Wednesday, 31 March 2021
Ceisteanna ó Cheannairí - Leaders' Questions
Friday is World Autism Day. This marks a moment when we should be focused on raising awareness of the challenges facing those on the autistic spectrum and discussing how best to support them. Instead, we find ourselves discussing again how badly the State treats and fails children with additional needs.
Yesterday, we heard the harrowing story of a seven-year-old called Lexi Forde, whose parents have been told she will have to wait until 2026 for school-age support. They said they have been left crying and literally begging for services for their daughter. Lexi’s story is not unique and comes on the back of shocking revelations that the Department of Health was compiling dossiers on children with autism and their families involved in legal actions against the State. It is important to understand that the legal actions being taken were around the State’s failure to provide these children with vital supports and services. The State set out to gather information that could be used to exert pressure, damage reputations, stall and silence these families.
On the very day the "RTÉ Investigates" programme aired, families were in front of the High Court fighting for their children’s right to a school place. The truth is that the State makes families of a loved one with special needs feel like a nuisance when they look for support. They face a closed door. The truth is that the State only gives begrudgingly and withholds services and supports begrudgingly.
Those who take on the system and the State in the courts and refuse to be silenced find that the State goes on the attack and vilifies them. This is a story we know only too well. It was faced by brave people like Brigid McCole, Louise O’Keeffe and Sergeant Maurice McCabe. The fact that this malicious behaviour on the part of this State now extends to the collection of data on the families of children with autism is scandalous and shameful. Inclusion Ireland and the Disability Federation of Ireland have condemned this practice. The Ombudsman for Children has expressed deep anger at how the State treated those whom he described as some of our most vulnerable children. However, the Secretary General of the Department of Health has sought to defend these practices. He says it acted within the law and the HSE goes so far as to describe these practices as "normal" - its word, not mine.
It is alarming that they do not get that the real scandal is that these practices were happening at all. Lawful or not, this was deeply unethical. I do not believe this Government or the State has the consent or support of citizens and taxpayers to attack families and vulnerable young people in this way.
Were these practices under way when the Taoiseach was Minister for Health and Children? Will he indicate whether these practices continue today as we meet? What steps have been taken to make full disclosure to the families on whom these dossiers were compiled and kept? Can the Taoiseach answer those three very direct questions?
First, I state unequivocally that the Government I lead is one that sees as its fundamental objective advocacy for children and providing services for children in education and health in the most comprehensive way possible.
All my political life, I have fought for children with special needs in whatever capacity I have served. I do not intend to change now. When I became Minister for Education and Science in 1998, I introduced groundbreaking change to education services for children with special needs, in particular children with autism. It is hard to credit that in 1998, children with autism were not even recognised as being a specific educational category deserving of specific educational supports. We changed that. I led that change by providing pupil-teacher ratios for the first time for all children with special needs and specifically for children with autism in respect of special classes, with one teacher and special needs assistant, SNA, for every six children, and providing supports for children with autism in mainstream and special classes.
I respect the Deputy's right to raise issues but she should not dare ever accuse me of trying to attack children with autism. That is not what I or my colleagues in government are about. The State has failed in the past and it can do better right now in terms of providing additional places for children with special needs. That is something on which I am particularly focused right now. The Deputy should cut out this kind of thing, saying she is somehow in some virtuous world and everybody else here on the Government side has no empathy or no desire or policy focus to do better for children with special needs, or children more generally. That is just not accurate or correct. There has been an explosion and expansion of services for children with special needs in education. That is incontrovertible. I would like to do more, however, particularly in terms of children having access to more therapies in a timely manner. That is something on which we are currently focused in both education and health.
I watched the "RTÉ Investigates" programme and I would not, in any set circumstances, support any Department seeking, for example, to breach patient-client confidentiality. That would be intolerable, unacceptable and unethical. The Department of Health does not accept that assertion, however, and is conducting a rigorous review of it. As I said, the Government will appoint a multidisciplinary team to assess that situation and give the full story around it. The Deputy has made assertions and damned the officials in the Department of Health without allowing them an opportunity to give their perspective on it. They are parents too and have children as well. They are not immune or somehow unfeeling, unethical people. It is easy to brand people in that manner in this House but is it fair to do so without full knowledge of the situation?
