paramedics, EMTs and others have said that they have had enough and cannot take any more. As far as I can see, they do not have confidence in the management of the National Ambulance Service because clearly if there are votes coming back all of the time where they are voting against recommendations and for industrial action, there is a problem. The problem is burnout and fatigue and can only be fixed by more capacity and better resources. I appeal to the Minister to do everything possible to support our paramedics and avert industrial action.
Sentiment score: -0.01
The paramedics that I have spoken to, and I have spoken to many, are all in favour of reform, but they also want to know that the Government has their backs and is putting in place the capacity. The Minister is right to say there has been an increase in the number of paramedics, but the objective was to double the number of paramedics over a five- to six-year period because that is what was estimated was needed. I gave the Minister the figure that, for 2026, the target is 4,780. The Department and the HSE are telling me that, at best, it will reach 2,920. We are going to be somewhere between 2,000 and 2,500 paramedics short. In 2023, the Government cut the target response times for categories purple and red from 80% to 50% and from 75% to 45%, respectively, within the specified time period, but those targets are still not being met. The targets that were set are not being met in relation to response times, and the number of paramedics that we need is not being met. It is falling back on those paramedics who are in the system. They are clearly crying out to the Government, the Ministers and the HSE to say they are voting for strike action and voting no confidence in the management of the health service and the National Ambulance Service because they do not see the concrete actions that they need being taken.
Sentiment score: 0.14
117. Deputy David Cullinane asked the Minister for Health the model that the Sláintecare programme board will operate on following the appointment of a new HSE CEO and a new Secretary General at her Department; the reason her Sláintecare implementation plan for 2025-plus does not have year-to-year measurable actions for 2026 onwards; and if she will make a statement on the matter. [28518/26]
Sentiment score: 0.01
I am seeking an update, if I can, on the Sláintecare programme board and how that will operate, given that we have a new CEO of the HSE and, indeed, a new Secretary General in the Minister's Department. I wish to take the opportunity to thank Mr. Bernard Gloster and Mr. Robert Watt for their many years of service, two people I have worked closely with and have a very high regard for. I also want to wish Ms Anne O'Connor and Mr. Derek Tierney the very best as well. We obviously want them to succeed. They are two highly professional people who I have a lot of faith in and I know they will do lots of good things. During the previous Dáil, the leaders of the Sláintecare programme board were the heads of the Department and the HSE. Will that continue? I also refer to the implementation plan, which I think ended in 2025. We need an updated implementation plan with clear timeframes and targets so that the new CEO and the Department head actually have a plan to work to.
Sentiment score: 0.36
I welcome some of what the Minister said but the problem is there are not clear deliverables and timeframes in the current Sláintecare action plan. That is something that has to change. I want to see, for example, changes to the medical card and GP card thresholds. There have not really been any substantial changes to medical card eligibility in a long time. The big reform that the health service needs, from an acute hospital perspective, is delivering the elective hospitals. If you really want to deal with waiting lists, then build the four elective hospitals as quickly as possible. I guarantee that that will give us capacity to deal with lots of the planned procedures that need to be done, separating scheduled from unscheduled care. I am big believer in a seven-day-week health service.
Sentiment score: 0.06
I know the Minister is. When she is pushing forward those reforms, I will be supporting them, as I did with the public-only consultant contract because we needed it. We have to get bang for our buck. I agree that we need reforms and efficiencies but we also need capacity. If we do not have the diagnostic capacity, the bed capacity and the staff in our hospitals, then it is more difficult to reach our targets and actually get the reforms. It is a combination of all of that, and all of that is obviously part of Sláintecare.
Sentiment score: 0.08
I could not agree more. I have been saying this for a long time. I am a big supporter of the surgical hubs. There is one coming in my own constituency adjacent to University Hospital Waterford, so I know the difference that will make. I fully agree that we have to look at how to take pressure away from our acute and major hospitals, for example, more off-site rooms for outpatient activity where we can free up clinical space. I am in favour of all of that. I am fully on board with a seven-day-week health service. I want all of that to happen, but for the efficiencies to happen, there also have to be the resources. While the surgical hubs will be a game-changer, I can tell the Minister for a fact that the elective hospitals will be an even bigger game-changer. I am saying that to her because there will be push-back from consultants. I have got it in relation to the elective hospitals. They want the low-lying fruit still in public hospitals. It is why insourcing was so profitable and something they were trying to protect. We have to protect public patients, get value for money and efficiencies but also reduce waiting times. I guarantee that if the elective hospitals are built, the Minister will see some of those wait times in orthopaedics and other areas come down rapidly. It will be the biggest reform that could be made in the health service.
Sentiment score: 0.20
119. Deputy David Cullinane asked the Minister for Health to provide an update on the delivery of new outpatient mental health capacity and mental health beds, as previously announced in the HSE capital plan for Waterford and the south east; and if she will make a statement on the matter. [28519/26]
Sentiment score: 0.01
I am looking for an update on the replacement of the existing adult mental health 44-bed unit at University Hospital Waterford with a 50-bed single bed unit. I acknowledge the work of the Minister of State, Deputy Butler, in making sure this was on the current capital plan recently. I was criticised in one local newspaper for doing so.
Sentiment score: -0.03
I think the criticism was because there was frustration that developments can be glacial and it takes a long time for these projects to get over the line. There are other projects I want to talk about, which I will later. On this particular project, it is important to have timeframes as to how quickly we can expect this development might be delivered, which I think we all accept would be massive and a game-changer for mental health services in Waterford.
Sentiment score: -0.04
I very much hope that the new adult mental health unit will progress as quickly as possible. I agree with the location and I want to see it developed as fast as it can be. There was also a promise for a 96-bed ward block over five storeys at University Hospital Waterford, and a multi-storey car park. The Minister of State issued a press statement a number of years ago where she said there was a proposal for a two-floor vertical extension over the existing outpatients department, to provide an additional 36 consulting rooms, four treatment rooms, four measurement rooms and two virtual consultation rooms. I do not know the status of that plan at the moment. I have been tabling parliamentary questions seeking updates on all of these projects. We need the additional 96 beds, we need the underground car park and we need the two-storey extension to the lab, but we also need the vertical two-storey extension that the Minister of State talked about and all that additional space. The frustration is that these projects are listed in the capital plan, or maybe some of them are not now listed. People do not know if we are going to get them, if they are funded or how quickly they will be delivered. We all want the best for our regional and local hospitals. I raise these projects because they are really important in the context of University Hospital Waterford.
Sentiment score: 0.14
I raise these issues to illustrate the point that when announcements are made, people expect things to be delivered and then ask how quickly they will get them. If there is an announcement regarding additional health capacity, that is really good news. It is exciting, and people want it. When people hear about the announcement of an additional 60-bed ward block over five storeys at University Hospital Waterford but then do not see it and when I am putting in parliamentary questions and cannot get answers on the timeframe for it to happen, that causes frustration. There was a clear announcement of a proposal for a two-floor vertical extension with all of those consultation and treatment rooms to come with it. We are now being told there is a change to that. We still do not know what that means and when the facility will be built, which also leads to frustration. It is the same with the multi-storey car park. In fact, it is the same with the mental health unit as well. I do not doubt that the Minister of State is pushing these issues; I accept that 100%. All I am saying is that there is frustration that when announcements are made by local Ministers or senior Ministers, they then seem to either fall off a cliff or take far too long to go anywhere. That causes frustration, particularly when we cannot get answers to parliamentary questions when we table them.
Sentiment score: 0.01