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Plan for reopening non-Covid healthcare services could take 'several weeks'

TDs have called for the plan’s publication to be accelerated.

CRITICISM HAS BEEN levelled at the new government over the delay in publishing the roadmap for restoring non-Covid healthcare.

Speaking in the the Dáil for the first time as health minister this week, Stephen Donnelly said the roadmap would not be released until next week, and that the full reopening could be “several weeks” away.

Cancer screening, mental health services, community health services, and elective surgery have been put on hold for much of the crisis with concerns raised there could be a waiting list of over one million people.

Social Democrats co-leader Róisín Shortall asked the new minister why there is still no clarity about when normal services, or something close to normal services, can return.

“I cannot see why we have not had the roadmap for restoring non-Covid healthcare long ago. This is about the sixth week that the roadmap has been promised. I do not blame the minister for that, but his predecessor promised week on week that it would be agreed the following week by the HSE board.

“We still have not seen it and there is a huge amount of capacity there that seems to be unused and that we are all paying for. That does not make any sense. When will that roadmap finally be produced?” she asked. 

Sinn Féin’s health spokesperson David Cullinane told TheJournal.ie: ”On 23 June the HSE confirmed that it would publish a framework document to guide hospitals and community services in developing local plans for the phased resumption of services. The publication of this needs to be accelerated.”

Labour leader Alan Kelly has also called for the government to publish a plan to reopen non-Covid-19 healthcare services.

He said there is growing concern over the impact on people’s health as many vital services remain closed to patients.

Health experts have said there is a risk of a jump in secondary deaths if some life-saving services are not reopened.

On Friday, the Central Statistics Office said there was a pronounced increase in death notices placed in April 2020, with the numbers of death notices rising from 2,861 in March to 3,502 in April before decreasing to 2,635 in May.

Based on the analysis of thousands of death notices, excess mortality (deaths above those likely to be experienced under normal circumstances) is estimated at 1,072.

Last week, a Hiqa report found that there were about 1,100 to 1,200 more deaths than would be expected based on historical patterns – a 13% increase between 11 March and 16 June.

At the beginning of last month, Kelly said: “The plan is late. It was promised on two different occasions but we still haven’t got it and this is a significant worry because of non-Covid preventable deaths and the whole issue of service provision for people is a real concern to us.”

He repeated his call for the plan to be released as a matter of urgency.

“We need a plan for reopening the health service. The HSE has published a kind of strategic framework for delivery; it has not published a full clinical roadmap. When will we get that? We have been waiting a seriously long time for it.

“He said on 11 June that screening was not being restored quickly enough, so I presume he has now put in place plans to accelerate screening. Will he give us some date,” said Kelly.

Donnelly confirmed that the HSE is “working on” a clinical roadmap for the delivery of non-Covid services in a Covid environment.

He has also asked the question about the roadmap delivery. 

“My understanding is that it will not be ready next week and may take several more weeks. It is something I will be looking into with urgency,” he said.

Donnelly said it will be necessary to reassess the targets set out in the national service plan as capacity in many services will remain reduced and demand is likely to be higher than normal, because elective activity was postponed during the crisis.

He said: “We will need to be vigilant in implementing the public health surveillance controls to avoid further spikes of Covid infections, while being prepared to deal with any upsurge in healthcare requirements.”

In a statement to TheJournal.ie, the minister said: 

“I want to see the roadmap ready and services back up and running for patients as soon as possible. I will be monitoring this very closely.”

Cullinane also raised concerns about the resumption of cancer screening services this month.

“The National Screening Service has announced the planned reopening of screening services along a totally different timeline. While CervicalCheck is to resume in July, BreastCheck and BowelScreen are delayed until September or even October. This is not good enough.

“People’s conditions will go unnoticed and untreated for months, which will decrease their chances of full recoveries. It is important to remember that care delayed is care denied, and that simple problems will be exacerbated and become more complex as delays continue. This will lead to an increase in costs,” he added.

The Waterford TD said the government has placed significant emphasis on the reopening of the economy “seemingly at the expense of the resumption of healthcare services”.

“While we have a detailed blueprint for the economy, we only have the beginning of a plan for healthcare services,” he said.

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