Thursday, 8 October 2020
Ceisteanna ó Cheannairí - Leaders' Questions
Following its meeting on Sunday, the National Public Health Emergency Team, NPHET, wrote to Government to outline their concerns about the increasing number of Covid cases throughout the State. It was, and still is, an extremely worrying situation. Since the weekend, there have been a number of large clusters in nursing homes, including one in Convoy in my own constituency. The rate of admissions to hospital has been on the rise and the number of Covid-19 cases in ICU has risen, as has the number of patients on ventilators. This is all reflected in the comments of the Chief Medical Officer, CMO, Dr. Tony Holohan, yesterday who said that his level of concern on Sunday was lower than his current level of concern.
Since then, instead of setting out a plan to deal with the situation in our hospitals, the Government has allowed a narrative to prevail that this it is everybody's fault bar their own. The Tánaiste said on RTÉ television that NPHET's advice was landed upon him as a surprise. We now know that is not the case. The CMO organised an extraordinary meeting of NPHET on Sunday and informed the Minister for Health of this on Saturday. He spoke to the Minister before and after the NPHET meeting. He did everything he could have to keep the Government in the loop. It was only when NPHET's recommendations made their way to Government that they were leaked. For 24 hours afterwards, the Government said nothing. When the Tánaiste did say something on national television, it was to engage in distraction and a sideshow. He played the man instead of the ball.
In all of this time the Minister for Health stayed schtum. He said nothing and allowed the perception to prevail that this had all come out of the blue. Most significantly, since then he has said nothing about increasing capacity in our hospitals. That is the real issue here.
We are unprepared for a surge in our hospitals due to the lack of capacity. The winter plan the Government published is insufficient, as everybody knows. The Irish Medical Organisation, IMO, has said that the winter plan will not be enough. Its president, Dr. Padraig McGarry, said that shutting down elective care to deal with any winter surge is not an option given the impact of delayed diagnosis, delayed treatment and ever-increasing waiting lists for outpatient appointments, inpatient day cases and investigative procedures. This lack of capacity and lack of beds is the crux of the problem.
The Tánaiste might talk about surge capacity and so on in his reply but we know that the knock-on effects of this approach will be absolutely catastrophic for the health service. He knows that and so do I. We need to tackle this issue head-on and to tackle it now. Does the Tánaiste accept that ICU capacity is a major issue? Does he also accept that the current plan is completely insufficient to deal with a second surge without having a massive impact on non-Covid care? Crucially, what is he going to do about it?
Covid is nobody's fault. Nobody in the Government is engaging in any sort of blame game. That is the game of others. This is a virus. Nobody is to blame for it whether here or north of the Border. I will not speak for the Minister, Deputy Donnelly; I understand he is to issue a statement later in the day. I can, however, speak for the Government and for myself. I can give the facts. Nobody in Government had any indication that consideration was being given to recommending a move to level 5 until Sunday. This was confirmed by the CMO at last night's press conference. It was a shock; it did come out of the blue. We were not prepared for it nor was the country.
What do I mean by "out of the blue"? The recommendation came on Sunday, only three days after NPHET had said in writing that it did not strongly support a move to level 3 nationally at that time. It was also not in line with the parameters set out in the Government's framework - a leaflet explaining it has gone through every door in the country. Under this framework, restrictions are to be escalated in steps. The criteria for reaching level 5 had not been met. A decision of such gravity needs to be talked through and thought through. I refer not only to the reasons for such a decision, but its implications for people, the exit strategy and co-ordination with Northern Ireland.
To clarify and to be very clear, the Taoiseach, the leader of the Green Party and I were informed on Saturday that a meeting of NPHET had been called for Sunday. There was no suggestion, not even an inkling, that level 5 was being contemplated. Had we known that, we would have sought an urgent briefing that night. That is what could, and should, have happened. The first indication I had that level 5 was being considered came on Sunday evening, after the NPHET meeting had taken place. I received confirmation in writing at 8.30 p.m., setting out the recommendations and the reasons for them. For some Minister, the first they heard of this on the news.
