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Sinn Féin's David Cullinane and Sec Gen of the Department of Health Jim Breslin.

Taking over private hospitals during the Covid-19 crisis will cost roughly €300 million

‘A fire alarm went off and we sent four fire tenders, and people are saying now we should only have sent three,’ the secretary general said.

LAST UPDATE | 2 Jun 2020

THE HSE has told the Dáil Covid-19 committee that the cost of taking over the private hospitals will be roughly €300 million.

The deal, which saw the State renting 19 private hospitals during the pandemic, was estimated to cost €115 million per month.

The arrangement is due to conclude at the end of the month, following a Cabinet decision last week.

The Irish Hospital Consultants Association told the committee earlier today that the deal was poor value for money. 

Sinn Féin’s David Cullinane agreed with the statement, particularly when less than half the capacity was used.

No cost-benefit analysis was conducted, according to the Department of Health’s Secretary General Jim Breslin.

He said the deal was negotiated over the period of one weekend, and was agreed on the basis the State might need the entirety of the private capacity.

Breslin said the department wanted to have all capacity at the ready, stating there were no other beds on the island the State could get access to.

Facing critism from Culllinane in relation to the cost, Breslin said: 

“A fire alarm went off and we sent four fire tenders to put out the fire, and people are saying now we should only have sent three… What if it needed more than three?”

‘Very poor value for money’ 

The consultants group said earlier today that the test of time has confirmed that the private hospital agreement, which is costing around €115 million per month, “represents very poor value for money from patient care and taxpayer perspectives”.

“The experience is that of very low private hospital bed capacity occupancy at around one third on average and low utilisation of theatre and other ancillary facilities.

“Furthermore, the private hospital contract is prohibiting the provision of urgent care required by patients with non-Covid-19 illnesses. This is leading to the accumulation on waiting lists of a large number of patients who require urgent care.

“There is now the additional risk that these patients will deteriorate clinically and will increasingly evolve into emergency cases if they are not treated without delay. All patients deserve timely access to quality care.”

Social distancing

The HSE also told the Dáil Covid-19 committee today that most of Ireland’s existing public hospitals will not be fit for purpose in terms of meeting the requirements of safe distancing.

In his statement to the committee, which is again being held in the Dáil chamber, Liam Woods, national director of acute operations, stated that even a relatively modest increase in the reproductive rate to 1.2 or 1.3 “would have very significant impact on both specialist critical care beds and the wider hospital system.”

“Our existing infrastructure in many of our public hospitals is not fit for purpose in terms of meeting the emerging requirements in terms of safe distancing,” Woods said.

In the last week, there has been increased pressure to reduce the social distancing rule from two metres to one metre by a number of sectors. 

Last week, Labour’s Alan Kelly said that the rule was hindering the reopening of the health service and screening programmes.

The committee was also told that until such time as there is a vaccine or cure for the virus, healthcare delivery will occur in a higher risk environment where outbreak and surge could occur at any time.

The underlying capacity issue remains in the acute system, the members were told, with the issues only being amplified by the need to manage Covid-19.

While the private hospital system is “not the sole solution for the safe delivery of care in the Covid-19 environment” it is the only immediate acute option that can help provide an occupancy of 80% delivering on the twin requirements of matching non-Covid demand and providing surge capacity for Covid-19, the committee heard.

As winter approaches this year there will be the additional challenge of Covid-19 patients on trolleys in emergency department awaiting admission to hospital wards, the HSE warned.

Speaking about the suspension of non-Covid care, the committee will be told of a build-up of waiting lists.

Areas of immediate priority include endoscopy, cardiology, cardiovascular, urology, orthopaedics.

The numbers waiting for more than three months for endoscopy at end February have gone from 11,801 to 17,664 at end April.

Equivalent waiting list figures for orthopaedic procedures go from 6,134 waiting more than 3 months in February to 8,672 by end April, 2020.

Similarly, all four national screening programmes have been suspended under clinical advice since March and can only recommence when certain safety conditions can be met, according to the HSE.

The committee will be told that virtual clinics could support the delivery of up to 50% of out-patient appointments in some specialties, and would reduce the requirement for face to face appointments.

On the private hospital deal, the HSE says that Ireland has a low number of ICU beds per head of population.

