Dáil debates

Thursday, 2 April 2020

Health (Covid-19): Statements

 

2:55 pm

Photo of Louise O'ReillyLouise O'Reilly (Dublin Fingal, Sinn Fein) | Oireachtas source

I will try to be as brief as I can. I offer my sincere heartfelt condolences to any person who has been bereaved as a result of this virus. I wish a fast and full recovery to those who are ill with the virus at home or in hospital. I would like to ask a number of questions about the situation as it stands, particularly on behalf of medical professionals and the medical and scientific community. Some of my questions have arisen in my constituency office and in the offices of my colleagues.

We have an opportunity today to put to bed some of the myths that have been circulating. Some elderly people in my constituency are at home and do not want to let anyone into their houses. They are normally visited by home help personnel. They are very anxious. I am not talking about people who do not need home help. They need these services, but they do not want to have people coming into their houses. That is why it is absolutely vital that we can make a statement here today with regard to the personal protective equipment, PPE, that can and should be provided to home help workers. Such a statement would put at ease the minds of constituents who need home help but are very anxious about allowing people into their houses. Of course they are very worried. They are doing what they should be doing. They are cocooning and trying to stay away from contact, but they need their home help. They need to hear from the Minister that PPE will be provided and that their home help providers will be able to visit, where appropriate, in a safe way.

I know that home help is going to be curtailed. We spoke about this yesterday. In light of the many debates we have had in this Chamber about the home help waiting list, the Minister will be aware of how much people value the home help service. We need to hear directly from the Minister about what will replace the services that are curtailed. We need to talk directly to people watching at home who need home help and have home help assigned to them. Many home help workers want to be able to do their work but they need the PPE to be able to do so. At this point in the proceedings, every worker in the health service is on the front line. There is no such thing as a non-front-line worker now. There is no differentiation between grades. Every single person in our health service is on the front line and every single person who is on the front line needs to have the PPE to do his or her job.

It has become evident in recent days that a lack of the reagent used in the Covid-19 testing process has led to significant delays for patients who are waiting to receive test results. As a result, the number of people being tested each day has been significantly lower than the number that was previously planned or announced. An international shortage of the extraction material used in the testing process is causing significant disruption to Covid-19 testing here and elsewhere. This is a global issue. As this crisis grows day on day, the international demand for this material will grow with it. This will put further pressure on the testing regime here. Dr. Cillian de Gascun has said that the extraction material used to extract the viral RNA in the testing process is proprietary, which means that strict patent laws govern who can and cannot manufacture it. The lack of this material is now causing delays here.

At what stage are the Government's engagements with the pharmaceutical companies that are located in this country regarding the development of test kits for domestic use here? It is clear that the international market cannot meet the demand that is going to be required. All options, including the compulsory licensing of intellectual property, should be considered in an effort to maximise production. We have a world-renowned and long-established pharmaceutical sector. The operation in this country of the top ten pharmaceutical companies needs to be utilised fully. Given that we have thousands of highly skilled workers in this sector, there is no reason we should not be able to manufacture test kits and materials here. We cannot sit back and hope the international market will deliver, because it will not do so in these circumstances. My colleague, an Teachta O'Rourke, and I have drafted some suggestions in this regard. As Deputy O'Rourke is a medical scientist, he has much more expertise in this area than I do. We have drafted a proposal and sent it to the Minister. Our aim is to be constructive. We must all make this effort together.

I know the Minister and the HSE have been working very hard to source additional PPE supplies from China and other countries. We have heard from Mr. Paul Reid that other large states with deep pockets are active in the market and thereby pushing up the prices. New supplies have been arriving, as we have seen, and more supplies will come. That is welcome, but we must ensure we have a continuous supply of domestically produced PPE, which is absolutely vital. I reiterate that there is no grade, group or category of worker in the health service that we cannot call a front-line grade, group or category. Every front-line worker needs the PPE to do his or her job. This is going to be absolutely vital.