I appreciate that the Deputy may want to make a big deal about which Minister knew what and at what time on Sunday but that is not the point. The point is that we had no indication that this was even being considered until Sunday. We need to move on from this. This should not be NPHET versus the Government or the Government versus the Opposition; this has to be Ireland versus the coronavirus.
The Government is acting in response to the escalating situation. We took the decision to move the entire country to level 3 only the other day and I believe the Deputy's party supports that decision and the decision not to go to level 5. If that is not the case, the Deputy may wish to say so. That decision is being implemented. We know that level 3 was successful in counties Laois, Offaly and Kildare. We can also see that it might be working in Dublin but it is too early to know for sure. The R-nought number, however, seems to be down to approximately 1. It will be the best part of ten days before we know whether it is working in the rest of the country but it is something on which we are acting.
Capacity is an issue in our health service. It is very often an issue. Going into this crisis, we had well above the European average number of nurses and about the average number of doctors at 3.3 per 100,000. We were a bit below average as regards hospital beds when compared with other countries but had more than countries such as Sweden, Denmark, the Netherlands, Canada and New Zealand. I could go on. Since then we have added 800 acute and subacute beds to the system, approximately 150 of which are currently being used by patients who have Covid. We have also increased the number of ICU beds, which was 225, by approximately 60. Approximately 25 or 26 are being used today. We have increased capacity and will increase it further.
The Tánaiste said this should not be a matter of NPHET versus the Government and I agree. Everybody needs to get on the same page. It was not me, however, who went on the national broadcaster to take the legs from under our Chief Medical Officer. It was not me who engaged in that type of dangerous behaviour. I put it to the Tánaiste that, if it had been me, he would be the first to stand up and say that it was reckless, that it undermined public confidence and so on. The question is one of capacity. The real reason the Tánaiste made his statement is because NPHET called that out. The reason we are even contemplating these stringent restrictions is the lack of capacity in our health system. The Tánaiste has been Minister for Health and Taoiseach and he has been in government for the past nine years. He has left the State extremely vulnerable with regard to our number of ICU beds. That is the question I have asked, not who knew what, when and where. It is a question of what the Government is going to do as regards ICU beds because its winter plan will fail. It is not enough. The Government is depending on surge capacity and this means closing down other elective care, which means delays in diagnosis and a lack of other crucial treatments. Where is the Government's plan? What is it going to do to address this real issue of capacity, which has not only been raised by those of us in Sinn Féin?
The Tánaiste should talk to people on the front line, the Irish Medical Organisation, IMO, and the managers in our hospitals. They are all singing the same tune. We are seriously stressed in terms of capacity in this State and the winter is going to be very difficult as a result.
On the issue of ICU capacity, as I outlined earlier, we went from 225 beds at the start of the year to close to 300 beds now. The number of patients in ICU with Covid-19 is around 25. We have the ability to go to 360 beds with surge capacity, and there is also the option of using the private hospitals. That option was available to us in the spring and it can be available again. Those are the facts of the situation.
I know what Deputy Doherty is trying to do, namely, play the blame game. He is trying to set it up so that if the country has to go back into severe lockdown, he can blame the Government and say it is all down to hospital capacity.
Let us look at other countries. Two good examples are the Netherlands and Spain. Both those countries have a much higher incidence of the coronavirus than Ireland and fewer hospital beds per head than Ireland and neither is at this stage considering going back into lockdown. That is the position.
In relation to the Chief Medical Officer, I did not say a bad word about him.
I spoke to the CMO on Tuesday night, which was the first time I had a chance to speak to him in ages. I did not want to bother him while he was off because his wife is sick. We had a good personal conversation. We cleared the air and neither of us has any issue with the other. We spent most of that conversation talking about how we are going to beat this virus, and that is what we should be talking about today.