Clinical modelling exercises undertaken within the HSE in March regarding the expected demand for acute care and critical arising from the pandemic indicated that by mid-April, 1,000 critical care beds and 2,000 additional inpatient beds might be needed to match peak demand.

Existing and usual public sector capacity was 250 critical care beds.

The Irish Hospital Consultants Association said the predicted steep surge did not occur because of mitigating actions that were taken, adding “at this time it appears it is unlikely to occur in the months ahead given the success of the public health measures implemented thus far”.

Need for ongoing capacity 

The Irish Nurses and Midwives Organisation will also address the committee today and raise the issue of capacity and how it put the Irish health service on the back foot from the beginning.

Its statement states that due to government neglect over the years, the Irish health system has huge deficits in terms of bed capacity which urgently need to be addressed if it is to continue to deal with the Covid-19 crisis.

The INMO has called on the HSE to publish its clinical roadmap for the reopening of services, stating that it must allow for a “gradual reopening” of both public and private care in tandem with prioritising patients based on clinical need.

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    Install the app to use these features.
    Mute Pateen Johncruck
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    Jun 3rd 2020, 7:37 AM

    Smart move….think before you speak

    624
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    Mute Minamino
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    Jun 3rd 2020, 11:23 AM

    @Pateen Johncruck: more like wait for the man in your ear piece to think before feeding you the new script off the top of his head. You never notice these pauses until now? All these politicians are told exactly what to say

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    Mute Dave O'Keeffe
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    Jun 3rd 2020, 11:55 AM

    @Minamino: then someone needs to get Miller out of Trump’s ear

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    Mute Peter Cavey
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    Jun 3rd 2020, 3:25 PM

    @Minamino: when your country is bolted to the north of a country being run by a megalomaniac, you have to be very, very, very careful what you say in public.

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    Mute Conall
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    Jun 3rd 2020, 4:13 PM

    @Minamino: They are probably just reminding themselves of what they decided to say earlier. Off the cuff comments about the big, and recently a bit unhinged, neighbour right beside you are unwise.

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    Mute Ken
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    Jun 3rd 2020, 8:07 AM

    Maybe Trump should consider pausing for 21 seconds every time before he speaks.

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    Mute David A. Murray
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    Jun 3rd 2020, 8:12 AM

    @Ken: He did pause for 13 seconds, while a rally crowd chanted “Send her back!”.

    67
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    Mute John Jones
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    Jun 3rd 2020, 9:18 AM

    @David A. Murray: The numnuts would have to count to 5 four times and add 1 to get his 21 seconds.

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    Mute pat seery
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    Jun 3rd 2020, 10:34 AM

    @Ken: he should pause for a week before sneaking

    14
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    Mute Dave O'Keeffe
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    Jun 3rd 2020, 10:36 AM

    @Ken: he prefers his pauses to be scattered throughout the sentence instead

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    Mute Brian Murphy
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    Jun 3rd 2020, 11:11 AM

    @John Jones: comment of the day….tip ur cap sir.

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    Mute JackSimpson
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    Jun 3rd 2020, 8:26 AM

    The king of virtue signalling.

    191
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    Mute Johnny 5
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    Jun 3rd 2020, 8:51 AM

    @JackSimpson: Yawn. You guys are so boring.

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    Mute Flexéire
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    Jun 3rd 2020, 8:55 AM

    @JackSimpson: it’s not his fault his mind can think bigger.

    66
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    Mute Wayne Connor
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    Jun 3rd 2020, 12:40 PM

    @JackSimpson: ‘virtue signaling ‘ is a term that’s been doing the rounds lately with these right wing cranks. It’s an obvious retaliation to their guff been labeled hate speech and I guess they needed to come up with something to use as they attack by nature. The fact that you’re attacking somebody because they are displaying virtue shows your base intent. Stop watching FOX, you’ve been had

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    Mute JackSimpson
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    Jun 3rd 2020, 1:34 PM

    @Wayne Connor: Good morning Wayne/ Bmul /other trollish accounts. I hope you slept well. Youve a long day of trolling ahead of you.