I repeat that there should never be any attempted breach of patient-client confidentiality. No Department official or anyone in government should ever seek to approach clinicians, for example, seeking files in respect of children on which there are legal cases. I am not clear yet as to whether that happened in any systemic way. The Deputy used a phrase about compiling dossiers. That has been denied. A report was compiled on this. Perhaps we need to pause and get the full story. It is unacceptable that it would happen. I assure the Deputy that the Government's commitment and its role and function are to advocate and provide for children.
As I said, on the very day this programme setting out these shocking revelations aired, families were before the court bringing the State to account for a failure to provide places for their children at school. Let me repeat my branding of the practice of compiling and holding files and dossiers on children with autism and their wider families by the HSE, the Department of Health or any other organ of the State for the purposes of facing off legal challenges as absolutely scandalous and shameful. It is a practice that should not be indulged in.
Rather than engaging in distractions, the Taoiseach might answer the questions I put too him. I asked him whether, when he was Minister for health, this practice of compiling files and dossiers of this nature was under way? I also asked him to confirm or deny that this practice continues as we meet here today. I also him to indicate, with regard to the families on whom these dossiers and files were held, whether that has been disclosed to them at this stage.
The Taoiseach relies heavily on the report that he cites. Can he confirm that this report will, in fact, be published? I thank the Ceann Comhairle for turning off my microphone.
Lexi Forde, the child referenced by the Deputy earlier, will not have to wait until 2026. We will make sure that is the case. No child should have to wait that length of time. I do not want to comment on specific individual circumstances. It was raised, however, and we will see to it that that does not arise in that case.
The allegations made in the "RTÉ Investigates" programme are being taken very seriously.
There was no practice. It was not a practice when I was Minister for health of deliberately going out either to authorise the collection of data in respect of individual children or families. From my understanding of litigation, what normally happens is that pleadings are made and in the course of the interaction between legal teams, the plaintiffs will often provide information to obviously justify the necessity for additional educational and health supports.
As I said very clearly, any breach of patient-client confidentiality or any attempt by any official or anybody to ring up a doctor or consultant, as happened - they had documentation in respect of one case - would be-----
In more than five years occupying this Chair, I have never turned off anybody's microphone. I have asked people to abide by the time limits, which are generally ignored. Will you not ignore me and please resume your seat?
The Labour Party wishes the Government well in the strategy the Taoiseach announced yesterday. The country needs it to deliver and we will play a constructive role in whatever way we can. We will also criticise where necessary. I hope and pray that the Government delivers with regard to the changes it made regarding the vaccine prioritisation. If not, gardaí, special needs assistants, teachers, carers, retail workers, etc. will feel very let down.
Everything that has been done and announced yesterday is based on underlining data relating to vaccines. The Government has put all its eggs in the vaccine basket. I just want to dig into the details of this data.
The statistics we have been given to date are that approximately 800,000 vaccines have been administered, with approximately 578,000 first doses and 225,000 second doses. We have also been told that all over 70s will be vaccinated by the end of May. This was meant to be the middle of May but it slipped by two weeks. Allowing for that, it will now be the end of May. This is great news but I just want to dig into the data.
We have now been told that, by the end of June, 80%, approximately 3.8 million of the population over the age of 16, will be "offered" their first vaccine. How many of them will actually get it? My wedding anniversary is in July. I am going to offer to take my wife out for dinner in a restaurant she chooses. I do not know, however, if I am actually going to be able to take her out to a restaurant in July because I do not know if they will be open.
Having said that, in all seriousness, I want to ask the Taoiseach about the word "offered". By the end of June, will 80% of the population have received a dose of vaccine? Will they, at least, be in a position where they would have received it? It is a key question.
I was thrilled and delighted to hear the Minister for Housing, Local Government and Heritage, Deputy Darragh O'Brien, say earlier on Today with Claire Byrne that in April a portal will be offered to everybody to apply for their vaccine. That means all the further cohorts and various different age groups can do this. Will the Taoiseach confirm that this will happen? Will he confirm that everybody will be able to apply for vaccine in April?
