Friday, 20 March 2020
An Bille Sláinte (Caomhnú agus Cosaint agus Bearta Éigeandála eile ar mhaithe le Leas an Phobail), 2020: An Dara Céim - Health (Preservation and Protection and other Emergency Measures in the Public Interest) Bill 2020: Second Stage
Simon Coveney (Cork South Central, Fine Gael)
Yesterday in Dáil Éireann we spoke about the truly unprecedented circumstances we are currently living through in Ireland and indeed worldwide. The global figures are stark, and as of yesterday in this country we have 557 confirmed cases of Covid-19. Sadly, yesterday we also had another death, and I know that this House will wish to extend its sympathies to the family and friends involved.
It is not possible to overstate how serious a challenge Covid-19 presents to all of us. When this Bill was before Dáil Éireann yesterday, I said the Oireachtas and its Members are rising to the challenge that confronts us as policymakers and legislators, and I say that again today. I also wish to put on the record again my appreciation for all the people in our health service who are working so hard to plan for and deal with this pandemic. Their courage, determination, organisation and togetherness really is inspiring, and it will need to be. There are also many other people across so many sectors who are all trying to work together to do what they can to plan for Covid-19 as it spreads through our population. Ultimately, however, it is the people themselves all over the country who need to play their part by following public health advice.It is heartening to see how many key messages have become front and centre in our lives such as the messages to wash hands, cough into elbows, reduce social activity and stay apart.
I know social interaction is important for all of us and it is even more important for some groups, but reducing social activity must happen at this time and we must persevere. Let us not forget what this is about. This is about protecting the health and lives of people who are vulnerable to this virus. I want to send a message directly to people who are not taking the public health advice, and unfortunately there are still many such people, particularly young people such as teenagers who are hanging out together in people's homes or on street corners, interacting, socialising and chatting as they would normally do. Through parents, families, peer groups and communities, we need to confront people who are not taking this seriously and ask them if they will throw a lifeline to a loved one in a vulnerable group who may be drowning if they have the option to do so? If they do not listen to public health advice now, they may not be able to positively influence the spread of this disease in a few weeks.
The truth is we have over 500,000 Irish people who are over the age of 70. We have 170,000 people in Ireland who are either recovering from, have recovered from or are in treatment for cancer, with some 40,000 extra people joining them in treatment every year. We have 7,000 children and young adults with Down's syndrome and tomorrow is world Down's syndrome day. We have people with cystic fibrosis, CF, we have tens of thousands of people with respiratory illness and asthma and we have so many other vulnerable communities.
I refer to the actions of people who ignore public health advice because they might not feel threatened themselves in their lives because they are young, healthy and have strong immune systems and if Covid-19 confronts them on a personal level it may mean two or three days of mild illness. For those people who are not taking this seriously, we need to change the conversation to ensure they do so. One of the ways in which we can do this as leaders in our communities, as legislators and as policymakers is to speak out in a responsible way to get that message across. We must not threaten or frighten but we need to confront people with the reality of what this country is facing. Anybody who listened to "Morning Ireland" this morning who heard the deputy mayor from Bergamo in northern Italy - a town I know well - and listened to the interviewer choking up as he was interviewing, realises what we are fighting for here, which is to prevent that reality manifesting in Ireland, whereby towns will have to be cut off because we will be trying to contain or prevent the spread of a disease in order to protect vulnerable people. All of these hundreds of thousands of vulnerable people are our neighbours, families, friends, parents, grandparents, children and cousins. That is what people who hold house parties in this environment or who meet up for games of football when they should not do so need to think about. If we do not carry that message in a responsible way, we cannot expect others to do so.
My message for today is that social distancing matters. It is not a theory, it is a protection. We need to confront our families, peers and communities to make sure everybody takes that seriously. If we do so, we will save thousands of lives. That almost sounds abstract and it sounds like we are living on a movie set but when we look back in six or 12 weeks' time, we will wish we had done more and we will wish we had confronted those kids on a street corner or at the end of a housing estate who are gathering under a tree, under a light or wherever.People should listen to what the Government is telling them. They should listen to what the Chief Medical Officer is saying. They should listen to what the Minister for Health and all legislators are saying to them right now, in unison. Let us, as a country, take this seriously and confront those who refuse to do that because they are fortunate enough to not have a personal fear of this virus as it spreads.
This pandemic does not afford the luxury of time and we recognise that here today. That is why I am asking Senators to consider this Bill and to facilitate its passage in very unusual circumstances that none of us would choose. We must support people who are affected by this virus and we must do everything we can to prevent, limit, minimise or slow its spread so we can allow our health services to manage the fallout over a sustained period of time, rather than it all coming in one wave that we cannot control. That is what this Bill is about. That is why I am asking Members to set aside the normal concerns they would of course have, as I would have, around issues such as civil liberties and giving too much power to the Government, Ministers or officials. This is a temporary emergency response that I hope we will not need but that I suspect we might. It gives us a series of measures to support those who are ill, quarantined, in isolation or unemployed as a result of Covid-19. We are also, temporarily, changing the rules for illness benefit payments and jobseekers' payments for workers affected by Covid-19. The Bill also allows for measures that will, as I said, serve to prevent or slow the spread of Covid-19. It is vital that potential avenues where there is a high risk of contact with the virus are closed off and that those who are potentially infected are provided with the necessary medical assistance, as and when required.
