Mr. Tadhg Daly:

I thank the Chairman and committee members for the opportunity to address them today. I am joined by my colleague, Ms Anne Costello, nursing committee director, Nursing Homes Ireland. The work of this committee will represent one of the most important analysis of a national emergency that will forever be ingrained in our country's history. I wish it well in its work in the weeks ahead.

Nursing homes are traditionally very positive settings and homes of inspiration and happiness to the communities within them. They are a home from home. Covid-19 has brought huge levels of upset, sadness and worry in through their doors. I now take this opportunity to call upon us to commemorate forever all those who, tragically, lost their lives in our nursing homes and in our country because of this cruel virus. We should take the opportunity to laud the considerable sacrifices of nursing home residents. The loss of a loved one's personal touch and, for many, the loss of friends has caused huge upset and worry for thousands of our most special residents. Under very pressurised circumstances, our staff have made extra time to sit with residents and have prioritised the use of technology to connect residents with loved ones, often taking time outside of working hours to fulfil such work.

We applaud the staff in our nursing homes, HSE, private and voluntary. These 40,000 people are on the Covid front line. They have made sacrifices willingly, and with great commitment they continue to provide person-centred care, comfort and support. I thank the staff in the nursing homes for the care and support provided to residents over the weeks and months, with much of it provided to residents with Covid-19. The recent months have presented a stressful and demanding time, and these people ensured residents received excellent care in the most challenging of circumstances.

Covid-19 has presented a tragedy for nursing home residents, but it should not be lost on us that four out of every five nursing home residents who contracted Covid-19 recovered from the virus. This is testament to the tremendous dedication and professionalism of the staff under extremely strenuous circumstances. There needs to be a greater appreciation that care of the older person is complex. Nurses in our nursing homes have very specific clinical expertise and a broad knowledge base founded on the science and art of the person-centred gerontological care model.

During the first three months of the year more than 2,500 people entered nursing home care under the fair deal scheme. Every month, 1,000 people transfer from our acute hospitals into private and voluntary nursing homes. During this national emergency, 7% of Covid cases entailed transfer of residents to hospital. As an easily transmittable virus, we knew in early January and February it could take the lives of nursing home residents in our communities.

Preliminary research indicates up to 40% of transmission is passed by asymptomatic persons. The mass testing of residents has seen asymptomatic residents and staff test positive. Nursing homes have huge levels of experience in managing the outbreak of flu and norovirus every winter and have extensive experience, both clinical and practical, in implementing infection prevention control measures, but a global pandemic is on a different scale entirely.

We were exasperated in early stages and felt the sector required a very specific plan. We knew Covid-19 had a disproportionate impact on older people. The planning and focus was almost exclusively on our acute hospitals. We were aware people in our nursing homes would be among the most susceptible to the virus and a national strategy and response was required. The challenges of personal protective equipment, PPE, testing, aggressive recruitment of nursing home staff and discharges from acute hospitals are well versed at this stage. Our decision to restrict visitors on Friday, 6 March was informed by our nursing committee, comprising clinical experts, and it was not taken lightly. It was taken on a Friday because we were conscious of the many visitors who may have come to nursing homes that weekend.

Key State organisations left the nursing home sector and its residents isolated in those early days, and the dismay will live forever with us. However, we welcome the lead of the Minister for Health, Deputy Harris, in eventually bringing senior officials from his Department and the Health Service Executive, HSE, around the table to support the sector and our residents in coping with Covid-19. The evidence from Ireland and internationally is no individual element of the health service can manage the global Covid-19 pandemic alone. The supports provided by HSE community services are appreciated and have delivered valued resourcing supports to residents.

Covid-19 continues to live with us. We give early welcome to the Minister’s commitment to establish a nursing home expert panel to support good planning and safeguards to protect people who call a nursing home their home. However, one significant voice is absent, that representing nurses from our nursing homes, who continue to operate very much on the front line.

Members of the Oireachtas will be aware that Nursing Homes Ireland has outlined annually a request that the Government should lead in establishing a forum on long-term care. That call has gone unheeded for almost a decade but today we reiterate that call. We wish to move forward but Covid-19 now lives among us. We are actively engaged with the Minister, Deputy Harris, his officials and colleagues in the HSE and the Health Protection Surveillance Centre, HPSC, in presenting measures that can ease visitor restrictions in our nursing homes. Clear policy is required and there is a requirement to balance delicately health, safety and risk to life against the mental well-being and happiness of residents. Social connection for nursing home residents is critical.

Lessons can be learned from closer engagement brought upon us by Covid-19. There is now a requirement for a better and more integrated working relationship between the State and the entire nursing home sector. The core focus must be on meeting the complex health and social care needs of nursing home residents. As a society, we will be stronger working together.