Last week, I spoke with the mother of a long Covid suffer who until she contracted the virus was a young and fit woman working as a doctor in a busy hospital. She has not stood on a hospital ward in more than 11 months because she is still recovering from the illness. Based on research conducted in Ireland and the Netherlands, 336,451 adults are experiencing or have experienced a long-lasting impact of this illness, known as long Covid. Long Covid encompasses a broad range of illnesses following Covid infection and is based on three clusters of symptoms. These are fatigue, respiratory issues and cognitive problems. They can range in severity from those who cannot recall the PIN for their bank card to people who are unable to get out of bed. The vast majority of these people did not require hospitalisation at the time of the original infection, with many experiencing only mild symptoms.

The HSE has recognised the need to support these patients and last September, it finalised an interim model of care for long Covid to provide a national approach for the provision of services and supports, yet up to last month only 20 of the 60 health service staff to be recruited to these regional centres for the management of prolonged conditions associated with Covid-19 were in post. We are told that until these regional centres are fully operational, we will not see the establishment of GP referral pathways. Even now there are still no plans to provide a dedicated service for children with long Covid. The eight planned regional clinics will primarily focus on fatigue and respiratory-related issues with a single consultant neurologist appointed to deal with cognitive problems. This is despite evidence presented to the Oireachtas Joint Committee on Health indicating that cognitive and neurological problems are emerging as the most significant long-term issues for those with long Covid.

The only clinic supporting those with long Covid neurological issues, which is at the Mater Hospital, is set to close its doors at the end of next week because of the failure by the HSE to fund it. I firmly believe the failure by the HSE to put in place a comprehensive strategy for those with long Covid is contributing to the record figures we witnessed last month with almost 10,000 patients on trolleys in our hospitals. Unless the interim model of care is revised to reflect the emerging evidence on long Covid and such a strategy for all of our patients, regardless of age and illness, is then delivered, this will compound a dire prognosis for our health service this winter.

I thank the Deputy for raising a very important issue that is affecting quite a number of people. I have tremendous sympathy for those suffering from long Covid. It is one of the reasons that during the height of Covid, when we had the lockdown, I was insistent on taking strong measures. It was not just about mortality. This was a deadly disease. When a person got Covid, it could lead to long Covid and affect a person's health and quality of life for quite a long time afterwards. People were saying we could get by, but this was a disease we had to try avoid people getting, at least until vaccination arrived. Vaccination has prevented the disease from impacting more severely on people than was the case prior to people becoming vaccinated. Vaccination was the game changer.

That said, there is an interim model of care, as the Deputy described, to provide long Covid services nationally. We want to see a more uniform framework. Considerable research is going on. In the nature of medical research, we will need more research, not just on identifying the features or, indeed, the duration of long Covid and the length of time it will impact on a person. Presumably, the research will also have to look at the model of care. If someone develops cardiac or respiratory issues and there is a long Covid centre in a hospital, ideally, the specialists in the centre of excellence for respiratory issues should then perhaps have to deal with the person's issues. It will at some stage need an integrated, multidisciplinary approach to some of the issues that manifest themselves as a result of long Covid. I will follow up on the matter. The Deputy is correct on the cognitive and neurological implications of long Covid. I do not believe they are disputed. We will follow up on that.

There are long Covid clinics in St. Vincent's Hospital, Beaumont Hospital, University Hospital Galway and, I think, in Cork University Hospital. There are post-acute Covid clinics in Galway and in Connolly Hospital Blanchardstown. Tallaght university and St. James' hospitals are operating a combined post-acute and long Covid clinic. There is a tertiary neurocognitive clinic in St. James' Hospital, led by a consultant neurologist with a background in neurocognitive disorders, which is accepting referrals from long Covid clinics throughout the country.

We are happy to work with the Oireachtas and the Joint Committee on Health on this. I do not dispute the issues the Deputy is raising. They are very serious issues. In the forthcoming health budget, we wish to see whether we can increase the level of resources available, specifically, in a ring-fenced way, for long Covid. Approximately €2.2 million has been allocated so far. An epidemiological survey is being planned that would provide insight into the prevalence of long Covid in the population.

With regard to the prevalence of long Covid, based on my analysis of the social welfare payments for Covid-related illnesses lasting 12 weeks or more following the initial infection, 21,000 people are unable to go to work due to long Covid. This figure does not take into account the tens of thousands who are suffering with less severe forms of long Covid who are going to work but not contributing to the same extent that they did prior to the illness, nor does it take into account the thousands of people who recovered from the initial infection but had a subsequent relapse. Not only is this having a significant impact on our labour force but, as an Australian long Covid study put it, even low rates of Covid-related permanent illness or disability could still lead to significant future burden of disease. We need to act now in a comprehensive way.

I do not disagree with the Deputy. There were clinics on HSE sites that were operational before the model of care was rolled out. The intention is to align all of them towards a national service. It is intended that the interim model of care will be expanded to put in place eight post-acute Covid clinics and six long Covid clinics within hospital groups nationwide.

Additional aspects of the service have been delivered, including supports within the GP and community settings and online supports. As I said earlier, epidemiological survey is planned that will provide insight into the prevalence of long Covid in the population. Again, the HSE is putting together the metrics, including waiting lists, number of patients treated and number of clinics operating to fully understand the extent of the need. The executive also recently commissioned a HIQA review to further inform development of the service.

I am told the incidence of long Covid in children is rare and of short duration, but that is something we must keep a very watchful brief on. At present, for children and young people suspected of having long Covid-----