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    Mute John Quill
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    Jun 3rd 2020, 7:55 AM

    The fact that he paused at all was probably enough to trigger the orange man-baby

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    Mute ianglen
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    Jun 3rd 2020, 7:59 AM

    I think that is a perfectly normal response to the insanity of Trump.

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    Mute The Equalizer
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    Jun 3rd 2020, 8:07 AM

    Another Virtue signaling liberal with double standards. He still remembers his blackface pictures. Snowflake guy

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    Mute Y U no spell good?
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    Jun 3rd 2020, 8:15 AM

    @The Equalizer: Congratulations for using all the inflammatory buzzwords you know. Next time see how many you can get in one sentence!

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    Mute Johnny 5
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    Jun 3rd 2020, 8:22 AM

    @The Equalizer: You ok hun?

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    Mute Dave Thomas
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    Jun 3rd 2020, 8:31 AM

    @The Equalizer: Awww, did somebody say something mean about trump? Put your dummy back in and stop throwing your toys out of the pram!!

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    Mute Brendan Heery
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    Jun 3rd 2020, 8:49 AM

    @The Equalizer: you left out ‘triggered’ and ‘woke’.

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    Mute Nowa Huta
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    Jun 3rd 2020, 1:13 PM

    @Brendan Heery: didn’t he give powers to his own police force to arrest and prosecute natives that were protesting against their land being forcibly taken from them so for an oil company. No you probably didn’t get feed in your social media platforms as some celebrity didn’t comment on it.

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    Mute Drunk in Dublin
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    Jun 3rd 2020, 3:18 PM

    @The Equalizer: how is this “virtue signalling”? He paused before he spoke so he could collect his thoughts.

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    Mute Declan Dowling
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    Jun 3rd 2020, 8:13 AM

    A lot of internal dialogue going on there!
    “Don’t say it” X 21

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    Mute Jesus Christ
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    Jun 3rd 2020, 7:36 AM

    He didn’t answer the question. He’s a coward

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    Mute iohanx
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    Jun 3rd 2020, 7:56 AM

    @Jesus Christ:

    Disagree. The abomination in the White House is causing many to choose their words carefully because he’s so thin skinned and liable to make really stupid policy decisions that effect millions.

    I.e. Paris Agreement, WHO, Trade deals etc etc

    Thin skinned and demonstrably stupid.

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    Mute Lad
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    Jun 3rd 2020, 8:12 AM

    @Jesus Christ: he did answer the question by saying it was time to listen, that racism is everywhere and enough is enough. If he had answered the question on trump like the media wanted him to, then he would have totally missed the point.

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    Mute Brian Dunne
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    Jun 3rd 2020, 8:17 AM

    @Jesus Christ: i think he made his point very tactfully.

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    Mute biggybald
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    Jun 3rd 2020, 8:20 AM

    @Jesus Christ: Because they rely on them for 75% of exports, that’s why he didn’t answer and not because he’s a coward.

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    Mute biggybald
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    Jun 3rd 2020, 8:21 AM

    @biggybald: In other words… using his loaf.

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    Mute Marie Broomfield
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    Jun 3rd 2020, 9:29 AM

    @Jesus Christ: you mean he didn’t give the answer some people wanted him to. Why should he be drawn into it that way. He was dead right to turn it on themselves and basically say ( in the words of jesus the christ) “first take the plank out of your own eye, and then you will see clearly to remove the speck from your brother’s eye.”

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    Mute Barry Teehan
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    Jun 3rd 2020, 8:20 AM

    ” You say it best, when you say nothing at all “

    68
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    Mute RogerRamjet
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    Jun 3rd 2020, 8:24 AM

    He would have known that question was coming. His response sounded well-rehersed from a prepared script.

    I wonder if the pause was intentional to make it seem like he’s a deeper thinker and that he was just coming up with the words that followed in the moment but he messed up the ‘lengthy pause for the gravity of the situation’ by carrying it on a bit too much.

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    Mute Johnny 5
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    Jun 3rd 2020, 8:48 AM

    @RogerRamjet: Canadian man bad. Orange man good.

    52
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    Mute Shazam37
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    Jun 3rd 2020, 9:24 AM

    @RogerRamjet: his pause was completely staged. He knew he was going to be asked and he had an answer prepared.

    Not a good actor.

