|
Minister of State at the Department of Housing, Planning, Community and Local Government (Deputy Damien English):   On behalf of the Minister for Health, Deputy Simon Harris, I thank Deputies Burton and Kelleher for giving me the opportunity to update the House on this issue. The Minister sends his apologies for not being able to be here.
As Deputies are aware influenza can be a serious illness for people in at-risk groups and can lead to hospitalisation and death. At-risk people include those aged 65 years and older, those with chronic illness requiring regular medical follow-up, those with lower immunity due to disease or treatment, pregnant women and residents of nursing homes and other long-stay facilities.
The priority for this winter is to increase take-up of the influenza vaccine in at-risk groups and in health care workers to reduce and control the incidence of flu and outbreaks in the community and health care settings. As Deputies will recall, the HSE launched its immunisation and Under the Weather campaigns for the 2017-2018 season earlier this month. By reducing the incidence of influenza, we reduce the need for people to seek treatments and, consequently, reduce the demands on health services. The HSE has put in place significant measures to ensure it is prepared for influenza this winter. A national steering group is in place to co-ordinate the response. Each hospital group and community health organisation has submitted a flu plan based on the evidence of last year’s successes and areas for action over the oncoming season. Each long-term care facility and private nursing home has received a detailed communication on how to prepare for and deal with flu. Additionally, each hospital group and associated community health organisation were requested to produce a winter plan which includes a specific section on flu. These plans were reviewed at a national meeting earlier this week. The HSE must be commended on the preparations it has made for this winter. Those preparations will significantly reduce the impact of influenza on the health services.
I take this opportunity to address concerns relating to the effectiveness of the vaccine and the impact of influenza in other parts of the world. The strain currently circulating in Australia is similar to the one which dominated in Ireland last winter and the vaccine for use in Ireland contains this strain of the virus and should afford protection. The latest surveillance reports relating to Australia indicate that the peak week of national influenza activity was comparable or higher than in recent years. However, clinical severity was low to moderate and the proportion of hospitalised patients admitted directly to intensive care units has been on the lower range reported in recent years. These latest reports also indicated that the vaccine was a good match for the circulating flu strains.
In Ireland, flu activity, as measured by influenza-like illness rates, is currently low, similar to other European countries. While it is too early to comment definitively on the efficacy of the seasonal flu vaccine, the Centers for Disease Control and Prevention in the United States have indicated that it is 50% to 60% effective in preventing hospitalisation in older people and 80% effective in preventing death in the elderly. Also of note is that no particular concerns were expressed in relation to either the current flu season or vaccine effectiveness at the EU joint meeting of chief medical officers and chief veterinary officers on influenza preparedness earlier this week.
Finally, I remind Deputies that vaccination remains, as Deputy Burton said, the most effective means of preventing infection by seasonal influenza viruses. We ask people to engage with the HSE's campaign of recent weeks.
Deputy Joan Burton: Critically, there is no reason anyone in a nursing home or who attends community care day centres, on a daily or weekly basis, should not be facilitated with the vaccine. By and large, the people attending those centres are older. Second, we have the more recent reports of the carbapenemase-producing enterobacteriaceae, CPE, bug. The HSE has acknowledged that it is extremely difficult to treat and already it has caused a significant number of deaths. A combination of this bug in hospitals and vulnerable people, both older and younger, going into hospitals as inpatients means a much higher risk in terms of mortality in that those who are ill with flu can get pneumonia and are highly exposed to the risk of developing the CPE bug. The HSE message is not being communicated sufficiently to people, including the HSE's own staff, where there seems to be a reluctance to get the vaccine. I urge the Government to act and minimise the damage and harm to people.