I watched the Tánaiste's interview on the "Claire Byrne Live" show on Monday night. The view I formed, and I think many people formed the same view, was that the Tánaiste got his information from a media leak. We know that was not the case, that there was an unscheduled meeting of NPHET on Sunday, and that the Minister for Health also had telephone calls before and after that meeting. Telephone conversations are two way. We would expect the Minister for Health to have asked questions to see what exactly that meeting was about and what measures NPHET was considering. Was the Tánaiste fully aware of that conversation and will he outline that for us?
In hindsight, given the escalating numbers, does the Tánaiste regret the interview with Claire Byrne? Does he accept that it has been a distraction in the fight against the virus? Does he accept that the primary focus this week has been about mending fences? Indeed, the Tánaiste has just said that he had a telephone conversation to clear the air. We really should be focusing on putting our collective efforts into fighting this virus. A collective approach is needed from the Government, NPHET, the political system and from the public. The public can only do so much, however. The State must also play its part and play it comprehensively. We must reduce the incidence of the virus and take the pressure off the hospitals, and those matters are already being talked about.
In March, the Tánaiste told us that there was a comprehensive strategy involving restrictions, social distancing, testing, contact tracing and isolation where there was a positive test result. That was followed in May when he announced the HSE's strategy on testing and contact tracing. There were going to be key performance indicators for testing and contact tracing. In recent days, a leading health specialist has warned that regional departments in the public health system can no longer cope and that Covid-19 outbreaks are going to be missed. Dr. Anne Dee, a consultant in public health medicine, is reported as saying that eight regional departments are now "throwing in the towel" and giving up on "proper" contact tracing. She spoke about the urgency of getting staff and was fearful that it will be the new year before those staff are in place. She added that "The regional health system is as close to collapse as it has been at any time before."
We trusted the Government to ensure that these systems were put in place and that they were resourced and functioning. The idea that contact tracing is nearing collapse should be a major source of concern. We cannot contain the virus if we do not know where it is and we do not ensure that people are properly traced. We need a frank discussion on the shortcomings and how they are going to be addressed.
Does the Tánaiste believe that, to clear the air, the Minister for Health should make a full statement in the Dáil so that people can ask questions? I ask because we must get rid of this distraction. Were those with responsibility for regional public health systems contacted and asked what is required? What systems are being put in place to ensure the contact tracing system works?
His office has informed me that he will do that today. I cannot answer the Deputy's second question regarding whether public health departments have been contacted, but I am sure they have been. We all appreciate the amazing work the public health departments are doing in contact tracing. They have had the assistance of people who would never have known what contact tracing was until recent months but who were trained to do exactly that, including members of the Defence Forces. It is important that they are properly resourced.
As the number of cases increases and the number of contacts people have also increases, contact tracing becomes all the more difficult. That is why we are asking people to minimise the number of social contacts they have, because that will make the job easier for contact tracers. If most of us have two, three or four social contacts, that makes the job of a contact tracer much easier than if we have 20, 30 or 40 social contacts. That is part of the rationale behind encouraging people to avoid gatherings and limiting the size of gatherings that people can have.
In relation to Monday night, I did not say I heard it from a media leak. I never said that. If that is the impression the Deputy got, that is the impression she got, but it is not something that I have ever claimed. I set out the timeline earlier in response to Deputy Doherty. It is how many of the public heard, though, and that caused fear, anxiety and panic for hundreds of thousands of people who thought they might be out of work the next day and for tens of thousands of businesses that thought they might have to close for the last time. It should not have happened in that way and that is not the way things were handled in the past. I totally agree with the Deputy, however, that the events of Sunday and Monday, all of them, are a distraction from what we now need to do, which is to fight the coronavirus together. The Government, the Opposition, the HSE, NPHET, the Department of Health and everybody must work together against this common enemy. That is what I want to do.
What we do not want a statement to be made and then further questions to be asked. Let us put this issue to bed. I presume the Minister for Health will be coming into the Dáil to make that statement.
