Facts or fiction. Some thoughts as we enter the winter months @DonnellyStephen @HSELive @roinnslainte @paulreiddublin @SusanMitchell_ @ciarakellydoc

1/ Why do we look for a winter plan every year . We know what’s coming. It comes every year. More acute admissions, the seasonal influenza outbreak, worsening of community acquired infections.

2/ Trolleys and EDs are full, patients can’t be discharged to step down facilities or nursing homes owing to lack of availability, slow processing of fair deal packages, no home care packages etc. We know this. It’s been the same for years.

3/ Why do we await a “new” winter plan. What is needed is the same this year as it has been every other year. What have we done during the past 6 months (when we knew what was coming) to improve the system.

4/ Again there were plans made, again there were announcements made as to how extra capacity was going to be built in the hospitals, modular units, more ventilators, more PPE, recruitment drives etc.

5/ And sadly, but not surprisingly, nothing has happened. The new unit in UL remains mostly empty and unstaffed. Other new modular units have not been built. Assurances were made months ago that we will never again have patients on trolleys.

6/ But to simply say it will be so doesn’t make it so. Words have to be followed by actions. No more announcements, no more report. Do or do not, there is no try.

7/ Michael Mc Dowell has asked the correct questions in his letter to the Irish Times.

8/ We have all had this unique period of time in our lives when everything stopped. A unique time to get off the treadmill and reflect. Many of us have wondered if maybe there is a better way to do things. Maybe the 2hrs on the road each day isn’t time well spent.

9/ Maybe the constant racing to and from places dropping off kids and picking them up isn’t the right way to live. There is a joy in more of the simple things now.

10/ Many who have got to get away in Ireland for a summer break are asking themselves why they haven’t holidayed at home more often.

11/ So what have the HSE learned? What changes in how they do things have they brought about. Constant fear and scaremongering isn’t helpful. I’ll fully agree that it’s important to try and ensure we don’t get complacent. But we are doing better.

12/ We haven’t had a Covid death in weeks, and COVID hospitalisations and ICU admissions are very very low. And yes of course it could change, but we are better now. We wear masks, we barely have skin left on our hands with the amount of washing and alcohol gel we subject them to

13/ There are no gatherings of people, let alone mass gatherings. We are better than we were. So we must continue to live and move forward. Protect the vulnerable.

14/ These were key months for our health services to use as an opportunity to make the changes. I have always felt that paying in excess of 700+ million for taking over the private hospitals was money which should have been spent in the public system.

15/ Use that money to increase the bed capacity, the ICU capacity, to build the modular units. Use that unique time in the lives of people, economy, and health to reflect and make better choices and changes for the future.

16/ But I fear that no real change has taken place. We continue to hear of trolleys and capacity issues. But 6 months is a long time to have made inroads into that. Why hasn’t it happened. Invest the NTPF funds back into the public system.

17/ Don’t pay the private system to clear waiting lists. Pay the public system to do it. Pay the hard working staff overtime to work into the night, weekends- keeping theatres open, radiology equipment running 24 hrs a day, waiting lists to be done at weekends.

18/ Why pump this money into the private sector. Open up the many wards in the public system that remain closed. Open up the 20% of ICU beds that have been closed for years.

18/ Employ some of the doctors, nurses, cardiac physiologists, physios etc that travelled home to answer Ireland’s call. You begged them to come back. And now what has happened to them - they are sent away again as it seems.

19/ These months @HSELive were the months to make these arrangements.