Simon Harris (Wicklow, Fine Gael) | Oireachtas source

I thank the Deputy for his questions. We are operating in a time when we are trying to do a great deal simultaneously and at speed. Normally, many of the matters we are discussing - redeploying staff from one place to the other, for example - would take months of negotiation. We are now doing them day in, day out with the WHO's mantra in mind, that is, speed trumps perfection. It has to. This means that we will not get everything perfectly right and that we will have to retrofit, tweak and improve things as we go, but I am determined that we will do that.

My heart, and that of the Deputy, go out to the family of every single person who has died. Sadly, more will die. We are all heartbroken by that painful reality. However, I will say to the people who are tuning in as well as the Deputy's constituents that, thanks to the efforts they are making, they are saving lives. That should not be lost in this discussion. The modelling by our experts predicts that there would have been more than 1,700 deaths in our country by this day next week if the R rate - the reproductive number - was at 2.7 and we could have seen 12,300 people die in Ireland by 7 May. People's efforts are working, but that does not take away from the devastating tragedy to which the Deputy rightly alluded.

I am pleased that the Deputy raised the important issue of people with disabilities. I thank him for that. He was right about it causing many people concern. NPHET, which comprises doctors and not politicians, approved the publication of what it called "Ethical Considerations Relating to Critical Care in the context of COVID-19". It published this on 3 April. This document deals with issues relating to the provision of critical care interventions in a situation where ICU is exhausted and not all patients who require intensive care can be admitted. Thankfully, that is not where we are at, and we are all working to ensure that we do not arrive at that point. We have 127 vacant critical care beds in the health service today.

The guidance sets out the criteria for ICU admissions and stresses that the allocation procedure must be fair, justified and transparent. The document recognises that each patient is unique and that all clinical judgments will be made on a case-by-case basis. It emphasises the requirement for clinical decisions to be based on an objective assessment of the severity of the patient's current illness in conjunction with several other interconnected clinical factors such as the likelihood of benefitting from critical care interventions and the potential for good clinical outcomes.

The document also emphasises that no single factor should be taken in isolation when it comes to accessing intensive care. Age is given as an example. However, as I have discussed with members of NPHET, this statement equally extends to other factors, including disability. To be very clear and provide the reassurance that people are looking for, the guidance makes it clear that everyone is morally equal, every life matters, everyone will receive care and no one factor should be taken in isolation, be that age or disability.

Regarding the air ambulance, Irish Community Rapid Response, ICRR, has been working closely with the National Ambulance Service, NAS, to examine workable solutions, including process efficiencies, to ensure continued provision. I was pleased, therefore, to hear that the ICRR was in a position to continue with the provision of its service in the short term. The Munster helicopter emergency medical service is provided by the ICRR under a service-level agreement with the HSE. Under the terms of that agreement, the ICRR commits to funding all maintenance, repair, fuel and other expenses incurred in the provision of the transportation element of the service. In return, the NAS commits to providing the clinical staff and consumables. It was never envisaged that Exchequer funding would be required to subvent the service and the decision to proceed with the service was contingent on that ongoing contribution to the cost of its running. The Deputy is right to be grateful, as I am, for the work carried out by the ICRR to date. I welcome the ongoing engagement with the NAS to try to find solutions to the current funding difficulties.

On the issue of testing, like every country in the world, we have been challenged in this regard.

We have gone from the National Ambulance Service visiting people's homes, maybe only if they had come back from holidays in Italy or China, to a situation now where we are testing a broader group of people, and we need to expand that definition again. I am pleased the number of tests is more than 91,000, and today I saw that 93,715 tests have been carried out in our country. We are among the top countries in the world per head of population for the numbers we are testing. We are consistently in the top five and often in the top three in the European Union, including the UK. We want to do more and we want to do better and we need to keep doing more and doing better. However, I have to be honest that there are a number of pinch points. Countries throughout the world are competing for reagent, supplies and swab tests. We are continuing to do this. Mr. Paul Reid, the head of the HSE, has said he believes he has secured laboratory capacity for 10,000 tests. This does not mean there will be 10,000 tests done every day. On an average day at present, only 3,500 to 4,000 tests are ordered, but it is important that we continue to grow this capacity, particularly when we move to a point post restrictions, or after some of the restrictions have been lifted, so that we can survey the virus very closely.

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