The public can only do so much. We hear senior people in the public health system saying that a system that is vital to dealing with this virus is close to collapse. What is being done about that? Can the Tánaiste give an assurance that the resources required will be put in place? If we do not shut down this virus, we will shut down the economy. The virus and the economy cannot coexist. That seems to be self-evident. The Tánaiste himself made great play of this in March, and rightly so, when he said tracing was to be a central part of the strategy. It must be meaningful, however. It is not just down to the public. I encourage people to reduce the number of their social contacts, but the State has a responsibility in this area as well.
The way we will beat this virus is through collective action led by the Government and individual actions which people take in their everyday lives. We all appreciate that individual actions are required, with all of us following those public health guidelines, and Government action to ensure we put the infrastructure in place. Part of that infrastructure involves testing, and we are now testing 100,000 people per week. There are 12,000, 13,000 or 14,000 tests every day. This is polymerase chain reaction, PCR, testing which is the gold standard in testing. Many other countries are not using PCR and are using less specific and less sensitive types of testing, such as antigen testing. There is a role for that type of testing, but we are using PCR testing at the moment. We are testing more people per head than many other countries that are often cited as models for dealing with the coronavirus, such as New Zealand and Germany. We are well up there in terms of testing.
On tracing, I did see that report, although I do not know exactly where it came from. I think it was anonymous but I may be wrong. I cannot speak for the HSE on the details of what resources are being provided for tracing but I totally agree with the Deputy that tracing is a crucial part of our response to the coronavirus. Those departments need to be resourced and they have been in the past few months. People from the Defence Forces, teachers and civil servants were trained up. Huge numbers of people were brought in to supplement the standing public health teams and that needs to be scaled up again, if it has not been done already.
The last few questions have been about Covid but I wish to discuss the situation of school secretaries, who did enormous work over the past six months to ensure the reopening of our national and secondary schools, which is one of the best achievements during Covid so far. Over 1,000 school secretaries are not being treated equally in their pay and conditions of employment. Will the Government enter into meaningful discussions in the Labour Court, as agreed by the former Minister for Education and Skills, Deputy Joe McHugh, in the House last October? That was 12 months ago. Over 1,000 school secretaries are being treated unequally as they are not getting paid other than through an annualised grant. They are working side by side with secretaries in other schools in their towns and villages who are getting their full pay and being treated as public servants with holiday pay and entitlements. We have relied on school secretaries to make sure that schools and their management have some resources in place. Many of these school secretaries worked over the summer months without pay to make sure the schools reopened. I understand that discussions have taken place but they have not been meaningful. Will the Government ensure fair treatment and parity of esteem for those school secretaries? They are not very happy that their issue has been kicked down the road and are contemplating industrial action. It would be an indictment of all of us if school secretaries had to go out on strike after all they have done. We have talked about front-line workers' bravery. I believe school secretaries are front-line workers as well.
I thank Deputy Canney for raising this issue. I know it is close to his heart and I remember us speaking about it months ago when we were in government together. The Government really values the essential work done by school secretaries and caretakers. Often, the school secretary is the first person one meets on the way into a school and the caretaker is the last person to leave in the evening. Schools would not operate without them and the role they play in our education system is as important as that of schoolteachers, SNAs and school principals. For that reason, it is the Government's objective to regularise their employment, terms and conditions, and pension rights. That can only be done going forward. It cannot be done retrospectively, for reasons that I will explain. Of course, it has to be done by agreement and engagement and I sincerely hope that engagement will take place.
I am advised that officials from the Departments of Education and Skills and Public Expenditure and Reform and school management bodies met with the trade union Fórsa on 1 October in the Workplace Relations Commission. An offer of a modest multiannual pay increase was made to Fórsa at that meeting but it was not acceptable to the union. The Department of Education and Skills, in conjunction with the Department of Public Expenditure and Reform, is considering the union's request to refer the matter to the Labour Court for determination. A number of technical issues exist as neither the Departments nor the management bodies are the employers of the staff in question. In these circumstances, Fórsa's statement that it is considering strike action is regrettable, and as we know, any such action would have a day-to-day impact on the operation of schools at this critical time and would disrupt tuition for students who have only recently returned to school after a six-month gap.
