Joan Collins (Dublin South Central, Independents 4 Change) | Oireachtas source

I thank the Special Committee on Covid-19 Response for doing this fierce body of work and the recommendations in it. It looks like most of the recommendations will go to the select committees to be overseen and to make sure, where possible, that they are implemented.

I was not a member of the committee. I would have liked to have been, as I was on the Sláintecare committee and I know the amount of work that members get involved in with public representations and the wealth of knowledge that one learns from being a member of such committees, particularly in relation to how our services work.

In approximately two weeks' time, extremely important decisions are expected to be made regarding what level of restrictions are required to hopefully continue to bring the Covid-19 pandemic under greater control. The problem is we seem to be making these crucial decisions in the dark regarding which measures are most effective. After eight to nine months, we seem to know little as to where the cases are occurring most frequently and where the risks of outbreaks are the highest. When one sees community contact, we are effectively saying we do not know where it is.

The pandemic has exposed many failings in our healthcare system and now we are seeing the consequences of the lack of funding, resources and, to put it bluntly, respect for those working on the key question of public health services.

Many Deputies raised the need to track and trace, the need to hunt the virus down and the need to do this and that. Public health specialists have a key role in the track and trace system. They can identify common exposure events and uncover clusters. They link apparently sporadic cases to one another. They can get to the causes of outbreaks and make the risk assessments and advise accordingly. Retrospective case control studies are crucial to the understanding of what works in terms of prevention and control and we should be on top of that now coming out of this second strict restriction.

When the pandemic struck, our public health service had nowhere near the capacity to deal with it. In a recent radio interview, Dr. Marie Casey in the mid-west stated that there are approximately 60 public health specialists, with 40 on the front line at present. Scotland has three times the number of public health specialists and is actively recruiting at present. We are not. That is the madness. That is what she said. They also have bigger teams of staff working with them. Here, we have no teams. There is a major problem with recruitment due to the fact there are no teams. There is no attraction to the specialty. There has been a call overseas. We have not got the response on that. I have seen an article by a public health specialist in Queensland, Australia, who stated that while he would love to come back, it is not attractive to work in the specialty.

These public health specialists have no right to take part in research programmes. They have a single-point salary scale. There is no movement for progression for these specialists. There is a single-point salary scale with no prospect of promotion and despite lip service, consultant contracts have still not been drawn up. The position of the director of the Health Protection Surveillance Centre has been vacant for years. No one is going near it. It was filled for one or two months over the past two or three years. It is just vacant, and that is the key role in public health in this country.

A Crowe Horwath report that was completed in April 2018 was commissioned by the Government. The recommendations contained within the Crowe Horwath Report were considered by the Department in the context of both Dr. Scally's recommendation and ongoing work in relation to Sláintecare. The Department stated that a process of engagement around implementation of these recommendations, including the development of a significantly different operational model for the delivery of public health medicine services, would commence with stakeholders early in 2019. We have a situation where these workers are voting for industrial action because none of this has been implemented. It has not even started. It has not even gone to the Department of Public Expenditure and Reform in relation to funding. This is in the middle of a pandemic and coming out of this restriction and asking how will we deal with this over the next period. The Government has much to answer for in relation to the past eight or nine months.

The inadequacy of the situation leaves us in a situation where some restrictions will be lifted in December in a hit-and-miss scenario with another possible blanket lockdown necessary in January. It is probably too late to correct the situation. As we have said so many times in the Dáil Chamber, lessons need to be learned but we are neither learning nor implementing them. Deputies in this Chamber have stated that people must respond and take responsibility. The Government must take responsibility. The Government must implement what it can implement to the poor people and then explain to them what needs to be done, and the people will support it.

In relation to track and trace, in general it seems we are still way off the HSE target of 800 contract tracers. This led to the system being overwhelmed in October with anything from 10,000 to 15,000 people being asked to track and trace their own contacts. I believe there needs to be many more than 800. I am not an expert but I think that is the case.

Finally, we have had good news of a possible effective vaccine being available early in the new year if it is peer reviewed and accepted. However, a vaccine only works if sufficient numbers avail of it and there is a real question here about how available these vaccines will be internationally, and particularly to poorer countries. Already, 80% of Pfizer and Moderna's output over 2021 has been bought up by the richest countries - the US, Canada, Japan, the UK and the EU - representing only 12% to 14% of the world population. India and South Africa have made a proposal to the World Trade Organization, WTO, to suspend global trade rules on health products until widespread vaccination takes place and we achieve global herd immunity. This would make companies such as Pfizer unable to defend their position to patent these vaccines for 20 years and allow the technology to be copied by other manufacturers. The Government must take a firm stand on this issue supporting countries in the global south to put people's health before the profits of these pharmaceutical companies. We cannot have the global rich taking all these vaccines. I would be first in the queue but we cannot have a case like this where poor countries are being left isolated. We need an international response to this.

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