Deputy Billy Kelleher: The Minister of State said it, namely, that at-risk people include those aged 65 years and over, those with chronic illness requiring regular medical follow-ups, those with lower immunity due to disease or treatment, pregnant women and residents of nursing homes and other long-stay facilities. The key component in all of our health services is front-line staff. The HSE said that there has not been a great level of take-up. One has to ask why the HSE is not being more informative to its own employees, who are at risk of infection and infecting. I urge the Minister of State to ensure that the immunisation programme for all these high-risk categories is rolled out in a robust way and that the HSE will engage with staff, through advocacy groups, unions and worker representatives, to ensure that there is a big take-up. It is a critically important component in ensuring that there is herd immunisation in the context of the flu vaccine.
Deputy Damien English: I will ask the Minister for Health to contact Deputy Burton about the superbug because I do not have the data on the threats associated with it.
Deputy Burton is correct about the communications plan. A stronger campaign is required. The campaign was launched on 2 October, with an initial focus on health care workers. The radio adverts, which will run for three weeks, commenced on 9 October and there will be a further two weeks of the radio adverts when the flu goes over the threshold. Those aged 65 and over and pregnant women are the primary audience for the radio campaign, which will also reach medically at-risk groups and health care workers as they make up a more generic radio audience as well. The trend is that increasing numbers of health care workers are availing of the vaccine, with the figure increasing from 22% last year to nearly 32%, although the figure is probably still not high enough. Fourteen hospitals have exceeded the 40% national take-up target, compared to seven in 2015-2016. Therefore, there has been an improvement although I understand what Deputies Burton and Kelleher are saying. It is still not enough and we need to do all we can to encourage our own workers, who are working with vulnerable people, to try to increase the level of take-up.
Let me repeat that the vaccine is available free of charge from GPs for all people in the at-risk groups and from pharmacies for everyone in at-risk groups aged 18 years and over. An administrative charge may apply to people who do not hold medical cards or GP-visit cards. Again, I stress the need for people to engage and to get the vaccine.
Emergency Departments
Deputy Brian Stanley: I am seeking certainty in respect of Midlands Regional Hospital Portlaoise. A plan was to be released in September 2015 regarding the future of the hospital but we have not yet seen that plan. However, there is a plan contained in what is described as the final draft of the Dublin Midlands Hospital Group strategy for 2018 to 2013, which was given to me at the weekend. Last night a public meeting on the matter was held and up to 400 people attended. According to the letter sent with it, this plan was a final draft which was to be signed off on yesterday at a meeting of health managers at 2 p.m. in Dublin.
We now know what is in it but, unfortunately, what is in it is the end of emergency department services in Portlaoise. There will be no more emergency treatment in Portlaoise and trauma cases are to bypass Naas. The implications are serious. It is one of the busiest emergency departments outside of Dublin, having dealt with almost 40,000 people last year. The figure is further increasing this year, with more than 20,000 people in the first six months of the year using the unit. Where are these people to go if there is no emergency department between Tallaght and Limerick? Critically ill patients will be stuck in rush hour traffic on the N7. The other morning it took me three hours and five minutes to get from my house to the Dáil. The N7 is chock-a-block and not for one hour at rush hour. Rush hour now lasts for three hours in the morning and three hours in the evening. It starts at 3 p.m. and sometimes is not finished until 7 p.m. How does Susan O'Reilly think the 40,000 patients will be moved about? Is it by helicopter? Will there be fleets of helicopters?
The meeting last night was attended by the public, hospital staff and consultants, and general practitioners. They are the experts and they are absolutely adamant that this will not work. There is no capacity in the system. This will lead to the collapse of paediatrics and maternity services in Portlaoise, which is a huge concern. Let me be clear that Dr. Fleming, a cardiologist in the hospital, said the problem is one of capacity and resources. It is not a specialist problem. This is the key point, and I want the Minister of State to take it on board. Susan O'Reilly was put in there to do a job, but the Minister of State and I are her paymaster as are the public on the street and the citizens of County Laois and surrounding counties that depend on the hospital. The Minister of State needs to get a grip on this issue. Do not outsource this responsibility to her. If she signed off on this yesterday, get it and put it in the shredder.
On Tuesday, I raised the issue with the Government. |
Page
of 82