What is the situation with regard to the refocusing of domestic capacity and manufacturing? What stage is the Government at in engaging with the domestic manufacturing sector? How much PPE can be produced here? When can it be produced? How soon can we get it out to people? People are asking these questions and they need to know that this is being worked on, that there is a realistic timeframe and when that equipment is going to arrive. On the matter of accommodation for front-line healthcare workers who have found themselves without somewhere to live due to the Covid-19 crisis, I note that there have been discussions with hoteliers and bed and breakfast owners. I heard yesterday that a list of available accommodation would be circulated. That is welcome but that list needs to be updated. I have had cases come to me of people who have lost a place to live simply because they are working on the front line. They have housemates who may be vulnerable. Nobody, and certainly not anyone on the front line in this crisis, should find themselves homeless or without any form of accommodation. That list needs to be published and made known to all healthcare workers.

Will the Minister elaborate on the public-private hospital agreement? How did he arrive at the decision to pay consultants from the private hospital network more than existing HSE consultants, namely, those who are new entrants? This is an issue that will cause unnecessary distress. Not much of the agreement has been made public but one of the stand-out details that we have seen is causing concern. It is unfair to perpetuate pay inequality in this new agreement. It is not fair to the people whom we are asking to go out and do a tremendous job in the coming weeks. Moreover, I ask for details of how much this will cost. I know that when the Taoiseach spoke about it, he was very clear in saying that we do not know how much it will cost because we do not know how long it will go on for. That is grand but there is a daily rate. We may not know how many days it will take but we certainly should know how much it will cost per bed or per hospital. There is no commercial sensitivity at play here because it is all public now, as the Minister told me. We really should know what this will cost.

The nursing home sector has come to the fore in recent weeks. There are a number of clusters of the virus in nursing homes. I know the HSE and medical professionals are doing sterling work to try to stop the spread and treat people as well as they can. I ask the Minister to do two things. The first is to make sure that staff working in nursing homes have the necessary PPE. Will he also ensure that they have the necessary staff? We all saw the call to be on call for Ireland and people have responded. On call for Ireland means being where one is needed, whether in a nursing home, in the community, in an administrative role or in a field hospital, step-down facility or clinical hub. On call for Ireland means being where one is needed. Our nursing homes absolutely need a steady supply of staff to keep the residents safe. We all know that staff in nursing homes are contracting this virus and have to take time off, but the residents still need to be cared for.

Will the Minister look into the situation relating to student nurses? I was contacted by a nurse the other night who has lost her SUSI grant because she volunteered to work on the front line and is no longer eligible for the grant. I fully appreciate that this is an anomaly and an unintended consequence, but it needs to be addressed. We cannot have people who sign up to work finding themselves in a situation where they are losing money. Likewise, student radiographers and other students who are signing up to go to the front line are finding themselves in a situation where they are either not being paid or they are losing money.

The situation regarding those who are in receipt of medicinal cannabis needs to be clarified. I think the Minister has some information about that and I know that work was done on it, but that needs to be shared with us.

I have tried to be constructive in my questions to the Minister. We have tried to be constructive at every step of the way. I have offered solutions and suggestions. The Minister has our support in the efforts that are being made, but we need to get some answers on the public record. Every healthcare worker is on the front line now. There are no grades, groups or categories. We also have to thank those who work in supply chains and keep them going and the men and women working in administration in the background. All those people are going beyond. We have been inundated with requests for information. People want to know what is going on, what the plan is, where they stand and what will happen to them. This is our opportunity to put the facts into the public domain.

There are many myths and the Oireachtas must ensure it can counter them. I have tried not just to pose questions today but also to offer some solutions and ensure we remain open in our dialogue and frank with people. We must put out all the available information. I ask the Minister to examine the issues around testing and consider Sinn Féin's proposal. We will work with him to ensure we can get those tests. Testing is key, as the World Health Organization has stated. All the medical and science communities have indicated we must test, test and test again and trace and isolate but we must test first. As I indicated, we made a proposal in that regard and I hope the Minister will have time to consider it.

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