I will now outline the content of the Bill. Section 1 provides for the Short Title, construction, commencement and duration of the Bill. Sections relating to illness benefit come into operation from 9 March, the date the Government decision on illness benefit was made. Sections relating to jobseekers' payments come into effect from 13 March. Sections amending the Health Act 1947 to curb the spread of Covid-19 come into effect on the enactment of this Bill.
The amendments relating to social welfare are in Part 2 of the Bill and will continue in effect until 9 May 2020. Any regulations introduced under the provisions of the Act will also lapse on that day. However, if so required by the interests of public health at that time, the amendments in Part 2 may continue to operate by order.
The amendments to the Health Act 1947 are in Part 3 of the Bill. Following an amendment which the Minister, Deputy Harris, brought to the Dáil yesterday to reflect the views of some Deputies, which I suspect are shared in this House, Part 3 will continue until 9 November 2020 and, if supported by a resolution of the Dáil, may continue later than that date. I am sure we all hope this will not happen and that extra time will not be needed, but we wanted to give reassurance to the Dáil last night that if there is a decision to extend, that would need to be endorsed democratically in the Dáil.
As I mentioned, Part 2 of the Bill relates to amendments to the Social Welfare Consolidation Act. Section 3 sets out the necessary definitions. Section 4 allows for self-employed PRSI contributions to be taken into account in the qualification criteria for illness benefit. This is only for specified circumstances relating to Covid-19. The purpose is to provide an income support to self-employed people who are unable to work based on a diagnosis of Covid-19 or who are required to self-isolate as a probable source of infection. Illness benefit will not be extended to the self-employed, other than for this specific situation.Section 5 provides for amendments to section 40 which deals with entitlement to illness benefit. Section 40(1)(b) changes the contribution conditions so that employees and self-employed people will qualify for illness benefit based on a minimum number of contributions. The number of contributions will be specified in regulation and will be set at one, this is, in effect, a nominal number to ensure that everybody qualifies. This is necessary in order that claims can be processed and to simplify the legislative change now proposed.
Section 40(7) defines categories of people who are "incapable of work" for the purposes of this special illness benefit payment. These will be people in the following categories: people who are certified by a medical practitioner as being diagnosed with Covid-19 or as a probable source of infection of Covid-19; people who have been notified, including by order, by a medical officer of health that they are a probable source of infection; people who are deemed under regulations to be a probable source of infection; and people in respect of whom a relevant order under the Health Act 1947 is in operation.
Section 40(8) provides that where people receive paid sick leave from their employer, such as a public servant, they will not be allowed to apply for this payment. Section 40(9) provides that the condition of six waiting days that generally applies for illness benefit claims will not apply in these special circumstances. Section 40(10) enables the Minister to prescribe the minimum PRSI contribution conditions required for these payments. As I have said, this will be set at a nominal level. Section 40(11) enables the Minister to vary the rate of illness benefit by regulation. This is to allow for the special payment rate of €305 per week for such period as may be prescribed in the relevant circumstances. Section 40(12) specifies that Covid-19 and its variants is the infectious disease in question in these changes.
Section 6 sets out the regulation-making powers to be given to the Minister for Employment Affairs and Social Protection. These regulations are to give full effect to the measures regarding illness benefit and set out the details that will enable the principles and policies in the Bill to be implemented. The regulations will provide for: setting out the people to whom these provisions apply; the manner in which a person is deemed to be a person to whom these provisions apply; the notification requirements; any variation in conditions for entitlement, including, for example, the variation in certification requirements; and any additional, incidental, consequential or supplemental matters necessary or expedient for the purposes of giving effect to the provisions.
Section 7 provides power to the Minister for Employment Affairs and Social Protection to vary the three-day waiting period for jobseeker's benefit. In other words, people need to get it straight away. Normally, jobseekers must have three days of unemployment before they are entitled to jobseeker's benefit. That requirement will no longer apply.
As many businesses are closing temporarily because of Covid-19 it is intended to remove the waiting days for people who have suddenly become unemployed as a result of Covid-19. Section 8 provides for a similar regulation-making power with respect to the waiting-day period for jobseeker's allowance.
