Mary Butler (Waterford, Fianna Fail) | Oireachtas source

The past two years have been hugely challenging for our public services, our health system and the people of Ireland. I would like to acknowledge the enormous and continuing contributions made by our health and social care staff in providing vital services across the country during the pandemic.

As the Minister of State, Deputy Feighan, outlined, the current outlook remains positive and the easing of the majority of restrictions is very welcome. We know, however, that the pandemic is not yet over. The highly transmissible Omicron variant is dominant in Ireland and incidence of disease remains high, although it is declining. Test positivity has reduced significantly in older age groups of people aged 65 and over, particularly in the latter part of January. However, those who are vulnerable and those who remain unvaccinated are still at risk of severe illness.

The public’s strong support for the national vaccination programme is essential and its success is a big part of what has enabled us to lift restrictions. More than 10.36 million doses of Covid-19 vaccine have been administered since the programme began in December last year, including more than 2.69 million booster doses. This has been an extraordinary national effort. We are immensely proud that Ireland continues to have one of the highest vaccination rates in Europe.

As Minister with responsibility for older people, I very much welcome the continued prioritisation of the booster vaccine programme among our older population.

More than 88% of eligible people aged between 60 to 69 and living in the community, more than 94% of people aged 70 to 79 and more than 93% of those aged 80 and over have received their booster dose. In total, approximately 933,000 booster doses have been administered to people aged 60 and over living in the community. I am pleased to inform the House that approximately 25,000 doses have been administered in long-term residential care settings, including mental health centres and nursing homes and the roll-out in these settings is now complete.

Vaccination is the best way to protect ourselves and others against the most severe impacts of Covid-19. The evidence is clear. People who have received a booster are less susceptible to infection and, if infected, are less infectious to others. Every effort is now being made to encourage everyone to complete their primary and booster vaccination programme and to reach those who are not yet fully vaccinated.

As Minister of State with responsibility for mental health and older people, I will take this opportunity to say a few words about what the easing of restrictions will mean for the most vulnerable in our society across a number of care facilities. In nursing homes, which were prioritised in our vaccination programme, we are again seeing the positive impact of the vaccines manifesting in a less severe disease profile among residents. However, there are still high numbers of outbreaks in nursing homes, with outbreaks currently being experienced in more than 40% of nursing homes. As of yesterday, 225 nursing homes currently have outbreaks. Residents who test positive are remaining largely well, however, and there are early indications that case numbers are reducing in nursing homes. The ongoing monitoring and management of Covid-19 across the nursing home sector remains a critical focus for me and for the Government as a whole.

The State continues to provide a range of supports to the nursing home sector. This includes the provision of personal protective equipment, PPE, supports, including FFP2 masks, free of charge. This amounts to €95 million in PPE for private nursing homes to date. It includes access to expert advice and support through the Covid-19 response teams and public health, temporary accommodation for staff, and training and education webinars on infection prevention and control standards and practices. I have recently met with the HSE and with the chief inspector of HIQA. Both confirmed that all of these supports continue to be deployed to assist nursing homes. Of note, serial testing was recently reintroduced as part of a targeted intervention to provide important information on the distribution of cases and risk across nursing homes. In addition to these supports, private and voluntary nursing homes still have access to outbreak assistance funding through the temporary assistance payment scheme. More than €122 million in payments have been made to date. That means the 225 nursing homes which currently have outbreaks can claim outbreak assistance at this time.

To continue the substantial progress being made in implementing the recommendations of the Covid-19 nursing homes expert panel report, almost €18 million was allocated in budget 2022, including investment in community support teams and safeguarding supports. The return to normal visiting arrangements is of critical importance to people living in nursing homes and their families. New public health guidance was published on Monday by the Health Protection Surveillance Centre and reflects many of the recent relaxations of public health measures. The new guidance will come into effect from 8 February. The primary change that residents will see is a move towards more normal visiting arrangements and access. Residents can expect to be able to receive visitors, indoors, on a daily basis at a minimum. To further support the mental health and well-being and social connection for residents, there will also be the introduction of a nominated support person. This person will be nominated by the resident and should normally have unrestricted access to the resident for most of the day, with the exception of some busy care times in the home. This will also support improved social connectedness during an outbreak. There will no longer be a need for visitors to show immunity through vaccination or previous infection. I very much welcome this approach to visiting and the further move to restoring normalised access in nursing homes.

I have received correspondence highlighting that, in some cases, visiting is not being facilitated at all in nursing homes. Last week, I met Sage Advocacy, which highlighted concerns of families and residents in respect of the implementation of visiting guidance. I want to be clear that this is not acceptable in the absence of a clear public health or infection prevention and control rationale. I wish to remind nursing home providers of their obligations for facilitating visiting in nursing homes and the right of residents to receive visitors. Significant support has been provided to nursing homes through the investment of significant public funding. It is of the utmost importance that providers facilitate visiting to the greatest extent possible.

The reopening of day care centres for older people has been an absolute priority for me following their closure last year due to Covid-19. I am pleased that 237 centres had reopened by the end of last year, with a further 18 expected to reopen in January and February. These centres are fundamental to promoting the health and well-being of our older population. I am also delighted to hear that active retirement groups across the country are planning for full resumption of meetings, days out, and many other activities. In our mental health settings, services continued to operate between 85 and 90% capacity of pre-Covid levels. Importantly, any services that were impacted by reduced capacity or temporary closure, such as day centres, are in the process of fully reopening. This will occur in line with evolving public health information and guidance. I am pleased to say that these developments coincide with a significant reduction in the number of outbreaks across our mental health services.

I am conscious of the impact that visiting restrictions in acute hospitals have had on patients and their families and of the value of regular personal contact with friends and loved ones in these settings. Throughout the pandemic, the HSE has developed and regularly updated guidance relating to visitor access to hospitals. This guidance is kept under constant review and updated in the context of the trajectory of the ongoing pandemic. The current guidance makes provision that all patients in inpatient areas of a hospital should be allowed to nominate one support person and access for that support person should be as flexible as possible. Visitor access can be accommodated in accordance with local hospital policy and it should also be acknowledged that visitor access may be limited when there is a significant number of Covid-19 cases in the hospital, Covid-19 outbreaks or high incidence within the community. At all times, guidance has sought to strike a balance between facilitating visitor access wherever possible while also recognising the need to keep patients and staff safe by reducing the risk of Covid.

With the removal of so many restrictions recently, I know people will look forward to seeing their loved ones again. However, it is important to remember that a hospital is very different to other settings in society, where social distancing may no longer be in place. Some of the most vulnerable to Covid are in our hospitals, and we have a duty to protect them to the greatest extent possible. That is why a greater degree of caution is required compared with other settings. While the easing of restrictions has been welcomed by many, I know that the reopening of our society and economy will cause concern and anxiety for some people. There are many people who are immunocompromised or more vulnerable to the severe effects of Covid-19. We must continue to collectively adhere to remaining public health measures and keep up the high levels of vaccination in our population to reduce the risk for the most vulnerable in our communities.

As we continue to adapt to the reopening of society, we can help by giving each other the space to respond to these changes in our own time and by supporting our friends and family who may be anxious and who continue to exercise caution. I encourage those who are concerned to be open about it and to share their feelings. It is okay to take your time. I hope and expect that we individually and collectively start to feel increasing benefits of the easing of restrictions and the reduction in harm caused by Covid-19. I look forward to Deputies' contributions.

See this speech in context