Denis Naughten (Roscommon-Galway, Independent) | Oireachtas source

The main reason I wish to speak on the legislation relates to patients with long Covid, many of whom are young with no underlying health conditions. They are presenting with prolonged multi-system symptoms that are impacting on their daily lives, affecting their ability to work and causing significant disability for some. Long Covid is having a significant impact on our labour force. An Australian study produced on long Covid indicated that even low rates of Covid-related permanent illness or disability could lead to significant future societal burden.

Long Covid is costing at least €500 million in lost work and welfare alone. Data from the Minister's Department has shown that 0.81% of those who contracted Covid-19 and claimed the enhanced illness benefit payment were medically certified as unfit for work 12 weeks later. If that is extrapolated across the total number of people infected with Covid-19 in the adult population, it equates to 21,459 adults who are unfit to work or hold down a job. If that is extrapolated over a six-month timeframe, it equates to €586 million in lost wages and welfare payments alone, never mind the impact long Covid is having on our overburdened health service. On a population basis, more than 21,000 people may be unfit to work due to long Covid. That excludes those who have relapsed after the initial recovery from the SARS-CoV-2 infection or the tens of thousands more experiencing less severe forms of long Covid who have had reduced participation while still in employment.

The sad fact for many of these people is that trying to get access to care and treatment is nearly impossible. On average, they wait six months to access long Covid clinics and, if they happen to be in Dublin, they are waiting more than 12 months. At the same time, the Mater hospital long Covid clinic, which treats neurological conditions such as brain fog associated with long Covid, is set to close at the end of this year. Many patients are being forced to travel abroad to access treatment because of the lack of clear referral and treatment pathways in this country.

The Minister will recall that on 9 November, my colleagues in the Regional Group and myself secured the unanimous support of this House for a motion on the issue of long Covid. There were two provisions in that motion. which was unanimously adopted by the House. One of them was to "ensure that all healthcare and frontline workers who are unfit to work due to long Covid are entitled to special leave with the removal of the arbitrary eligibility date of 7th February, 2022, for healthcare workers and further ensure that the current scheme does not abruptly cease in June 2023".

For some bizarre reason, the health service, through the Department of Public Expenditure and Reform, has set an arbitrary date in that someone in the health service had to have contracted Covid at least 84 days prior to 7 February of this year and be out of work for that period to get extended leave until June of next year.

We actively supported and encouraged front-line healthcare workers to go in to work during the depths of this pandemic at a time we did not know what this virus was doing or have access to vaccination. We are now setting arbitrary dates without any justification as to why these dates were being plucked out of the sky. I know of two healthcare workers who contracted the virus last January. They were young, fit, capable women who are still out of work today and, because of the system in place, they are living on fresh air as their entitlements have been exhausted.

The key issue with regard to all of this and the reason I am bringing this up with the Minister is we need to recognise long Covid as an occupational illness for all healthcare workers and other front-line workers. To do that, we need her to act under section 87 of the Social Welfare Consolidation Act 2005 and the 2007 regulations introduced on occupational injuries and bring forward an amendment to those regulations to allow for long Covid to be considered an occupational injury for front-line workers.

Under those particular regulations and section 87(2) of the primary legislation, it states that a condition where there is a risk to a person's occupation that is not common to the population as a whole should be considered under this scheme. The reality is that the vast majority of front-line healthcare workers who contracted long Covid did so at a time a vaccine was not available. However, those workers continued to go in during the height of the surge in the most recent variants. The Minister and I spoke earlier and she told me that a substantial amount of the additional €16 million in the Social Insurance Fund was down to the surge in the Omicron variant earlier this year.

The workers who went to the front line of our health service during the Omicron peak to treat patients in hospital and ended up contracting Covid-19 and remaining out of work due to long Covid are denied any support at present. I ask the Minister to amend the regulations to include long Covid as an occupational injury in those circumstances. This change is happening in other countries throughout Europe. Denmark has brought it in and Israel, Italy, Latvia, Norway and Slovenia are doing it at present. The European Commission has recognised long Covid as an occupational illness yet we are not prepared to do that here for our own front-line healthcare workers.

The difficulty is that healthcare workers have an arbitrary date when they will be completely knocked off benefits. Other front-line workers, who are not healthcare workers, are getting no support whatsoever because they did not get the extended leave. I know one healthcare worker who was a clinical specialist physiotherapist within our health service. She is a very young, fit woman who has, since the beginning of this year, gone to the private Covid clinic in the Beacon centre and for private MRI and ear, nose and throat, ENT, appointments in Tullamore. She has attended the public Covid clinic in Galway but has also gone to private appointments in Dublin with Dr. Jack Lambert. At this point, this woman is paying €120 per month for essential Sublyme capsules; €65 per month for a multivitamin treatment; €30 per month for a probiotic treatment; €30 per month for melatonin and €25 per month for Naltrexone. The bills go on and on. This is someone who went to work because the Government asked her to do so to provide care for people who were ill and who went in during surge after surge and wave after wave of Covid-19 to work in our health service.

Now the State is turning its back on those individuals and it will turn its back on many more next June. That is only the healthcare workers, not to mention other front-line workers. When we had this debate in the House earlier this month, colleagues from all sides spoke about front-line workers, including teachers, who contracted Covid-19 in school. Some were in special schools, providing supports to children with a disability. They are being denied any support from the State, which is turning its back on them.

On top of those public sector workers, at least 4,000 people were still out of work 12 weeks after they contracted Covid. They were medically certified by the Minister's Department to be unfit for work. I believe they are only the tip of the iceberg in this matter. We need to recognise this as an occupational illness. I hope the Minister will do that.

In the time that is left, I want to raise one other issue with her. We need a root-and-branch overhaul of our tax and welfare system in this country to ensure that work always pays. People should always be financially better off in work than on the live register or claiming welfare. The systems are built against people. The evidence is that where people work and are able to actively participate in the labour market, they are financially better off. Research was published by the ESRI earlier this year into the impact of one-parent family payment reforms on the labour market outcomes for lone parents. There was a lot of criticism when these changes were brought in back in 2015 but the conclusion of the ESRI research is that the reforms led to an increase in the average hours worked by lone parents. Household income increased by between 9% and 12%. There was an increase of between 23% and 29% in earnings from employment. There are clearly many incentives to support people in employment.

One area that has not been reformed in years and is now a major barrier to people gaining employment is medical card income thresholds, which have not been increased in 17 years. In that period, both the Minister and her predecessors have increased the basic rate of social welfare by €71.20, yet medical card income thresholds have not increased. Everyone in receipt of a social welfare payment is technically over the income limit for the medical card. However, they are given on a discretionary basis to people who are on social welfare, but if people earn €1 on top of their social welfare payment, they are automatically denied the medical card. That is a basic barrier to work and I ask the Minister to consider it.

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