Tuesday, 15 December 2020
Ceisteanna - Questions
11. To ask the Taoiseach if he will report on the work of the high-level task force on Covid-19 vaccination, which includes representatives from his Department. [43140/20]
I propose to take Questions Nos. 9 to 12, inclusive, together.
The Government established the high-level task force on Covid-19 vaccination to ensure the requisite oversight, agility and specialist input is available to support the HSE and the Department of Health in the effective, efficient and agile delivery of the Covid-19 vaccination programme.The task force, chaired by Professor Brian MacCraith, has met three times to date, most recently on Monday, 7 December. The agreed terms of reference for the task force are: to support the Department of Health and the HSE to deliver a Covid-19 immunisation programme that meets best practice and provides good governance as a critical public health intervention in the prevention and control of Covid-19; working with the Department of Health and HSE to develop a national Covid-19 vaccination strategy and implementation plan for the safe, effective and efficient procurement, distribution, delivery and recording of Covid-19 vaccines, when approved vaccines are ready to be distributed; to provide a focal point for engagements with sectoral and specialist expertise as may be needed to support the development, implementation and agile iteration of the strategy and plan; and to monitor progress and report to Government, as may be required, on the development and implementation of the strategy and plan.
The task force includes senior representatives from across the Department of Health, the HSE, the Health Products Regulatory Authority, HPRA, the Office of the Government Chief Information Officer, the Office of Government Procurement, IDA Ireland, the Department of Enterprise, Trade and Employment and the Department of the Taoiseach, as well as expertise in the areas of public health, supply chain logistics, cold chain logistics, and programme management. The chair of the senior officials' group on Covid-19 represents my Department on the task force.
When the task force was established in mid-November, significant work was already ongoing on planning for this vaccination programme and governance in place across the HSE and the Department of Health. Under the co-ordination of the task force, this has all been brought together under a single integrated work programme utilising the wide range of relevant and high-level expertise and experience of task force members. The HSE has ultimate responsibility for the delivery of the Covid-19 vaccination programme, through its National Immunisation Office, NIO, which designs and implements all vaccination programmes in Ireland.
The task force has prepared drafts of Ireland’s national Covid-19 vaccination programme strategy and accompanying implementation plan. The Minister for Health brought these to Government this morning and both documents were approved by Government. The strategy document is designed to be a comprehensive framework establishing clear objectives and principles. It identifies the pathways for managing a programme of this scale. The implementation plan is designed to be a living document, in that it needs to be agile, flexible and capable of evolving over time, for example, to accommodate vaccines with differing characteristics or to respond to lessons learned in our local experience or internationally.
It describes the logistical, operational and human resource requirements for Ireland to begin vaccinations in line with Government guidance in early 2021 - and it could be sooner now - assuming the approval of one or more safe and effective Covid-19 vaccines for use. The strategy and implementation plans are being published today on www.gov.ie. The task force is committed to the ongoing oversight and monitoring of the vaccination programme and will update and revise the implementation plan as required to serve the overall goals of the programme.
It is clear that it will be many months, and perhaps six months or more, before we will have a full roll-out of the vaccine across the country, which will obviously be enormously welcome. There will, however, be a significant time remaining where social distancing, ventilation and handwashing and a strategy based on investment in testing and tracing, etc., will be necessary to minimise and, if possible, eliminate community transmission. In that context, I ask the Taoiseach about the increased number of cases of Covid-19. I think we are on a worrying trajectory towards having 500 cases, or more, a day by the time Christmas arrives. It could put Christmas family visits at risk or pose the need, unfortunately, for another lockdown in January.
That is a consequence of the decision the Government made to, in the words of the Taoiseach, take a more conservative approach on the household visits, and then trade that off with visits to hotels and restaurants. It is increasingly clear that the decision to prioritise the reopening of gastropubs was the wrong choice. Will the Taoiseach reverse that decision to protect family visits at Christmas?
I also raise the situation which developed at a school in Claremorris in Mayo. It is utterly shocking. Some 10% of the students had Covid-19. The principal and the board of management took the decision to close the school, and were then ordered by the Department of Education to reopen and, in the words of the principal, to remain open at all costs. That principal is now considering his position. It is a reckless position from the Government. It should be supporting parents and students.
I commend the important work of the task force led by Professor Brian MacCraith. It is an arduous task and the entire nation is dependent on a positive outcome from it. The Taoiseach may be aware from representations to his office that there is a widespread concern that the Government decided not to recognise people with disabilities in the priority list of groups for vaccination published last week. This omission has caused widespread concern and, indeed, considerable hurt. People with disabilities repeatedly tell policy-makers and decision-makers that they feel invisible or ignored and that provisions in political decision-making are too often an afterthought. Their carers also feel ignored by Government in its plans for the roll out of the vaccine.
Down Syndrome Ireland has raised its concerns with all Teachtaí, and has highlighted the increased risk of hospitalisation and severe disease amongst adults with Down's syndrome. However, it seems that those concerns have been ignored. British research has found that people with Down's syndrome are five times more likely to be hospitalised and ten times more likely to die as a result of the virus. Additional research, also from Britain, shows that people with a learning disability are dying from Covid-19 at a much younger age than the general population. These are very concerning data. The Disability Federation of Ireland has urged the Government to prioritise people with disabilities to receive the vaccine, as has Family Carers Ireland. I urge the Taoiseach to do precisely that.
