Transcript generated automatically by AI and may contain errors.
Chapter 1: Who are the guests featured in this episode?
Now it is time for our Friday gathering and this week I'm joined by Grace Boland, Fine Gael TD for Dublin Fingal West, Duncan Smith, Labour TD for Dublin Fingal East, Liam Doran, former General Secretary of the Irish Nurses and Midwives Organisation and Christina Finn, political editor with thejournal.ie. Good morning to you all. You're very, very welcome and thanks a million for coming in.
Duncan. It must pain the opposition to praise a government minister, but has Jennifer Carroll-McNeill done the right thing here?
Yes, she has, yeah, and it doesn't pain me or the opposition to praise the right thing to do, and the minister did the right thing here. Sláinte Care, there's a political consensus around Sláinte Care. It is the future, we hope, of healthcare in this country, and to do it and to implement it is going to have its moments of friction, and this was one of them, and the minister stood up to the
consultants in the rotunda in this regard. I'm sure there'll be more battles ahead. We know the HSE's own internal audit says that there's still a way to go in terms of private practice in public hospitals. But, you know, the minister did well this week and, you know, we still are behind in terms of implementation of sláinte care and we need to continue pushing it.
But no, it doesn't pay me at all.
OK. Grace, we know from the response into this programme, into other programmes on RT Radio, indeed, there are lots of women out there who are very annoyed about this. They feel that they are being denied choice. I presume somewhat least of them are Fine Gael voters. Do they have a point?
So firstly, I'd like to welcome the decision of the Board of the Rotunda this week. The Minister absolutely is committed to sláinte care and we saw that this week. We saw Fine Gael, we saw this government committed to sláinte care. Sláinte care is about providing public health services in our publicly funded hospitals.
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Chapter 2: What is the significance of Sláinte Care in healthcare discussions?
And if you're a consultant on a public-only contract, then you are to be providing public services in a public hospital.
OK, so you've no concerns about this issue of choice, which a lot of people have raised, particularly women.
Well, I think it's really important to say that there is private maternity cover in our hospitals today.
But there won't be for that much longer.
Well, I think we're probably looking years into the future. We have many consultants who are on the old contract who are continuing to provide maternity private maternity cover. But fundamentally, what Sláinte Care is about and what the Minister is doing is strengthening the maternity care in our publicly funded hospitals and it allows her to bring forward reforms for all women.
This is about ensuring that women don't have to consider whether there's costs, whether they need to go private. It's about improving our maternity cover in our publicly funded hospitals.
Is it right that private consultants can still do private work in public hospitals?
Well, the reality is we had an old system. Sláinte care is moving us away from that system. As I said, we've seen Fine Gael and this government really committed to sláinte care and providing public only health care. But the reality is, David, they're on contracts. You know, we couldn't force them to move on to these contracts. They were given the option to do so.
So for the moment, we will have to balance things.
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Chapter 3: How do women feel about maternity care choices in Ireland?
But you're not guaranteed to see the same person throughout your journey through pregnancy, which is why a lot of women want to pay for private, which is why women and particularly when you're, you know, like women that got in touch with us and. To give you an example, there was one woman who had gone through several miscarriages and she had gone through the first one.
And after the second one in the public system, she asked, could I get investigations about what's going on here? Because it had taken her a long time to even get pregnant through IVF and the rest. So, you know, she was used to the medical process of trying to get pregnant. And she was told, we only do investigations after your third miscarriage. So come back to us then.
She should be able to get those tests that she requests. And, you know, I asked the HSE and the Department of Health about, you know, additional scans and additional appointments that women might want throughout their pregnancy. And they said that only scans and appointments are given in accordance to clinical need.
So they're not routinely given unless there's a clinical need identified, like if you had cramping or bleeding or spotting. Well, you know, I think this whole conversation has begun about, you know, even women's mental health throughout pregnancy, pre and postnatal. And a lot of women who have had difficulties or perhaps not positive experiences within the public system.
Just want that extra bit of reassurance, that extra bit of care, maybe seeing the same face at an appointment, having a scan maybe before the 12 week scan. You know, I've spoken to women this week who have had miscarriages again, who want to have a scan at six, seven, eight weeks just to see that everything is going OK.
And at the moment, we're not having the conversation, I don't think, about what if we're going through to a slouch care model of public health. Only care of maternity care. What does that look like? Does it mean levelling up the public service to more of a private care model? Because at the moment we're talking about consultants and employment law and insurance and all the rest.
But there are very human stories.
There are very human stories and women who are pregnant right now or who are planning pregnancies in the future and want to know what level of care they're going to be offered.
Okay, Liam, you're straining it a bit there to get in, because this is a subject that is so close to your heart, sláinte care.
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Chapter 4: What challenges are faced in implementing Sláinte Care reforms?
Two, it requires strong management within the HSE. And the roster, the internal audit thrown up this week suggests we don't have that strong management within the HSE. They're not getting the benefit of it. And thirdly, it requires societal buy-in and confidence that the new model that we evolve to will provide the same quality by levelling up, but not by levelling down.
That's exactly Exactly the point that Christina was making.
And can we be confident in that? No, not in the sense that we speak with, you know, governments can speak with two or three dimensions on this. Like the minister was quite rightly very strong on the public only contract. But it is for the last number of 12, 15 months, we've had a pay a number strategy in the health service, which is directly, it's a recruitment embargo in all but name.
