This fits in with the rest of the debate going on here. It is to ask the Minister about the targets for the inpatient waiting times. I acknowledge her focus on productivity and reform within the health service. Deputy Neville has pointed out that with all these things it is an ecosystem and they are interconnected. If you cannot have an efficient admission and discharge policy for both elective and acute, you will end up with long waiting lists.
Sentiment score: -0.07
There are brilliant people working in the public health service who do their work very well but we can acknowledge, and I think the Minister acknowledges, that there are some hospitals in areas of the country where that productivity is not apparent. I will speak about the HSE West and North West region. In the past, at the health committee, the Minister acknowledged there are issues around discharge and management of patient flows. The west and north west is the poorest region of the country, with the highest proportion of the population in receipt of disability payments and the highest proportion of the population in receipt of a full medical card. We have a situation where we cannot discharge patients from a level 4 hospital, namely, UHG because there are not any step-down beds and not enough rehabilitation beds or enough home-help hours. In addition, we have a level 4 hospital that is purporting to carry out all the services of a level 4 hospital without having that capacity. We need a commitment to a new hospital in the west, at UHG in Galway. In addition, we have a situation where there has been an over-reliance on the private developer-delivered primary care centres and also an over-reliance on individual GPs to deliver that infrastructure. If we are completely serious about the interconnectivity of our health service, we need to get some of that investment into primary care. The vast majority of the very considerable investment by the State over the last five years has continued to go into hospital care and acute care and not enough has gone into developing primary care. We have the longest waiting lists for speech therapy, psychology, community physiotherapy and speech and language therapy in the community. Unless we fix that capacity in the community in tandem with the acute service, we will not see the end of these waiting lists.
Sentiment score: 0.17
I have a case involving a patient who has critical ischemia of her leg. She is a hard-working woman in her 60s. Twice she has had to be admitted to hospital and twice she has been sent out. She needs a procedure done. She has now been sitting for two weeks in a bed in UHG because they cannot get theatre time to do the procedure she requires. That is simply not a productive system. We have people who have given up on certain specialties, such as dermatology, rheumatology and others, in the west because they cannot get access. I completely agree with the Minister and she has my full support for any productivity reforms. We also need to deal with the fact that our health service has not been digitalised. We are off the record. The EU 2030 Digital Compass requires that patients will have fully digitalised records in every country in the European Union. Ireland is so far off that chart. Countries like Estonia, Malta and Lithuania can do this, and we cannot. We need to focus on enabling productivity. The Minister is right that we should be using our physical resources insofar as we can. However, there is an issue with UHG, and we need a new hospital there over the next ten years in order to make sure it functions properly as a level 4 hospital. That is the type of specialty treatment that some people need but they are competing with people who go through the emergency room, elderly people who need care in the hospital setting and people who might be better cared for in a community setting. We have to deal with primary care. We need to get over the culture that because it is a contract-led service by GPs, the infrastructure should be borne only by GPs. If we are completely serious, we should be building State-led primary care centres and have five-year, rent-free zones to attract young GPs into those centres.
Sentiment score: 0.17
I would like the Minister to reflect on the support for the Planet Youth model, which covers about five different regions in the country and dwells on youth mental health, well-being and the maintenance of that well-being, including through repeated surveys of youth to find out what makes them tick.
Sentiment score: 0.62
I am glad that the Minister of State recognises the value of the Planet Youth project, which is based on the Icelandic model of intervening early to try to identify the reasons young people may fall into lifestyles that will be deleterious to their health. One of the Planet Youth reports, which came out from Galway, Roscommon and Mayo in 2024, identified the fact that things such as unsupervised time for young people on the street gave them nine times more risk of smoking cannabis. Being unsupervised in a friend's home makes a young person five times more likely to engage in drinking at an early age. Other things that came out included that 18% of young people under the age of 13 had viewed pornography. These are really important pieces of data that allow us to target schemes at those young people to try to prevent them for getting into trouble.
Sentiment score: 0.16
The value of having repeated data collection means you get an evolving picture of how things are on the ground. In the Ballinasloe area, for example, if your parent had an alcohol problem, you are something like five times more likely to have taken alcohol by the age of 14. If your parents were permissive around the use of alcohol, the risk of having a problem with drink in later life is three times higher. These are important parameters that allow us to plan health services based around health and well-being and working upstream so that we avoid the problems that develop in later life. Alcohol, drug abuse and the viewing of pornography lead to unsafe and sometimes dangerous practices for young children and adolescents. Data allows us to intervene earlier with measures that will prevent future problems.
Sentiment score: -0.31