I will now turn now to Part 3 of the Bill concerning amendments to the Health Act 1947, which as Members will know are targeted at the prevention and minimisation of the spread of the virus. Section 9 is a standard provision, providing for the definition of terms used throughout Part 3. Section 10 inserts new sections, 31A and 31B, into the Health Act 1947. The intention is to provide for regulations to prevent, limit, minimise or slow the spread of Covid-19. The regulations will deal with unprecedented circumstances including through prohibiting some events and imposing travel restrictions, if necessary. Regulations may also be made specifying requirements that may need to be put in place by organisers of events. In addition, regulations may place requirements regarding premises to prevent the risk of infection to people visiting or working there. Requirements may also be imposed regarding crèches, schools, universities and other educational facilities, including the temporary closure of such facilities, to prevent or minimise the risk of infection. Regulations may provide for any other measures that the Minister may consider appropriate for the minimisation of the spread of this disease.Subsection (2) sets out what the Minister must have regard to in making regulations, reflecting the extreme nature of this national emergency. Under subsection (3), in making the regulations, the Minister will consult with all relevant Ministers and other relevant persons. Subsection (4) provides that the Minister may, after consultation with any Minister deemed appropriate, exempt specified classes of persons providing essential services, statutory functions, other specified public services, or other services, from the provisions of any regulations made. This is important to maintain essential services and we will be relying on the co-operation of many people working in those services to keep this country going.
Subsection (5) provides that this new section is without prejudice to other provisions in the Health Act 1947, including as they may relate to Covid-19. Subsection (6) provides for offences relating to regulations and compliance. Subsections (7) to (12) have enforcement powers, including powers for An Garda Síochána. There are also related offences. Subsection (13) provides for the implementation and enforcement by relevant persons, for example, medical officers of health. Subsection (14) provides for assistance to relevant persons by An Garda Síochána. Subsection (16) defines terms used in sections 31A and 31B.
The new section 31B provides that the Minister may, by means of an order, specify an area or region to be an affected area. This means an area where there is a high risk of infection or importation of Covid-19. Travel and event restrictions will relate to such areas. When making an affected area order, the Minister will have regard to the advice of the Chief Medical Officer and will consult other relevant Ministers.
Section 11 inserts the new section 38A into the Health Act 1947. The intention of the new section is to allow a medical officer of health to order the detention and isolation of a person where the medical officer of health reasonably believes that the person is a potential source of infection and where the person refuses to self-isolate. The medical officer of health must keep the person under review and a medical examination must be carried out as soon as practicable but in any event no later than 14 days after detention. This reflects the incubation period and is intended to indicate an outer time period. In practical terms, the person would be medically monitored throughout any time of detention. The person detained may also ask for a review of his or her temporary detention by another doctor, which we think appropriate in the circumstances.
Subsections (1) and (2) of section 38A set out the order provisions and what a medical officer of health must consider before making decisions. Subsection (3) imposes a requirement upon a medical officer of health to certify his or her opinion on the matters outlined in the order for it to have effect. Subsection (4) requires a medical officer of health who makes an order to keep the matter under review and to ensure that a medical examination is carried out as soon as possible and in any event, as I said, no later than 14 days from the time that a person has been detained. Subsection (6) provides for a review by another doctor where one is requested by the person detained.
The intention under subsection (7) is that the provisions of subsections (2)(a) to (g), (3), (4) and (5) of section 38 of the Health Act 1947 shall apply to a person who is subject to detention and isolation. These provisions include the provision of a copy of the order to the Minister, the person detained and their appropriate person, for example, a parent in the case of a child. Subsection (8) is the offences subsection.
Under subsection (9), the costs of maintenance and treatment during detention and isolation will be paid by the HSE. Subsection (10) defines the terms used in section 38A.
We are living in difficult times, and therefore need strong measures, but they need to be appropriate. We are asking Senators to support, as temporary measures, restrictions that we would never normally even contemplate, with a sunset clause that means they will end as soon as we can end them.However, we need them to ensure we have the powers to act quickly to protect the vulnerable communities that I mentioned earlier.
I want to end by letting Senators know that we have plans to manage this crisis for the health and welfare of people living here. This challenge is not without hope. We have seen an extraordinary and heroic effort from the HSE in recent weeks to prepare for what is to come. We are planning for thousands more beds in the system. We are effectively decanting people from the current hospital system to create space and resources for the increased numbers whom we know we will have to treat through our hospital system.
We are the fortunate ones in some ways. We have had some time to learn from Wuhan and from what Italy is going through right now to try to ensure that it is not us in a few weeks' or a few months' time. Those in the HSE have probably done more in two weeks than would normally be possible in two years in terms of normal procedure and decision-making. Those of us in the Government will do everything we can in terms of financial resources, legislation and policy to allow them the freedom to be able to do what they need to do as healthcare professionals to prepare to look after the thousands of people that they will need to look after in the weeks and months ahead.
Finally, I wish to say two things to all Members in the Seanad. I thank them for facilitating this because this is not normal practice - I know that. We are asking people to agree to things that they normally would not agree to. I hope Members will see the need for the measures given what I have said. On a personal level, for those Members who are not standing for the Seanad again I thank them for their contribution. For those who are, I wish them well in the elections taking place at the moment.