Considering that everything depends on the volume of vaccines and that we are getting 1 million doses in April, May and June, will the Taoiseach tell us how many vaccines will be given to Ireland over the three months by the four companies, AstraZeneca, Pfizer, Johnson and Johnson, and Moderna?
I thank the Deputy for raising those issues.
The vaccination programme is a key part of exiting Covid-19 and endeavouring to bring life back to some degree of normality. The measures we adopted yesterday were essentially designed to continue to keep the pressure on the virus, particularly over the next four weeks, in order to reap a bigger dividend later in the summer, rather than taking risks now, which would have the consequence of increasing the prevalence of the disease and creating more pressure on our hospitals before the summer even starts. Such a scenario could potentially mean the rest of the summer would be mopping up if there was an escalation of cases and so forth. That is the thinking behind it, particularly as we are rolling out the vaccination programme.
We are into a different era in terms of the first three months. We always knew the volumes would be low but even that knowledge was compounded by the fact that we had difficulties with delivery schedules. AstraZeneca's supply and manufacturing issues are well known in respect of not fulfilling the European Union contracts.
That said the data is much stronger for the second quarter, April, May and June. The target is to have 80% not just offered vaccination but to get vaccinated by the end of June. The European Union has a figure of 70% across Europe, on average, to be fully vaccinated by the end of July. There will be an intense vaccination programme during the summer months. The situation is improving for the companies involved. The Halix plant has been authorised by the European Medicines Agency, EMA, which is significant for AstraZeneca's capacity to provide vaccines. Moderna has stronger manufacturing capacity within Europe, particularly in Switzerland. Pfizer-BioNTech has its Marburg plant in Germany. Johnson and Johnson's supply chain is independent of the US in terms of its contractual commitments to Europe. It means the national task force on vaccines is more confident in terms of supply lines and the delivery of vaccines. That focus will switch to the administration of far higher volumes of vaccines in the coming while.
With the evidence the national immunisation advisory committee, NIAC, has put together, it and NPHET are saying that the biggest factor in mortality and in severe illness arising from Covid is age. The change announced is about getting the most vulnerable in our society vaccinated as fast as we possibly can. It is about having no barriers or obstacles in the way of getting mass vaccinations done.
Many older teachers and key workers more generally, as well as the more vulnerable, will now be vaccinated more quickly.
I thank the Taoiseach for answering one of the three questions. I am delighted to hear that 80% of the population over 16 will be vaccinated by the end of June. That will be an incredible achievement and I look forward to it.
Yes, but it will be a vaccination received.
Will the Taoiseach confirm that the portal will be in place in April? Will he confirm that everybody will be able to apply for it? What number of vaccines from the four companies will be arriving here in the three months of the second quarter?
On what happened in the Beacon Hospital, the old private school club of access to whatever one wants, whenever one wants, was at play again. The Beacon got access to vaccines and became a vaccination centre early on. There were issues about it vaccinating its own staff above some who should have been prioritised in January. Then there was the fact that it would not sign up to the national ICU plan. Then there was what happened over the past number of weeks which was brought to light by Craig Hughes.
Why did we offer the Beacon as a hospital for vaccinations? Who decided that?
The national task force envisages having the portal up and running in mid-April, perhaps the third week in April. I will get the specific dates for the Deputy. That is the intention.
On the specifics of each company, I will get the details on each of them for the second quarter for the Deputy. On average, between April and May, we are looking at 2 million doses with a higher amount in May over April. It is 860,000 by the end of April with a higher amount in May. Delivery schedules will determine the weekly administration. There will be higher figures again in June and July.
The Beacon is a good vaccination centre. It was facilitating vaccinations, particularly for the people in that area, as efficiently and effectively as it could.
I want to raise the fishing deal the Government agreed to which is now seen as the greatest political sell-out of any industry that any Government has ever agreed to in the history of our State. This sell-out has angered fishing communities beyond words from Union Hall to Castletownbere, all along the coast to Donegal. New evidence in replies from a series of parliamentary questions confirms that the Government blindly supported the EU negotiation mandate in respect of the Brexit negotiations. In doing so, the Government betrayed not only the sector and coastal communities but the entire country.
