Alice-Mary Higgins (Independent) | Oireachtas source

I welcome the Minister of State, Deputy Feighan, to the House. Like most of those who have spoken today, I supported the move to level 5. I believe it was necessary and that it is a pity that we did not do it a couple of weeks earlier. We have seen what a reluctance to act can lead to. The model of Belgium, which the Tánaiste, Deputy Varadkar, had been promoting, is now a strong cautionary example to everybody across Europe. It shows what happens when we fail to take scientific warnings sufficiently seriously. It is also an example of what happens when we do not invest in having adequate medical support in place.

I support the level 5 lockdown and, like others, agree that we need to be very strong in challenging anti-science and anti-mask messages. As I have said before, the State has powers to deal with those engaging in harassment, making threats or causing others to have reasonable apprehension for their safety. We need to be able to use these powers where we see people attempting to do their, often essential, work endangered by anti-mask protests that seek to create a climate of danger for those essential workers.

I am, however, concerned about how this new lockdown is to be used. The previous lockdown, during which the public did extraordinary work to flatten the curve almost to a point at which zero-Covid was in sight, was wasted when we moved rapidly away from restrictions when sufficient work had clearly not been done in scaling up ICU capacity and health service recruitment. It is vital that the Minister of State indicates what comes next. I do not support the overall idea of living with Covid by way of an ongoing cycle of lockdowns. We need to show a clear strategy for moving past lessening the curve and on to flattening the curve. We need to know what it will look like when we get back down to double figures again. Will there be, for example, a massive improvement in testing, tracing and investigating the causes of cases? In Ireland, we have really only been checking with whom those who have contracted the virus have been in contact rather than investigating where it was contracted. We have not been working to track down the causes of asymptomatic spread.

Part of the cause of this is the very inadequate system of recruitment. The use of agency staff has been mentioned, as has the fact that these are insecure contracts. The HSE has a HR department. We need to recruit and train the staff who are going to work in tracing. They need to know that their contracts are secure. We also need to make sure that those doing other essential work, such as diagnostic workers, speech therapists and others, who have ended up in the testing and tracing system have contracts that allow them to carry out their own essential work. Medical and health issues, both Covid-related and otherwise, have to be prioritised.

Another priority about which people will tell one is that of relationships. One issue at the intersection of health and relationships is the situation of those undergoing scans through maternity services who may, for example, be facing the prospect of a miscarriage. That is right at the intersection of the two areas I consider most important, that is, health and relationships. Those issues may need to take priority over other issues I have previously raised and challenged people on. An example of such an issue is the fact that certain betting sports are continuing even through a level 5 lockdown while partners are still not allowed to accompany pregnant women for scans.

I will return to another employment issue. This is the crucial question because it will be the test. What is being done not only to scale up recruitment, but to ensure retention? We know there is a crisis of morale in the health service. We know that many who answered the call and came back to Ireland faced such difficulties in having their applications for recruitment processed and in getting to a point at which they felt securely employed within the Irish health system that they are now considering returning to the health services of other countries.That will be a major loss. The student nurses have been mentioned but how are we signalling to them that we value them and we want them, when they graduate, to continue to be part of our health service? We do that by valuing them now.

Will the Minister of State inform us of what is happening with training and specialisation required for ICU staff? It takes six months to give somebody the skills to work in ICUs, so how many people have been trained in the past six months? How can we ensure we do not end up in a position like Belgium, which is experiencing a crisis with health workers who are themselves Covid positive having to work?

Retention, recruitment and the valuing of staff are crucial but I also point to a wider issue around social support to combat isolation. This is something in which Ireland has fallen short and it is a hallmark of places, including parts of Australia and New Zealand, where they have managed successfully to get to or close to zero Covid. One of the key facilities is that they support isolation by people and they make it a positive. We do not want a punitive model of isolation but rather a positive support model of isolation both for those who are diagnosed and for those who are at risk, for example, vulnerable people in direct provision or in housing hubs. I am talking about those who are basically in situations where they do not have adequate and secure housing. Senator Clifford-Lee mentioned those people in inadequate housing on halting sites as well. There is a range of people who need carefully thought through, culturally appropriate and sensitive isolation facilities, and we should not have a situation, such as I have heard, where someone has been given a diagnosis on a Friday and been told to check in on the Monday if there is a place where they can isolate. That is not good enough. We need very clear support so people can isolate properly, and that is support for those who are at risk and vulnerable as well as those who receive a diagnosis.

The question of quarantine is something that other countries have managed much better than Ireland. Frankly, in Ireland the "mind yourself as you go through the airport" model has been very inadequate. We know in other countries, for example, people have been checked on multiple times after coming into a country to ensure they have quarantined. In other countries there are quarantine hotels, for example, that are specifically set up to allow for a period of quarantine subject to testing. As the testing science is improving, that does allow for that.

My last question is very important and it concerns international solidarity on vaccines. We know Europe is purchasing a vaccine but will we support the COVAX project? Will we support other projects to ensure that, globally, health workers and those who are most vulnerable can access a vaccine when it becomes available?