Richard Boyd Barrett urges full public takeover of private hospitals
Richard Boyd Barrett pressed the minister on the use of private hospital capacity during the COVID-19 pandemic and urged full public ownership of private hospitals. He argued against a return to a two-tier health system and called for an integrated single system to manage COVID care, surge capacity and waiting lists.
Call for public ownership
The deputy urged that private hospitals be taken fully into public ownership rather than rented from private owners, arguing that paying large rents effectively benefits billionaires and that only public ownership would allow proper planning of capacity and resources.
Rejection of a return to a two-tier system
The speaker said a return to a two-tier system is untenable while COVID-19 remains a threat, criticised suggestions that the system could revert soon, and insisted the government must decide to keep capacity integrated rather than separating public and private care again.
Capacity, ICU and staffing needs
He called for COVID care, surge capacity and attention to non-COVID waiting lists, stressing the need for significant additional ICU capacity and increased staffing across the healthcare system to manage the pandemic and future demand.
Nursing pay and contract issues
The deputy pressed for pay parity and implementation of awards for nurses, citing the IMNO demands, a major recruitment campaign and rapid rollout of the enhanced nurse contract. The minister noted 4,500 nurses are now on the enhanced contract compared to 3,200 last month and said the HSE has been instructed to speed access.
Plasma therapy and the minister's reply
He asked why plasma donation machines at James's were reportedly idle despite volunteers for trials; the minister said she would revert in writing. The minister also outlined the existing agreement with private hospitals - an initial three-month use with options to extend month-by-month, operation on an open cost-book basis with CNAG and PAC scrutiny, a 30-day review period at the end of May, and no intention to acquire ownership under the current arrangement while Sláinte Care considers longer-term reform.
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Minister, can I press you on the issue of public and private? I think given that Covid is going to be with us for the foreseeable future, any consideration now of a return to the two tier system is just untenable and the government need to make up its mind. Fianna Fáil seem to be somewhat sitting on the fence and even hinting maybe we should go back sooner rather than later to the two tier system. I want to push in the exact opposite direction. and say it shouldn't just be for a few months. We need Covid care, we need Covid surge capacity and we need to deal with the waiting list crisis and non Covid care. The only way that can be done is to integrate all healthcare capacity, public private into a single system. And I put it to you Minister, we need to grasp that nettle now and take the private hospitals fully into public ownership, not on the basis of paying huge amounts of rent, effectively to billionaires who own them, but actually taking them over fully. Would you respond to that? Thank you. Thank you very much Deputy Boyd Barrett. I have to be very careful on the floor of this door because I am conscious that we are in an agreement obviously between the private hospital association and the HSE in relation to the use of private hospitals for in the first instance a three month period, which I think from my memory runs to the end of June, with the opportunity to extend for a further month and then the opportunity after that of extending on a month by month basis. We are with both sides of agreement to that regard. We are not providing profit for anybody as it is done on an open cost book basis, will be subject to CNAG scrutiny, PAC scrutiny and all that no doubt as well. But there is a clear understanding in the agreement that at the end of this month, the month of May, there is a 30 day kind of review period. I do intend that my department at the HSE will use that period of time to review the arrangement. Lots of suggestions and comments have come up and then to arrive at an informed viewpoint to engage with the Department of Public Expenditure and Reform and to reverse to government and to the Oireachtas. It is not my intention to take over the ownership of the private hospitals through this arrangement. It is my intention to try and keep the capacity at the level we require for the COVID-19 pandemic. I think the question Deputy Shortall asks about the future beyond that is, in my view, a question for the Sláinte Care work being led by Laura Magáhy. Well, I think we need to go further now, Minister. I mean, I just don't see... There was never a justification for a two-tier system. There has been a general acknowledgement with Sláinte Care that that is the case. Now that we have the private healthcare capacity in our hands, why on earth would we go back? It doesn't make any sense. There is a problem with this contract because it's essentially rent to people who are making profit from health. Whatever way you put it, why not take it directly under public control? And it's the only way we can establish how much additional capacity we need. But we certainly need significant additional ICU capacity generally, staffing levels right across the healthcare system. Unless you have a single integrated system, I don't see how you can even do that. But also you need, and I'd like to hear your response to this, to respond to the IMNO's demands in terms of pay parity for nurses with other healthcare workers, big recruitment campaign, paying them the awards that they were granted as a result of the industrial action. And one quick question you might not have time to answer, I just want to ask you is about... I've been asking for a long time about blood plasma therapy. There is trials going on and 500 people have signed up to donate plasma, but the machines in James's, the phoresis machines, are sitting idle at the moment, okay? And I know that from somebody who went up there and the staff told them. The results from blood plasma therapy are very good. If there's people willing to donate, why aren't we not collecting the plasma? I'll revert to you in writing on it. On the enhanced nurse contract, I'm pleased that the number of nurses now on it is 4,500 compared to 3,200 last month. But I want us to see that every nurse who wants that enhanced nurse contract can get it quickly. And I've been clear to the HSE in that regard. Regarding nurses or other staff working in private hospitals, my understanding from the agreement is that they remain employees of that entity. So just to be clear on that, look, I want to create a universal health service. I want to create the Solange Care Health Service, but the reality is we don't own the private hospitals. We have the use of these buildings for the period of time by agreement with the private hospital owners. You'd like to go further, I know you would, but I just want to put the factual position on the record of this. We'll make a cool thing about this. We'll be getting started, we'll get started. How about this? We'll be getting started, OK? Just like... We'll be getting started. How about this? We can't buy this information. Well, I'll be getting started, OK, we're going to get started, right? Yeah. We can't even do that. That's amazing. We'll be getting started. We'll be getting started, right? You might as well get into it.
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