The Government is keenly aware of the role played by these vital staff and significant improvements to the pay of secretaries and caretakers have been made since 2015, under a pay arbitration scheme. This provided for a pay increase of 10% between 2016 and 2019 for staff, with a minimum rate of €13 per hour phased in over that period. The average hourly rate for a school secretary is now €15.49, which is in line with the hourly rate for a grade 3 clerical officer, taking into account that a clerical officer works through the summer.
There are a number of issues here. The Tánaiste talked about engagement and it is important that engagement takes place. It has been a year since the then Minister for Education and Skills agreed to enter into engagement with school secretaries. The offer made by the Department was for a pay rise, but what the school secretaries want is equality in their pay, terms and conditions. This issue has not been addressed by officials from either the Department of Education and Skills or the Department of Public Expenditure and Reform in the discussions. If we are going to bring into force what we say about holding school secretaries in high esteem, we need to engage in the mechanisms that are in place. I again urge that this issue be taken up as a matter of urgency. School secretaries are not people who want to go on strike. They are not threatening it if they do not get somewhere but there is a short window of opportunity for the Departments to engage meaningfully to find a resolution to this matter once and for all.
The Deputy is correct that a pay rise has been offered, but this is not just about pay. It is about other issues as well and school secretaries and caretakers understandably want their employment terms and conditions to be regularised. They want to be public sector employees, like teachers and other secretaries in the public service, working in local authorities or Civil Service departments. However, we need to work out what equality means. Secretaries and clerical officers working in Departments and local authorities work year-round and only have a few weeks of annual leave. Many of those issues have to be worked out because equality must be defined in that context. As is always the case with industrial relations matters such as this one, anything we do would have to be prospective and not retrospective. If changes were retrospective, they would kick off claims from up to 100,000 other people who are not directly employed by the State but by bodies that are grant-aided by the State. The Deputy will be familiar with a similar issue that arises with supervisors on community employment schemes. The resolution can only be a prospective one but we do want to resolve this.
Last Monday, my colleagues and I had a very important meeting with the excellent CEO of Kerry County Council, Ms Moira Murrell, and other directors of services with the council, including Michael Scannell, Charlie O'Sullivan, head of finance Angela McAllen, and others. One of the items on the agenda was the deficit in local authority funding. I am fearful that there will be cuts in basic day-to-day services, such as taking care of housing stock, work on essential issues like roads and keeping services like libraries and public toilets open. Our county will not be able to progress with new projects and initiatives. Rather, it will struggle to provide essential services like those I have outlined already. All our local authority has got so far is six months of a subvention on rates but it will now have to go after businesses looking for the other six months' worth of rates. How in heaven's name can we go after cinemas, for example, which barely opened to very small numbers, and ask them to pay rates? Our excellent county councillors on our local authority had to vote blindly on a property tax last week, not knowing what money they will be getting from central government.
Now we are faced with a new issue, namely, the climate Bill. New responsibility will be put on local authorities, which will be required to produce annual climate action plans, dealing with both the mitigation and adaptation sides of climate issues. Frans Timmermans, the European Commissioner and Vice-President in charge of overseeing the European green deal, says we must plough ahead with this agenda at all costs. What about the implications of imposing billions of euro of extra taxes on a public that is in dire straits and hurting already?
I will get a bit personal about this, not because she is my daughter as there are many other people's daughters. Rosie Healy-Rae and Micheál O'Shea, a very nice, young, respectable local man were getting married this Saturday. It has been cancelled. The implications and the economic bang of that for the hotel, the hairdressers, the car hire company and the people who provide the flowers is enormous. That is only an example; there are other people. 10-10-20 was going to be their special day, like a bag of fertiliser.