This provides infuriating confirmation that the Irish fishing industry must now pay a huge price for our Government and Ministers opting to tow Brussel's line in these Brexit negotiations. The shocking and utter lack of engagement and dialogue with the EU side, on behalf of the Irish fishing sector, by the Government and the Minister in the months leading up to the Brexit deal is now glaringly obvious.
In fact, at his first EU Agriculture and Fisheries Council meeting on 21 September last, the Minister failed to raise the Irish fishing sector's pre-Brexit concerns. At his second meeting since becoming Minister, on 19 and 20 October, he again failed to table or raise the implications of Brexit for the sector. Instead, he chose to engage in a rather meaningless three-way bilateral meeting with fisheries ministers from France, Denmark and the Netherlands. Astonishingly, at the third Council meeting on 16 November 2020, weeks before a deal was to be struck, no fisheries items were raised. One would be forgiven for wondering what was being discussed at such meetings.
Further meetings attended by our Minister on 27 November and 15 and 16 December, at which the fisheries element of the Brexit negotiations was discussed, point to the Minister acting as a protector of European quota interests rather than the protector of the Irish share of the quota. All in all, this new information about the Minister's and the Government's activities in protecting Irish fishermen's rights illustrates the complete blindness with which the Taoiseach and the Minister trusted the EU negotiators. It also clearly demonstrates that the Minister and the Government strategically and deliberately chose not to stand up for Irish fishing interests. Instead, they sought praise from the Brussels elite. Sadly, at a time when Irish fishermen and women were depending solely on the Government to protect their interests, that did not occur.
In an overall context, data from Dublin City University estimate the Irish share of total fish catch in the Irish maritime zone is only 20%, which means that the other 80% is caught by foreign vessels. The Brexit fisheries deal means that Irish vessels operating in UK waters were hit with massive quota reductions while other EU countries got sweet deals. Despite the fact that foreign vessels continue to extract 80% of the fish from Irish waters, we have a Government and a Minister who are hell-bent on forging ahead with wide-scale decommissioning of the Irish fleet. This is being dressed up as some sort of review process. All the while, foreign vessels will be allowed to continue fishing in our waters. The sector was only seeking a fairer distribution of quota - nothing more, nothing less - and it was betrayed in that regard. The Government should have made the decision to adopt a much tougher stance during the Brexit negotiations. Why did it choose to let the Irish fishing sector down? Instead of forging ahead with decommissioning, will the Taoiseach give us a guarantee that he will seek a greater share of the quota for Irish vessels in the Irish maritime zone in order to make up for the mess created by the Government's own inaction?
I reject what the Deputy has said. He accused the Government and the Minister for Agriculture, Food and the Marine, Deputy McConalogue, of not negotiating or engaging on the issue of fisheries during the Brexit negotiations. I consulted with fisheries representatives and so did the Minister for Foreign Affairs, Deputy Coveney, who had ongoing engagement with Michel Barnier. The Minister for Agriculture, Food and the Marine also had an ongoing alliance with counterparts from like-minded countries in respect of the fisheries issue right up to the end of the Brexit negotiations.
Everybody knew that a no-deal Brexit would have been the ultimate disaster for fisheries because of the historic catch we have in British waters. Everybody knew from the moment Brexit was announced and was later passed by referendum, that we were in difficulty as regards fisheries. Deep down, the fishing industry realised that. I recall meetings four years ago at which the consequences of Brexit for fisheries, and Irish fisheries in particular, were well known.
I have never thought Brexit was a good idea. The Deputy is blaming the Government as opposed to looking at the real issue here, which is Brexit and the decision to forge ahead with it.
We certainly had to avoid a no-deal Brexit. I am sure the Deputy will accept that a no-deal Brexit would have been a disaster for fishing. In that context, we fought for as high a share of quota for the Irish fishing industry as we possibly could in order to ensure we can create viability into the future.
