David Cullinane (Waterford, Sinn Fein) | Oireachtas source

Almost two years ago, when Covid first struck, none of us knew exactly how long we would have to live with the consequences of this disease and how far-reaching those consequences would be. If we cast our minds back to March 2020, when the first restrictions were imposed, they were designed to last for a few short weeks in order to flatten the curve. Weeks became years. For most of those two years, tough public health measures had to be put in place. My party supported those measures on the basis of the public health advice that was given. That is to say that we were not conscious of the impact those public health restrictions had on individuals, families and businesses. We will have to deal with the fallout from and legacy of those restrictions for some time to come.

Many people have mental health challenges and difficulties arising from the pandemic.

Many people lost their jobs and many found things very difficult. It has been a very tough two years but people stepped up to the plate. The public were absolutely fantastic in responding to the challenge. Despite all of the difficulties and the fact that nobody wanted restrictions and public health measures to be in place for as long as they were, people recognised what needed to be done. We know our front-line healthcare workers stepped up to the plate. People in essential retail also stepped up to the plate, as did many public sector workers, including teachers, gardaí, and others, and so too did the vast majority of the public. They took the public health advice, implemented it, got vaccinated, wore their masks and abided by the restrictions. That collective effort got us through what has been a very difficult two years.

It is fantastic that we now have an easing of restrictions. This is something that we can all rightly celebrate. As has been said by public health experts today and over the past few days, however, the disease is still here and we still have to exercise a degree of caution and continue to abide by the very limited restrictions that are still in place. The Government must spell out in the coming weeks exactly what public health infrastructure and public health surveillance will remain in place. We all anticipate that we will see a winding down of testing and tracing at some point. There will be questions around vaccination and whether that will be an annual occurrence. We also have to look at the whole area of public health and how we see it now in contrast to how we viewed it before. While we were caught on the hop or caught by surprise by the severity of this disease and this pandemic, the WHO has been warning for many years about the dangers of a pandemic and the fact that the world was not ready or prepared for it. Hopefully, all of those lessons will be learned.

On the issue of lessons being learned, there must be a full public inquiry into the State's pandemic response and into the level of preparedness of the State. I certainly do not want to see an inquiry that is long drawn out or that costs huge amounts of money or one that is about apportioning blame. I want an inquiry that is an opportunity to learn and that is about taking action and making changes where they are needed. In terms of some of the changes that need to be made, my party and others in opposition were making the case for them long before the pandemic struck. The pandemic caught the Government by surprise, but hopefully it has learned some lessons. I hope that it is now on the same page as the rest of us and understands that we need a single-tier health service that is fit for purpose, that is properly supported and staffed and has the beds and capacity to deliver better and fairer healthcare, as opposed to the deeply unfair two tier system that we had to deal with at the start of the pandemic.

If we hold a public inquiry, we have to look into what happened in nursing homes in the early stages of the pandemic. We have called for a non-statutory, Scally-type inquiry to examine issues of isolation, neglect and abuse but also to look at the clinical governance frameworks that need to be put in place. An expert group or panel has made recommendations in that regard and the Government has said that it is committed to implementing those. However, HIQA has said that the HSE did not understand the private nursing home sector that it was funding and important lessons need to be learned in that regard. As far back as 2009, the HSE said that we needed 579 critical care beds. We came into the pandemic with 255 such beds. That was subsequently increased but the total is still nowhere near what the capacity review sought. The same is true for inpatient bed capacity, beds in the community and staff. The Government can point to the billions of euro that have been invested in health in recent years but we must set that against decades of underinvestment and the fact that beds and staff were not put into the system over many years. That is why we do not have a health service that is fit for purpose.

Any review must also reflect on the huge collective effort of the people who stepped up to the plate. It must also, in fairness, reflect on where the Government got it right as well as where it got it wrong and, in particular, where Departments got it wrong. It has to be said that there was a lot of last-minute decision-making. While the Government might say that is what happens in a pandemic, there was also a lack of contingency planning, indecision at times, confusion around regulations, kite-flying and mixed messages, very often coming from senior Government representatives at the very top.

I have already mentioned the deficiencies in our health service and I could say the same about workers' rights. We do not have a statutory sick pay scheme or safe working environments in some areas. Meat plants are a good example of the latter. I hope these are all lessons that we can learn. We also need to learn the lesson of the importance of an all-island response. We did not get that right. Despite the fact that my party, both North and South, pushed hard, including in the Executive, for much greater collaboration between the two Ministers for Health, it did not happen. In a pandemic, on an island, we need to be responding on an all-island basis, making sure that whatever strategies, policies, supports or public health measures are put in place are aligned on an all-island basis as much as possible but that did not happen.

I hope all of those lessons will be learned. I hope that we can commit to building a better health service, one that does not leave people behind. The current health system is not delivering for many; it is certainly not delivering for the 900,000 people on waiting lists, the people who are on hospital trolleys every day, the children waiting for access to child and adolescent mental health services, CAMHS, or those with scoliosis and spina bifida who are waiting for life-changing operations for which funding is not being made available. I hope we have learned lessons and that if anything comes from this pandemic, it will be that the solidarity the public showed will be met with solidarity from this House and that we build a better health service and a better society for the people of this country.

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