And we had the master of the rotunda this week come out, correctly point out, now I wish the rotunda had been very loud in this over the last 12 or 18 months, that they're sharp midwives. They should have wanted 29.5 by international best practice. No hospital in this country has it. In Portlaoise, 15 years ago, David, we had one midwife to 55 births. And we know what happened there. We haven't.
We're better than that now, but we're still not at the international norm. So we have we can't have sláinte care if on the one hand we clap ourselves in the back because we did the right thing about public only contract. But on the other hand, we preside over a failure.
to invest in staff if consultants have to work Saturdays and Sundays and be rostered we need more consultants and less NTHDs we need more nurses and midwives in hospitals in the community we need more physios OTs dieticians in the community small injury units have got to be open extended hours in the community all those things have got to happen and when they happen
over a 15-year period, then we can have the confidence to say to society and to every mother-to-be, to every elderly person, to every person with a chronic condition, you are safe in the public health service's hands.
But I can imagine if Jack Chambers is listening to this, there's probably steam coming out of his ears. But it's a choice. Because we are spending more on health than we ever spent before. Yeah. And for years we underfunded health.
We are still short acute hospital beds. And by the way, acute hospital beds is not the solution to all our problems. I keep looking at, I live in County Louth. We have an ED department that's overworked in our Lady of Lures. The nearest small injury unit, which is excellent by the way, is in Dundalk, 25 miles away. We're looking at the growth of DRADA to increase from 50,000 to 80,000.
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Chapter 5: Can women access midwife-led care in public hospitals?
There's one opening in Swords today, I think. But it will be open by the end of the week. The official openings say it will be open by the end of the month. These are going to bring big differences. So this is the moment and this is the time where we are going to have to see this balance.
And the pressure is going to be on this minister and subsequent ministers to, I don't like the phrase level up because it has British Tory party connotations, but to improve and resource our public health system to a level where if you grow up in this country, you naturally will go down to your community for minor care, for clinics, and you don't have to go into an overpacked, bomb-out hospital for everything.
I want to move on to the economy. Grace, the Fiscal Advisory Council not very happy with the government borrowing to save, which doesn't seem to make an awful lot of sense. As Gabriel McClough, the governor of the Central Bank, agreed on Morning Ireland. Is the government going to start listening to the Fiscal Advisory Council?
So I think it's also important to say, David, that the IFAC report expressly said that the economy is in a very healthy state. We've got robust growth.
Which is exactly why we should be saving for the rainy day, which is inevitably coming.
And we are, and we have two funds that we put money into. But we also have to look at this in a broader context. Antoinette, the Minister for Finance, has to look at what's happening in the global sphere. There is the pressures that the closure of the Straits of Hormuz put on all of us. We're looking at the ECB increasing interest rates to try and tackle inflation.
We are obviously talking about investing more in health care services where we need to support families and in particular vulnerable families. So it's always a balance.
So the answer is to cut taxes, according to the Tony stuff.
Well, I very much welcome IFAC's concerns. I think it's really important. I'm very focused on public spending. I'm on the Public Accounts Committee. Unfortunately, you know, at that committee, we focus on things when they go wrong and we do see week in and week out public leakage. And that is a point that I put to the Secretary General of the Department of Public Expenditure.
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Chapter 6: What are the current issues with continuity of care in maternity services?
It will be played at a neutral venue away from home on the 4th of October. We don't know yet where that will be. I understand it won't be Hungary-Israel games since the conflict broke out in the Middle East have been played in Hungary in the past. But the game will not be played in the Aviva Stadium.
Yeah, Tony, the statement from the FAI quotes Communication they've had from the Palestinian Football Association regarding the fulfilment of the fixtures and the Palestinian Football Association in a statement expresses its appreciation for the principled positions taken by the FAI in support of the rights of the Palestinian people and Palestinian athletes.
The Palestinian Football Association also affirms its respect for the decision made by the FAI within the framework of its sporting and international obligations in a manner that it enables it to continue fulfilling its noble mission of serving football and promoting the values of justice, solidarity and mutual respect.
And the FAI go on to point out that if they refuse to play the game, there would be serious financial and competitive implications for them.
Yeah, the EGM last November, the General Assembly of the FAI made it very clear their feeling on the issue. They wanted the FAI to bring a motion to UEFA asking that the Israeli Football Association be suspended for playing in occupied territories and various other statutes of UEFA that had been infringed. And that had a huge majority support.
And as I mentioned, the Stop the Game campaign has continued to draw support from a wide variety of people within Irish football. And the players have been put in a difficult situation, as has the FAI itself. So the fact that they have been in contact with the Palestinian FA, their counterparts, and have such a...
communication, offering solidarity and support for the Palestinian football association, they may feel will ward off some of the protests and some of the objections to this decision.
OK, Tony O'Donoghue, RT Soccer Correspondent, thank you so much for joining us with that analysis. Duncan Smith.
Yeah, it's not unexpected, but it's an answer to a question no one was asking. No one was asking for the game to be moved. People are asking for the game not to go ahead. Football people are driving this. Football fans, football players, former Irish football managers, Brian Kerr. Israel should not be allowed to take part or should not be taking part in UEFA or FIFA tournaments.
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