Mr. Paul Reid:

I thank the Chairman. I will try to be brief going through the questions. My colleague, Dr. Henry, might mention one of them. The first question related to transmission in healthcare settings; I think it mentioned hospitals and transmission of the disease. The learning from the early phases and the work NPHET has been doing over the past while demonstrates that certainly the early transmission of the disease was happening within the community. That was where the major transmission of the disease took place. Obviously, the work and protections we put in with regard to our own healthcare workers were geared towards stopping the transmission of the disease, particularly in hospitals, and then in nursing homes also.

The second point, and I will answer briefly, was on the opening of outpatient departments, and the Deputy gave some examples. The chief clinical officer and the chief operations officer, who are both here with me today, are working through a plan on how we get back to non-Covid-19 services in a very safe way. The Deputy gave an example of an outpatients waiting room, which cannot be the case any more. We cannot have the numbers of people waiting for the various patient services they would come forward for congregated together. We have to go back to this in a very different way. It may not be the most efficient way but we have to go back to it in a very safe way. That is the work we are doing now. What would be the priorities about the services we would restore, and we spoke earlier about screening services and other services? What are the risks we have to manage for each of those services? What are the equity issues we need to put in place and the various risks? That plan is currently being finalised by my two colleagues who are with me here today.

The Deputy referred to the European Centre for Disease Prevention and Control, ECDC, report. I briefly went through that this morning. The Deputy is correct. It does reference the various countries, approaches to it and the data collection. I cannot comment specifically on the issue the Deputy referenced at the end of her contribution about the data for our own long-term care settings but I can come back to that.

On private hospitals, and I might ask my colleague to come back on the nursing homes, the Deputy is correct. I want to say again that it was procured for a particular reason. Thankfully, we have got through that. The biggest caution we have to put in place, and this is WHO guidance, is that a healthcare system needs to keep 80% capacity levels. We all know that, traditionally, the Irish health system operates at 95% on a normal day. We cannot go back to the way we were so we have to keep extra capacity. The thought process now is that: first, if we meet another surge we still have to keep capacity; second, even as we head into a winter we have to head into it knowing that we have to create capacity; and, third, what mechanism or way would we create that capacity in the future? That has to be part of the consideration being given to the current usage of the agreement we have with the private hospitals. Would we keep that for a further period as part of the agreement? Would we only keep some of it for a period of the agreement or would we go into something in a very different way? Ultimately, that is a decision for our policymakers in government.