Duncan Smith (Dublin Fingal, Labour) | Oireachtas source

I wish to pass on my sincere condolences to all those families who have lost loved ones to Covid-19 since the House last met a week ago. The crisis continues and the sadness mounts as we continue to battle against this appalling virus. To reiterate, the Minister has our support in leading that fight, as do the CEO of the HSE, the CMO and all the workers on the front line and in support capacities in our health service.

We also support the work of the NPHET. For the past week and a half, we have raised issues concerning its transparency and decision making. We welcome today's publication of the minutes of NPHET meetings for the month of April. When questioning the Taoiseach today, our leader, Deputy Kelly, raised further concerns. I echo them, although I will not repeat them now. We look forward to seeing increased transparency, which I am sure the Minister will support.

The NPHET is the decision-making body for tackling the Covid-19 crisis, but the Minister has overall responsibility for Covid-19 and all other health matters. In that regard, what measures are being put in place to manage the knock-on effects of this crisis for people with non-Covid-19 illnesses? What are the consequences of people not turning up for appointments and of operations being cancelled? Has much modelling on this been done? The Minister raised the question of how that currently unused capacity would be activated. We have severe concerns about secondary deaths. How is the Minister judging and managing that responsibility against the demands of Covid-19 with the directives that are coming through the NPHET?

We have major issues with the income supports for HSE workers, a matter that has been raised with the Taoiseach today as well as more recently in this debate. Will the Minister commit to issuing a directive under the relevant health Act to ensure that the pay deal for nurses agreed last year will be paid this May? Ten days ago, the Labour Party called for a €1,000 pandemic payment for health workers to coincide with May Day, which is tomorrow. Unless the Minister has a surprise for us in his closing remarks, that is probably not going to happen, but has he considered this proposal? It has been done in other countries.

What plans has the Minister for income supports for healthcare workers who have been unable to attend work during the pandemic because of their own pre-existing conditions? We want to ensure that they will not be impacted unfairly by such matters, which are outside their control, and that not only their incomes but also their certainty of work is protected.

Is there planning under way in the Department of Health for the healthcare workers who came home to join the fight against Covid-19? They showed the utmost selflessness and bravery in taking the decision to leave places where they usually had secure and, in many cases, well-paid employment to join our domestic fight. Will the Minister give assurances that they will have jobs once we have passed the stage of pandemic reaction and moved towards returning our health service to more regular business? Many people who were working in the HSE prior to the outbreak of Covid-19 had been pushing for the restoration of pay. We want to see progress on that front.

Deputy Ossian Smyth discussed student radiographers. That situation requires urgent repair by the Minister and his Department. Our position has been consistent and clear that student radiographers working on the front line in the battle against Covid-19 deserve the same respect as nursing, midwifery and medical science professionals and students. The Department and the HSE must recognise and respect the role that student radiographers are playing every day in the battle to stop the spread of Covid-19. I was encouraged by the Minister's remark that he had at least offered something similar to student nurses using the same principle. I would be interested in seeing whether that can get us to where we need to be.

I wish to discuss PPE. Last Wednesday week, the Department of Health issued a directive that all healthcare workers should wear face masks when working within 2 ft of a person. This policy change had implications for all health services. We have heard about acute, residential, outreach and clinical services, for example, but many home help agencies have been struggling during the crisis and many have lost staff. They are continuing to offer support to priority patients and all unnecessary calls have been stopped, as per the national direction. Many home help agencies have been struggling financially. Not all of them are private enterprises with pools of money on which to draw. Every community healthcare organisation has a not-for-profit home help agency under its umbrella, often set up by well-meaning, former healthcare professionals who want to help their local communities. Now the agencies must source face masks themselves or wait in line for the HSE to offer same if and when resources allow.

GP surgeries and nursing homes can purchase face masks from suppliers and are not liable for VAT, for example. Home help agencies need to be afforded the same exemption as soon as possible. If home support agencies are not given assistance, it will absolutely mean an increase in hospital admissions for non-Covid-19 related reasons. The number of older people currently supported by home support agencies is phenomenal and issues need to be addressed as soon as possible as the knock-on effect could be catastrophic.

I am also hearing that the primary insurance company of home care support agencies has issued advice that if healthcare workers do not have personal protective equipment, PPE, such as face masks, the agency is not insured. I am interested to know if the Minister has a comment on that or if he can investigate it further.

To move to screening, CervicalCheck has been suspended since the end of February or the start of March, initially to allow for the switch to human papillomavirus, HPV, testing in April. Unfortunately, we do not know when HPV testing is going to be introduced. Women need certainty when it comes to this essential screening service. When will it be coming back on stream and is there a plan for that? I know that an awful lot of the radiographers who work in screening have been redeployed to deal with Covid-19 and are doing a wonderful job, but I am interested to hear if we have a pathway out of this.

We still have no plan for dentistry. Dentists have been crying out for PPE in order for them to return to work. The Chief Dental Officer has offered direction in terms of emergency dental work, but there is also serious and routine dental work that is important. Speaking in a personal capacity and as someone who has had complex dental needs in the past, I and many people like me need routine dental work in order to prevent serious or emergency dental work down the line. In the absence of routine visits, we are potentially storing up serious and emergency dental problems in the not-too-distant future. We have already seen the somewhat stark protests, let us say, of dentists in France and I do not want to have to see my dentist taking part in similar protests here for basic PPE.

I turn to ask about direct provision and vulnerable settings. We have heard about the direct provision centre in Cahersiveen through the media and I would appreciate it if the Minister could speak to that. Have many clusters of the virus developed in direct provision centres or other vulnerable settings, such as prisons? I received a long and detailed response from the Minister, Deputy Flanagan, last week about the measures that his Department has put in place in conjunction with local authorities, the HSE and approved housing bodies for direct provision centres. I hope that those measures are being implemented and are working.

We will need direction on the use of personal face masks and whether we will need to wear them in shops or on public transport. There has, until recently, been contested medical advice on the utility of wearing masks in public to control the virus. It now seems that there has been a shift towards a view that we should be wearing them, at least in some capacity. It has been mentioned that the public will understand a shift in the Government's position on that, but we need clarity and to bring the public along with us. Will we have sufficient supply for members of the public so that they are not waiting in line behind front-line workers, staff from nursing homes, dental and home care workers?

I thank the Minister and, if he does not manage to get to every question, I would appreciate it if he would correspond with me.

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