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    Mute Drunk in Dublin
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    Jun 3rd 2020, 3:20 PM

    @Shazam37: what is wrong with you? Who “stages” a pause? The mental gymnastics your brain performs are incredible. 12 points.

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    Mute Shazam37
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    Jun 3rd 2020, 7:17 PM

    @Drunk in Dublin: who stages a pause? This chap.

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    Mute paul starrs
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    Jun 3rd 2020, 8:29 AM

    FAKE NEWS us park police have already issued a statement saying they didnt fire tear gas they were smoke grenades and they also had no knowledge trump was going to the church for said photo op. A lie can travel half way round the world while the truth is putting on its shoes.
    https://www.nps.gov/subjects/uspp/6_2_20_statement_from_acting_chief_monahan.htm

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    Mute Thomas Harrington
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    Jun 3rd 2020, 8:34 AM

    @paul starrs: concussion grenades too – don’t forget them unless you think the bishop of St. John’s church is lying

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    Mute Dave O'Keeffe
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    Jun 3rd 2020, 8:40 AM

    @paul starrs: Bill Barr personally ordered the use of force to disperse a peaceful protest according to some sources

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    Mute Dave O'Keeffe
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    Jun 3rd 2020, 8:41 AM

    @paul starrs: just because the police didn’t know it was for a photo op doesn’t mean it wasn’t for a photo op. See what the leader of the church he went to had to say.

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    Mute paul starrs
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    Jun 3rd 2020, 8:47 AM

    @Dave O’Keeffe: he didnt order them to use tear gas on ” peaceful protesters” the caches of projectiles and weapons they found and the injured officers might be a giveaway

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    Mute Dave O'Keeffe
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    Jun 3rd 2020, 9:05 AM
    22
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    Mute Dave O'Keeffe
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    Jun 3rd 2020, 9:14 AM
    19
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    Mute Pauric J O'Brien
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    Jun 3rd 2020, 9:15 AM

    @Thomas Harrington: no such thing as a “concussion” grenade. Concussion is a medical diagnosis not a military ordinance term. Unless you are suggesting that the good bishop is a military ordinance expert…….
    Ps, it’s a percussion grenade. Basically a loud banger, one of the safest methods to clear s croud.

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    Mute paul starrs
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    Jun 3rd 2020, 9:30 AM

    @Dave O’Keeffe: yeah that one mentions the weapons cache too lol. Does it mention that this was less than half an hour before the 7pm curfew

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    Mute Derdaly
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    Jun 3rd 2020, 9:48 AM

    @paul starrs: it was still before the curfew. If you were queuing for last orders and were told the bar had closed thirty minutes early I’m sure you would be more than a little surprised.
    These were federal police and agents, not DC police and not under the control of the DC police chief. So who issued the orders?

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    Mute Dave O'Keeffe
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    Jun 3rd 2020, 10:38 AM

    @paul starrs: it mentions police saying there were weapons, it also mentions reporters saying that’s bs. At least I provided a source showing both sides.

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    Mute Shazam37
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    Jun 3rd 2020, 9:22 AM

    Completely staged.

    30
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    Mute Derdaly
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    Jun 3rd 2020, 9:38 AM

    @Shazam37: do you really thinks so? You only mentioned it 3 times already… Are you paid by the quantity of posts?

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    Mute A2 Poster
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    Jun 3rd 2020, 11:11 AM

    @Shazam37: I don’t really think it matters, even if it was staged to be honest. Nothing would change if it were not. Same question, same pause, same answer. Trump is a budding dictator and many people are looking on in horror at what the US has become in 4 short years.

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    Mute Shazam37
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    Jun 3rd 2020, 12:57 PM

    @A2 Poster: depends on the point you’re making.

    Plenty here are suggesting this shows he “thinks before he speaks” because he paused for 21 seconds before answering. Some have suggested oh he’s better than Trump – he thought about his answer.

    The reality is that’s all optics. And the people who think that have been hoodwinked through their own sheer nativity.

    The reality is that staged, spun responses like this damage democracy. You can’t get a straight answer from a leader. Lies. Spin. Misleading the public.

    As the article says the HONEST answer is “I don’t like him or how he does business but we rely on the States as major trading partners”

    The public need to be better informed and realise the actual choices rather than be infantilised by things like this.

