Gino Kenny (Dublin Mid West, People Before Profit Alliance)
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5. To ask the Minister for Health if he is aware that an organisation (details supplied) recently published the Irish national ICU audit annual report showing that an average 5.6 critical-care beds per 100,000 population were open in 2022, which is less than half the mean value of 12 for Organisation for Economic Co-operation and Development, OECD, countries; and if he will make a statement on the matter. [25786/24]

Gino Kenny (Dublin Mid West, People Before Profit Alliance)
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I thank the Leas-Cheann Comhairle. My question relates to the Irish national ICU audit. There was a recent audit on intensive care beds in the State. It pointed out a number of an anomalies and, obviously, deficiencies. There were also positive things in that report on our healthcare system. I wish to hear the Minister’s views on the report.

Stephen Donnelly (Wicklow, Fianna Fail)
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I thought it was a very useful report. I have a lot of numbers here as I got into a lot of the numbers comparing our baseline with the OECD figures in preparation for this morning. The situation is better than the OECD comparison suggests. I will explain why. There is no question that we have had a shortage of intensive care beds. We know they are needed for very sick patients and for scheduled surgeries. Not having enough of them can have a serious knock-on effect, particularly for the sickest patients or for those most in need of complex surgery.

When Covid-19 arrived, we had 258 beds. We are adding 92 to that, which will bring us up to 352. That is nearly a 30% increase which is very useful. That is phase 1 and it will be finished at the end of this year. Phase 2 brings us a lot further; there will be a further 106 beds, which will bring us up to 458 beds in total. That is a very big and much-needed increase. In fact, it goes beyond the 2018 capacity review. The Deputy will remember that a capacity review was completed following the Sláintecare report. The review stated that the correct number of beds for Ireland is 430. We are going beyond that to 458. We are going a good bit beyond what the capacity review said was required.

To answer the Deputy’s question as to how, if that is the case, Ireland is still well below the average in the OECD figures, the information I received is to treat the international comparison with care because some countries count neonatal intensive care units, paediatric beds and other types of beds that other countries do not count. It is, therefore, difficult to do a like-for-like comparison. I will comment further in my next response.

Gino Kenny (Dublin Mid West, People Before Profit Alliance)
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I acknowledge there has been significant progress in intensive care beds since Covid-19, which exposed crack lines in medical need. Obviously, there is more demand in our public healthcare system because of population growth and so forth. Obviously, not having ICU beds creates a knock-on effect and a trickle-down effect. If there is full capacity at ICU level, that will have a knock-on effect in terms of bringing people out from the ICU into hospital wards.

Another issue to which the audit referred was the staffing of ICU beds. For every ICU bed, six well-trained clinical staff are needed. The audit pointed out that, in order to keep and retain these staff – which is a big issue in our public health system - there must be incentives to keep them. I wish to hear the Minister’s views in that regard.

Stephen Donnelly (Wicklow, Fianna Fail)
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I have been looking at the ratios. The OECD average is 12 beds per 100,000. When neonatal units, paediatric beds and level 1 beds are included, we get to approximately 11 beds per 100,000. It actually goes way up. For whatever reason, however, we do not count all of them in our OECD submission. We are going on the baseline, that is, the 2018 baseline set out in the report which examined what was needed in Ireland, and we are exceeding it.

As to the Deputy’s point on highly skilled staff, I could not agree more. In fact, in opening the beds we have opened during the lifetime of this Government, we have recruited nearly 800 extra staff into critical care alone. These are incredible staff who are highly trained and who deal with very complex health situations which are, sometimes, very emotionally and personally difficult. They really are extraordinary staff and I take my hat off to them. I meet them around the country. They are incredible healthcare professionals. I fully agree with the Deputy. We have hired nearly 800 so far. The plan is to keep going in order that we can open more of these ICU beds.

Gino Kenny (Dublin Mid West, People Before Profit Alliance)
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I accept that. I said from the outset that there has been progress in respect of ICU beds. The report referred to the issue across our health system in retaining staff who are trained here and who may emigrate and so forth. There are mitigating circumstances in this regard such as the work-life balance and staff getting accommodation in built-up areas like Dublin, Cork, Limerick and Galway where many of these beds are located. That is having a knock-on effect. Other countries have incentivised staff, whether that is retaining staff or bringing staff from overseas. There has to be imaginative ways to keep staff in terms of the cost of living and accommodation. If that can be done, people will stay. Accommodation is one of the factors for people not staying. Although it is not a simple thing, if it can be addressed, a lot of staff will stay in the Irish healthcare system.

Stephen Donnelly (Wicklow, Fianna Fail)
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I wish it were simple.

Gino Kenny (Dublin Mid West, People Before Profit Alliance)
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Yes.

Stephen Donnelly (Wicklow, Fianna Fail)
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While this is an issue, it is not an issue in all of our hospitals. In the context of some hospitals, the cost of living in the local area is much lower and rents and house prices are much more affordable. However, as Deputy Kenny has said, in some parts of the country, it really is an issue for someone on, say, an ICU staff salary, whether that is an ICU nurse or ICU healthcare assistant. It can be difficult. There is no question about that. The good news is that we are significantly increasing our nursing graduate places. From the start of this Government's term of office to the end, we will have gone from approximately 1,800 first year entry places to approximately 2,500. That is approximately 700 extra places per year, and we are going to continue to grow. We need to double the number of nursing places. We must have a situation whereby people want to work in the HSE. Approximately nine out of ten graduating nurses either start work in Ireland or, after a few years abroad, come back here. However, I fully acknowledge the cost-of-living issue is one that the Government and everyone in the Oireachtas need to keep working on.