It is an extremely difficult deal for fishing. We are not at all happy with Brexit and its implications for fishing but neither would I do as the Deputy has done, which is to try to make this a simplistic issue. He has not really created any alternative ideas other than suggesting that we adopt a much tougher stance, whatever that means in practical terms. I do not think it means a whole lot and is nothing much other than rhetoric. There comes a time in negotiations or planning for any industry where, in trying to ensure and protect livelihoods, we need to go beyond simplistic rhetoric and concentrate on a solutions-based approach. The Minister engaged energetically on this issue, as did his Department, with other EU member states whose fishing industries were likely to be most affected by it. They had a strong alliance on this matter up to the very end. It is regrettable that the UK Government adopted the aggressive position it took in respect of fisheries. That was obviously a factor as well.
I thank the Taoiseach for his reply. He said he consulted with the industry but he obviously did not listen to it or to the fishermen's groups. Listening to his reply, it is clear he has no future vision for the fishing sector in Ireland beyond decommissioning. He has no honest answers for the Government's shambolic handling of the Brexit negotiations, from which we came out the worst in Europe.
I welcome the Taoiseach's sudden change of heart in setting up a fishing task force in February. A few months previously, in November, when I requested a task force for west Cork he more or less called task forces a waste of time. Why has the Government not been able to secure a bluefin tuna quota for the Irish fishing industry? Other EU countries are negotiating quotas additional to those they have already and we have none. The crisis this fishing sector is going through is not only affecting the larger fishermen. It will also have serious implications for the inshore sector in this country. If the Government's only solution is a decommissioning process that will lead to numerous job losses along our coastline and west Cork in particular, what is its solution in respect of these job losses? I have spent years in the Dáil pleading with this Government and that which preceded it to fight and save our fishing industry from Brexit. I pleaded with the Taoiseach during the negotiations to form a Government to appoint a Minister for fisheries and he refused. In layman's terms, if this Government was a company that dealt with its affairs the way the Taoiseach and his Government have dealt with the fishing industry in Ireland, both he, as CEO, and his board would have been fired months ago for their incompetence and shocking handling of our most precious resource.
The Minister has established a task force on the Irish fishing industry and creating a sustainable future for it. Resources will be allocated to ensure that and to continue to fight for and ensure balance in quota distribution. I wrote to the President of the Commission in the aftermath of the deal pointing out the disproportionality of the deal on fisheries with the United Kingdom and its implications for the Irish fishing industry and the need to quickly restore balance to the member states' fishery quota shares. The Minister continues to pursue the matter actively and raised it again at the EU Agriculture and Fisheries Council meeting on 25 January. The cost of the final quota transfer by Ireland will be approximately €43 million, which is about a 15% loss of the overall value. That is serious. This is obviously something to which the Government will respond as strongly as we possibly can as regards the allocation.
The shortage of vaccine supplies relative to the demand is well known, as are the reasons for it. I have no doubt that if the Taoiseach could source more vaccines, have vaccines manufactured in Ireland or even make vaccines himself, he would do so. Given that Dr. Mike Ryan talked about the ethical dilemma of administering vaccines to healthy young people when healthcare workers and elderly vulnerable individuals across the world need it, why are we administering them to healthy young people who have immunity and antibodies arising from previous infection? The latter can be proven by means of an antibody test. HIQA accepts that immunity following infection lasts for at least six months. We do not know that the immunity resulting from a vaccine will be much longer than that. It is certainly hoped and expected that it will be longer but we cannot say that with certainty, any more than we can say with certainty that there is immunity from having contracted the virus. That is generally accepted and it informs the approach of Israel, which is considered to be a world leader in vaccination. Israel afforded certain additional freedoms to people who had been vaccinated or who had immunity arising from infection and recovery. Likewise, it informs the EU digital pass, which, depending on its detail, may prove to be a good thing or a bad thing in facilitating freedom of movement. Why are we using such a scarce resource, that so many people want, and giving it to young, healthy people working in medical settings or who just happen to work for an NGO or a body that has front-line workers, even if they are not front-line workers themselves?
Unfortunately, that scenario is commonplace.