I have two basic questions. How many new staff will be required to roll out the vaccine? Will the vaccine be rolled out exclusively through the public system, or is it envisaged that contracts may be awarded to private companies to administer it?
As has been said, it is going to be many months before we can get the population vaccinated. Until then, and perhaps beyond, the front line against Covid-19 remains in our hospitals. I want to respond to the systematic misrepresentations on the Taoiseach's part of the issue concerning student nurses and midwives, arising from a motion which we tabled several weeks ago. Let us be clear what is at stake and try to address directly what the student nurses and midwives are asking for.
During the Covid-19 pandemic, they have been covering the gaps of many sick and infected healthcare workers and they should be paid for that. The situation has not changed because Covid-19 is still with us and it will remain with us for at least another six to eight months, if not longer. Will the Government simply pay them for that work? I ask that because they are doing that work, and all the denial in the world will not change that.
I refer to the ongoing situation.
I have not met one nurse who said student nurses' education was ever protected under the degree programme. What they say is that they have always worked. They want a degree programme, but they also want to be paid for the work they are doing and for the denial to end. By the way, if Government were to pay them for the work they are doing, that would protect their education because they would not have to be doing other work on the side when they are supposed to be studying. The Government should add to that by not imposing fees of €3,000 to €7,500 on them.
Deputy Murphy raised the issue of the decision to exit level 5. The people of Ireland were under level 5 for six weeks and, I think, adhered to it very well, to such an extent that Ireland has the lowest incidence of Covid-19 cases in Europe. That never gets acknowledged, but that happens to be a fact. On balance, I do not think we could have kept people under that level of restrictions for an indefinite period. That is my view. I also think those working in the hospitality sector, insofar as is possible, deserved an opportunity to go back to work too and that the employments in which they work would also have some prospect of a future in that their businesses would be kept intact. These three weeks are important in that regard for them in terms of getting people off the dole, having more work available and giving workers an opportunity to get a decent wage. That was part of the motivation, as was the mental well-being of our citizens and the protection of lives.
In terms of the impact of the second wave, our mortality rates compare favourably and are one of the best, if not the best, in Europe, and that is because of decisions taken by Government and by the people. There is a balance here and personal responsibility is extremely important as we move into the Christmas period. This is very difficult all round for people. It is difficult for societies to cope with a pandemic of this kind, which is upending their normal lives. The data are clear in terms of the spread of the virus from households. By the end of this week, we hope to be able to say to people working in Dublin or elsewhere that they may travel home to meet their families but to mind themselves and their families in terms of how they behave. They should act as if they have the virus, make sure they do not pass it on to somebody else, and keep their contacts to a minimum. Every contact matters. Personal behaviour and collective behaviour are essential requirements in terms of keeping the pressure on the virus. We have to work extremely hard at that.
I believe that non-essential retail and restaurants - not everywhere - did deserve an opportunity to try to keep their operations going as well. There is a balance here in terms of protecting lives. We have protected a lot of lives and saved a lot of lives - hundreds of lives in the second wave through our actions in the serial testing programme. We have a very strong testing programme now.
A lot of people are very worried, stressed and anxious about their future because of Covid-19. We are trying to protect both lives and livelihoods. It is not a question of balancing the two. Protecting both is the objective.
I have said repeatedly "protect both". In any event, the social distancing will be required. If we can get the vaccine into nursing homes initially and to healthcare front-line staff, that in itself will make a significant difference. We can then move on to the various sequencing.
I am, again, very disappointed in Deputy McDonald's comments and the very bitter and partisan political way she frames things. Government did not decide not to recognise people with disabilities in the roll-out of the Covid-19 vaccine programme. That is what the Deputy actually said, and it is a reprehensible thing to say. Government did not decide the sequencing. Public health experts decided the sequencing. The national immunisation advisory committee recommended on the sequencing, and NPHET endorsed that sequencing and made it clear that it is a live document. Does the Deputy not accept that?
It does not do that and the Deputy should not suggest that it does, or assert that it does. That is what the Deputy said. I have no doubt that the public health expertise will engage with disability organisations in terms of the roll-out of the vaccine. In the first instance, it is being rolled out to the elderly and residents in nursing homes because they are the most vulnerable. The data from the first wave show that. We know what happened. There was serial testing in nursing homes to keep the pressure on the virus in nursing homes and likewise the vaccination. We will work with the Disability Federation of Ireland. Nobody is making premeditated decisions to deny anybody. We received the sequencing from the national immunisation advisory committee through NPHET.
It is important to say to every Member of the House that if we all start coming at this from different perspectives in terms of the order of prioritisation, we are going down a slippery slope towards the politicisation of this. I believe that, insofar as is possible, prioritisation should be the domain of public health expertise in terms of who the vaccine will help most in protecting illness and protecting people from dying. That is the motivation behind it.
I dealt with the student nurses earlier. I say again that, in my view, a first-year student on a nine-week placement should not have to work a 13-hour roster. The clinical placement cannot be protected if a person is working flat out.
That is not what the degree programme is about. Any employer - I need to be careful because a person's words get twisted all the time around here - any employer should not abuse student nurses in that situation.