Minister for Health Stephen Donnelly asked the HSE to put in place "walk-in" coronavirus testing that did not require a referral from a GP over the Christmas period.
He asked HSE chief executive Paul Reid to bring in temporary self-referral for tests amid concern over the speed of access to testing over the holiday period.
Letters released under the Freedom of Information Act show Mr Reid rejected the suggestion as it was “untested” and carried an “inordinate risk” to the capacity of the testing and tracing programme.
The HSE’s testing system came under huge pressure in the days after Christmas due to a surge in Covid-19 cases.
The testing of asymptomatic close contacts of people with confirmed Covid-19 was suspended for almost a month from the end of December.
Mr Donnelly wrote to Mr Reid on December 21st, 2020, on the subject of preparations and resourcing for Covid-19 testing and tracing over Christmas.
He said there would be an “inevitable curtailment” of normal GP availability and an increased reliance on out-of-hours (OOH) services.
Concern
Mr Donnelly raised concern that the number of people referred for testing at weekends and on public holidays was lower than on weekdays and said he believed this was attributable in part to a reluctance to seek immediate referral through the OOH route.
He wrote: “Therefore, I request that, on a temporary basis and for a two- to three-week period, the HSE put in place arrangements to enable people who are concerned that they have Covid symptoms, if they so wish, to self-refer for a test – up to and including a walk-in option.”
He added: “This would not necessarily mean that everyone should take this route, but it would be a clear alternative for those who may be reluctant to seek testing if it involves going via the OOH services.”
Mr Reid wrote back on December 23rd rejecting the suggestion.
He said that on weekends and evenings, the GP out-of-hours service would be open around the country over the Christmas holidays and would assess and refer people with Covid-19 symptoms as necessary.
He said the HSE believed the existing arrangement for getting referrals for tests through GPs was “the optimal model” and introducing an alternative “would not be consistent with our current public health advice”.
Mr Reid also said: “It is also untested and therefore carries what we consider to be inordinate risk to the testing and tracing programme capacity, particularly given the current resurgence in infections.
“The testing pathway was set up to deal with 15,000 tests per week based on Nphet recommendations.
“We have enhanced this to higher levels which are currently being stretched as we enter the Christmas period.
“Establishing a self-referral system would require significant additional resources or alternatively the deployment of some of our existing resources at a time when they are most needed.
Under review
“This is not feasible within the timeframes suggested,” he said.
Asked about Mr Donnelly's proposal, a Department of Health spokeswoman said the department is regularly in contact with the HSE in relation to the response to the pandemic.
“On an ongoing basis, the Minister and the Department of Health considers and reviews, based on public health risk assessments, how best to target testing to detect, and mitigate the impact of, the virus across the population,” she said.
“This includes keeping Ireland’s national testing policy under continuing review and considering any relevant options that might be evaluated to ensure that a robust testing service is in place.”
The department did not respond to a subsequent query on whether Mr Donnelly’s request to bring in temporary self-referrals for Covid-19 tests was recommended to him by the National Public Health Emergency Team (Nphet) or anyone else.