My second question is that the Taoiseach informed the Dáil and Deputy Naughten categorically that there would be no compulsory vaccination in the State, that that was never our approach and that this was based around bodily autonomy and informed consent. Given that, why are student nurses in Ireland now being told that they have to be vaccinated to be able to finish their placements and thereby finish their degrees? We need these people. These are nurses who have been on the front line all along. They have put their health and their bodies on the line for this State. Many of them are delighted that they are going to be given the vaccine but there are some who simply do not want it. The Taoiseach has acknowledged that there will be no compulsory vaccination.
The Government’s Minister for Health categorically denied in the Dáil that Mass going would be a penal provision and we now know that the State has adopted a contrary approach. He needs to correct the record of the Dáil in that regard for the sake of parliamentary democracy. That is a different issue, however, and I ask the Taoiseach to respond to the questions I have raised.
On COVAX and what Dr. Mike Ryan has said more generally, Ireland and indeed the European Union is the strongest contributor to COVAX and, as we know, given the EU’s strong manufacturing capacity with manufacturing sites across Europe, it is one of the biggest contributors globally to the distribution of vaccines which are paid for by other countries but are manufactured within the European Union geographically. Funding and policy-wise Europe is contributing hugely to COVAX because no one is safe until we are all safe.
We take our advice on vaccination policy from the national immunisation advisory committee and from NPHET. Notwithstanding people having antibodies I support that advice and I do not think that the evidence is strong enough not to vaccinate those who currently have antibodies. For example, the level of antibodies could differ where some could have a higher level of antibodies than others. The advice is to vaccinate.
Again, as has been outlined earlier, we want everybody over 70 to be vaccinated, so we are still predominantly dealing with those more senior in society in age terms, and for them to have a first dose by mid-April. Those with underlying conditions of all ages should be vaccinated as quickly as we possibly can. The HSE is operationally going through that fourth cohort, which is challenging in itself in identifying individuals via GPs, consultants and so forth.
On compulsory vaccination, there is no mandatory compulsion on people to vaccinate in the country. Within the health service I would argue that there are particular obligations in terms of collective solidarity and preventing the spread of the disease. We know from the last wave that the numbers of healthcare workers who got Covid-19 was very challenging, for example, in respect of the number of staff members working in nursing homes. Thankfully, with the vaccines the impact has been dramatic. The serial testing in nursing homes is indicating 0.3% which is very low. This is a very good vindication of the vaccines and their impact on reduced infection as well as reducing severely the incidence of mortality and this has likewise been the case in the hospital setting. For the overall good, we have to do everything we possibly can to prevent the spread of Covid-19 and to protect people within the hospital setting and the health setting more generally.
I fully respect religious worship and the right for people to attend services and the extent to which this is impacting on them but Covid-19 is the enemy here, not the Government.
The issue for the Taoiseach is not whether he respects public or private worship but is whether a Minister correctly informs the Dáil when he is bringing in legislation, which he specifically signed off on, which was not made by the Dáil but by the Minister. That is the issue. He specifically said that it was not a penal provision and that it would remain thus. Now the State is adopting a contrary position down in the courts and it is that that needs to be clarified.
Going back to my initial question, the Taoiseach is saying that notwithstanding what the European Centre for Disease Prevention and Control, ECDC, what HIQA has said and what most scientists around the world agree upon, healthcare professionals who have had Covid-19 because of their work and have put themselves on the line, have recovered and have antibodies, have to take a vaccine to get antibodies that they already have or be fired at a time when we need them most. These are in circumstances where there are elderly and vulnerable people across this State crying out for that self-same vaccine, who have no immunity, and for whom Covid-19 poses a very significant threat.
-----from antibodies. We cannot ignore that reality. I prefer the cautious approach and when we said we wanted to vaccinate healthcare workers, it was, incidentally, warmly received in hospitals and the relief there and in nursing homes was overwhelming and could be seen when people were vaccinated. I am not sure we are talking about a huge cohort of people here in any event.
There are the two issues: the compulsory issue and the issue on antibodies. I would err on the side of caution on the antibody question and defer to medical advice and vaccinate, particularly people working in healthcare and particularly in frontline healthcare settings. We are still learning about this virus, about its new variants, and so on.