    Canadians should be aware – sure we can criticise Trump, justifiably, but that might mean you all lose jobs and income.

    Same goes here. Let’s make adult choices – and that begins by knowing the actions and the consequences.

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    Mute A2 Poster
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    Jun 3rd 2020, 3:37 PM

    @Shazam37: First off, thanks for spending the time to write out a good reply.

    “The reality is that staged, spun responses like this damage democracy. You can’t get a straight answer from a leader. Lies. Spin. Misleading the public.”
    - This is related to the point I was trying to make above when I said it didn’t matter that it was staged because I don’t think that the answer would change. So I would disagree that what he said was a lie or misleading.

    “As the article says the HONEST answer is ‘I don’t like him or how he does business but we rely on the States as major trading partners’”
    - It would certainly be more blunt, but the real world doesn’t work this way, and what you have said is a little idealistic. Truth is he needs Trump and the giant economy on his doorstep. Trump has pulled out of climate deals, global health organizations, peace treaties, all to the detriment of his own country. He may well do something drastic if his nearest neighbour were so forward is his condemnation.

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    Mute Paddy Doherty
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    Jun 3rd 2020, 8:56 AM

    Excellent answer, that carefully constructed answer required thought. Trudeau only needed 21seconds. I don’t think Trump could have managed an answer like that in 21 seconds

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    Mute Shazam37
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    Jun 3rd 2020, 9:27 AM

    @Paddy Doherty: what planet are you living on? That carefully constructed answer required hours and a team of people.

    How are people THIS naive?

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    Mute Paul
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    Jun 3rd 2020, 8:35 AM

    He a man who knows which side of his maple leaf needs to be kept buttered

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    Mute Keniby, Just before the apocalypse.
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    Jun 3rd 2020, 8:00 AM

    Forget about anything he said eventually, the 21 seconds said it all.
    I understand diplomacy and the importance of trade but just once I’d like to see a politician on the same level as him lay into him. Preferably face to horrible orange face.

    37
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    Mute Shazam37
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    Jun 3rd 2020, 9:25 AM

    @Keniby, Just before the apocalypse.: The 21 seconds doesn’t say anything except – “this is what my spin doctors came up with”

    It’s completely staged. To go from that to a pre prepared answer? What you think he was struggling to remember his lines?

    Now one can debate the tactics effectiveness – silence as an implied criticism – and that’s fine. But let’s not pretend it wasn’t pre planned.

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    Mute Brian Ó Dálaigh
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    Jun 3rd 2020, 9:30 AM

    @Shazam37: who said it wasn’t pre-planned? Your entire comment sounds like a rebuff to a comment that doesn’t exist.

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    Mute Val Ruscheniko
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    Jun 3rd 2020, 10:08 AM

    Maybe he also needs to take a short drive across the US border and back again to see if his eyesight is OK!

    11
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    Mute Martin Smith
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    Jun 3rd 2020, 11:16 AM

    Man who painted his face black pauses before answer I not sure which is worse the painting face black or using tear gas to quell violence.

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    Mute Dave O'Keeffe
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    Jun 3rd 2020, 11:58 AM

    @Martin Smith: using tear gas to quell peaceful protest just about takes the win.

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    Mute Ian
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    Jun 3rd 2020, 11:29 AM

    The guy was just waiting for the autocue to load his prepared speech, I think people are reading to much into this!

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    Mute Drunk in Dublin
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    Jun 3rd 2020, 3:23 PM

    @Ian: yes, like making up the ludicrous idea that he had a prepared speech. Not everyone is out to get you, Ian.

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    Mute Seriousnojoke
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    Jun 3rd 2020, 8:47 AM

    Pathetic hyp0crite and c0ward.

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    Mute James Walsh
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    Jun 3rd 2020, 10:08 AM

    @Seriousnojoke: I usually call Trump a tangerine turd or orange abomination but everyone has their personal favourites I suppose?

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    Mute Alan McDonald
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    Jun 4th 2020, 3:05 PM

    I didn’t see any paws of any length. Fake news.

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    Mute
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    Jun 3rd 2020, 8:50 PM

    @MrMichaelSpicer – The room next door man should do a take on this!

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