While all this is going on, the Tánaiste and the Cabinet are signing up to €9.5 billion of additional carbon taxes on a public who, like I say, are really hurting. It will be €1 billion a year of additional taxes. I am not a climate change denier. I want to protect all species on this planet, including the human species. It is suggested that households may have to pay excise duty on their electricity to compensate for the drop in revenue to the State from the people switching from petrol and diesel to electric vehicles. This is according to a report from the Department of Finance's tax strategy group. People will be penalised for going green.
I thank Deputy Healy-Rae for raising this important question. I know that the issue of local authority deficits is a matter of concern around the country. It is coming up from Deputies from all constituencies. I understand from Deputy Griffin that the financial gap for Kerry County Council is estimated at about €5 million or €6 million for 2020, potentially rising to €13 million for 2021. That would be a grave situation indeed. The Government understands that local authority income is down for many different reasons, ranging from parking charges not coming in to other charges and income streams being depleted. It is a matter that is being worked on by my colleagues, the Minister of State, Deputy Peter Burke, and the Minister, Deputy Michael McGrath. As the Deputy knows, we waived commercial rates for quarters two and three for most businesses. There was a commercial rates holiday for most businesses for six months. Usually, even in a good year, a local authority might only collect 87% or 88% of that money. We gave them the full 100% anyway, so they got more than they would have from commercial rates in a normal year. We are examining what we are going to do about quarter four rates. An announcement about that will be made in the budget next week. We are aware that additional funding will be required for local authorities to plug deficits that are arising. It is very much in the mix for the budget.
I thank the Tánaiste. Ministers are being told that they will be audited with regard to carbon emission-reducing measures. What will that mean for our farming community and fishermen who are already in dire straits? I have discussed this with Irish Farmers' Association leadership over the last 24 hours and I am again coming back to the fact that the Cabinet is saying that our State will have to come up with €1 billion of additional taxes every year for the next ten years. What are the implications for our tourism industry, including, for example, our airline industry? This is outside of Covid. Will we have to reduce the number of people allowed to come into the country? We are continuously trying to attract people here. Will we say that planes will not be able to fly? Will we have to say to people that they will not be able to burn turf or timber in their fires? We always said the one thing that people had to do was to keep the home fires burning. Are the Tánaiste and the Cabinet, and present and future Governments, tying people's hands behind their backs and saying that they cannot do that? I am not denying that we have issues to deal with with regard to our climate but we have to protect the present and future public from being overburdened with tax. I appreciate the sincerity of people like Deputy Eamon Ryan but we cannot go blindly into this, signing a blank cheque and putting future generations of people at enormous expense for something that we cannot even discuss.
I assure the Deputy that the Government will certainly not tell people in rural Ireland that they cannot burn their own turf or timber in their own fire. That will not happen. That would be totally disproportionate and unnecessary, given the fact that air quality is very high in rural Ireland. It is a different issue in towns and cities where we have a problem with air quality and that is impacting on people's health, especially those who have chronic conditions such as asthma and COPD, and therefore action needs to be taken.
Taking climate action is one of the reasons why this Government was formed. It is why Fianna Fáil, Fine Gael and the Green Party came together, to accelerate Ireland's response to climate change and to up our game when it comes to climate action, to honour the commitment to go from being a laggard to a leader as soon as we can. The Government has made good progress in that regard. The July stimulus included a package of investment in everything from bog rewetting and bog restoration to cycling and pedestrian facilities, which will have an impact on the climate in a positive way. Just yesterday, the Minister, Deputy Eamon Ryan, published landmark legislation, a climate action Bill, and I congratulate him on that. It builds on the good work of Deputy Alan Kelly in the Fine Gael-Labour Government with the first climate law. Now there is a much stronger climate law brought in by Deputy Eamon Ryan.
The carbon tax will go up in the budget. That is programmed into it. Bear in mind that most of the cost of the carbon tax will fall on business and the rest on households. It will all be ring-fenced for things like dealing with fuel poverty and investment, mainly in rural Ireland, in things such as retrofitting. It will be a ring-fenced increase with the money being ploughed into poverty reduction and climate action measures.