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Ceisteanna ó Cheannairí - Leaders' Questions (Continued)

Thursday, 15 October 2020

Dáil Éireann Debate
Vol. 999 No. 4

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(Speaker Continuing)

[Deputy Richard O'Donoghue: Information on Richard O'Donoghue Zoom on Richard O'Donoghue] In Tipperary, however, they are doing it virtually and their list is down to four people. Is there a scheme or not?

The Tánaiste: Information on Leo Varadkar Zoom on Leo Varadkar I appreciate this is an important issue for the Deputy and for his constituents. I am afraid I am at a disadvantage in that I did not know this topic was going to be raised and I do not have a note on it. I am aware, however, that there are implications from that court case. The Minister for Finance is across that issue and is working on a solution, if it is possible to come up with one, which I am sure it will be.

On assessments, my strong view is that if an assessment can be carried out virtually it should be done virtually and if it is being done in some counties I do not see why it should not be done in all counties. There may be occasions where a physical examination or an inspection of a home needs to be done but where these assessments can be done virtually, that should be done.

Deputy Richard O'Donoghue: Information on Richard O'Donoghue Zoom on Richard O'Donoghue On 6 October, a letter went out from the office of the Minister for Finance, Deputy Donohoe, to the community care centre stating that in light of the Supreme Court judgment, his officials had informed him not to restart the services for assessment. That letter was sent by the Minister. I also have copies of letters, dated 9 October, stating that a person with a disability was on the list. On 6 October the Minister told the community care centre to stop the assessments and on 9 October someone was being put on the list. Is this list for a scheme that does not exist? Where is the joined-up thinking? In addition, separate from the people who are on the phantom list, I have 170 people who are appealing the judgments. The Minister said this was to be stopped on 6 October and on 9 October someone was told he or she was on the list.

The Tánaiste: Information on Leo Varadkar Zoom on Leo Varadkar I beg the Deputy's indulgence in allowing me to come back to him on this. I do not have sight of any of those letters. I know this is an issue and it has been raised by other Deputies. I will be in contact with the Minister for Finance later today and I will get the Deputy a proper reply as soon as possible. I appreciate this is an issue that needs to be sorted but I do not want to give an assurance or make a comment here in the Dáil that might turn out to be incorrect.

Deputy Michael McNamara: Information on Michael McNamara Zoom on Michael McNamara I wish to raise a matter which pertains to a constituent of mine who has passed away. He stayed in University Hospital Limerick and was accommodated on a trolley in the corridor. After he passed away, his family were charged €813 per night. I raised this matter with the Minister for Health, who referred it to the hospital. The hospital replied to say the inpatient and day case charges are applied based on section 55 of the Health Act 1970, as amended by the Health (Amendment) Act 2013. I looked at that Act and it defines charges in respect of single occupancy rooms, multiple occupancy rooms and where overnight accommodation was not provided. A corridor is not a room. I am sure that in his previous time as Taoiseach and in various ministries, the Tánaiste has necessarily had to travel for work and rooms have been booked for him. I doubt if he was ever offered a corridor to sleep in and if he was, I doubt his officials paid for a room. Can the Tánaiste confirm to this House that a corridor is not a room?

Today is pregnancy and infant loss remembrance day and I refer to the restrictions in place at our maternity hospitals. Women attending for ultrasounds and antenatal visits cannot attend accompanied by partners. For anybody to first see the heartbeat of one's child is a profound and moving moment and one which should be made available to them. I can only imagine what it must be like to be told there is no heartbeat, and to have to go through that alone is inhumane. I accept this is a time of a pandemic and that restrictions are necessary. Equally, humanity has to prevail. Likewise, with regard to visits during birth and, in particular, after the birth of a baby, there is no uniformity of approach across the State. University Maternity Hospital Limerick does not allow visits and I know the National Maternity Hospital just across Merrion Square is in a position to allow visits. I ask that some guidance be provided and a uniformity of approach be adopted across the State in that regard.

The Tánaiste: Information on Leo Varadkar Zoom on Leo Varadkar When patients are admitted to a public hospital, they have the option of whether they wish to be treated as private or public patients, depending on their insurance status. Patients opting to be treated privately in a public hospital have chosen to pay the consultant and the hospital for the services each provides. The fee is not just for the bed, therefore, it is for the service of the consultant and for other services provided by the hospital. Under section 55 of the Health Act 1970, the HSE is required to levy statutory private inpatient charges on all patients opting to receive private inpatient services. The statutory hospital charges that apply for such an episode of care depend on the category of hospital, the duration of stay and whether the accommodation provided was in a single or multiple occupancy room.

The core purpose of the public hospital system is to provide services to public patients. Nonetheless, historically and currently, a proportion of activity in public hospitals involves the provision of care to private patients and income generated in this way is a key component of funding the public hospital system. It is Government policy that users of private services in public hospitals should pay towards the cost of providing those services. The charges applied in respect of private care in a public hospital relate to costs which include those associated with non-consultant hospital doctors; nursing staff; medicines; blood, medical and surgical supplies; radiology; diagnostics; operating theatres; laboratories; administration; and support staff.

On visiting maternity hospitals, I know this is an issue that has been spoken about a lot in recent weeks and an issue that is causing a lot of concern and worry for expectant mums and, in particular, dads who want to be able to be there for those important appointments and crucial scans. It is a difficult situation but we need to bear in mind that so far at least, no pregnant woman has died of Covid-19 in Ireland and we want to keep it that way. Most women who are pregnant are in good health but sometimes there can be women in a hospital or on a ward who have a complicated high risk pregnancy with underlying medical conditions. We need to be honest and be wise to the fact that the more people who come into the hospital, whether it is partners or visitors, the higher the risk that Covid-19 could be introduced to the hospital. Therefore, there would be the risk that somebody who has a high risk pregnancy could get Covid-19, which could possibly result in the loss of the life of both the mother and the child. That is the risk that has to be assessed by the clinical directors and masters of the maternity hospitals and we need to respect their decisions when it comes to visiting. I understand what the Deputy is saying and as much as is possible, we should allow partners to attend, particularly at anomaly scans and so on. That should be done but we have to put our trust in the masters and clinical directors of those hospitals to make the right decision, based on the situation in their hospitals.

Deputy Michael McNamara: Information on Michael McNamara Zoom on Michael McNamara If the Government is going to continue to treat a trolley in a corridor as a multiple occupancy room then we will inevitably have an expensive court case of the type to which Deputy O'Donoghue referred to sort out this anomaly because a corridor is not a room. It is that simple.

I want to move on to one other associated area, namely, the latest restrictions which have been announced for not visiting other homes or houses. I have no doubt the majority or a large number of people will adhere to those restrictions. However, others will not. Before this is put on a legislative footing, I ask and urge the Government to look at the potential for unintended consequence. This has the capability to seriously damage contact tracing because people will simply not give the names of the people with whom they have been in contact. That is a big problem in Britain, which has put everything on a legislative footing with penal provisions and if this provision is also put on a legislative footing, we risk damaging the ability to contact trace, which is the key weapon the State has at its disposal.

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