Seanad debates

Friday, 12 March 2021

Nithe i dtosach suíonna - Commencement Matters

Vaccination Programme

10:30 am

Photo of Timmy DooleyTimmy Dooley (Fianna Fail)
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As the Minister of State well knows, family carers are an invaluable but undervalued element of the healthcare service in Ireland. Over 350,000 carers provide essential care on a daily basis to over 400,000 people saving the State an estimated €10 billion a year, which is very significant. Many of these carers devote a major part of their lives to caring for a loved one in situations that are often, let us be honest, very lonely. These carers remain silent and isolated. They accept their lot and get on with the task in hand. If it was not for the sacrifice made by family carers, many of those who are cared for would have to be provided with long-term State care that would cost multiples of millions of euro, which would place an intolerable financial burden on the State.

Like many other politicians - I talked to Senator Malcolm Byrne on my way in about this matter and he recognises the same problem - we have all been inundated with calls from family carers wondering why their work is any less valuable than other front-line workers in the health service or elsewhere. This is not about pitting one worker against another in a race for people to get vaccinated. The practical question is as follows. Who would mind the person who needs the carer if the carer is struck down with Covid? That is a very simple question for the Minister of State, for me and for everybody else.

We know that younger carers have a lower risk of hospitalisation or death if they contract Covid. However, we have being continuously told by NPHET and others, and rightly so, that this disease can have very serious implications across all age groups.

Many family carers are frantic at the thought of contracting the virus because they do not have a plan B to provide care for the people or individuals who they are caring for. Let me give an example. Yesterday, I spoke to two different carers. One is a teacher in her 50s. She is a single woman and she provides critical care to her three elderly relatives in the early morning, at lunchtime, in the evening, at night and at weekends.That is her task. They are her parents and her aunt. The four of them live together. She is back in school and, consequently, is more susceptible to contracting the virus but she is doing her duty at both ends, as a teacher and as a carer. While her mother, her father and her aunt who she minds at home have been vaccinated, the carer, who is just over 50, is unlikely to be vaccinated for the next couple of months. She is worried sick that if she comes down with Covid-19 she has no one to turn to for help. She asked me a simple question: where will her parents and her aunt go? They suffer from various illnesses, have very poor mobility and certainly could not manage 24 hours on their own, let alone a week or two, if she were to be out of commission. If she contracts the virus, she is in the house and no one else can come into it. As a result, she is in an intolerable position.

Another very sad case involves a single mother who was in contact with me. Her husband died in tragic circumstances two years ago. She has three children under the age of ten. Two have autism and are at the severe end of the spectrum. She does not have any family locally so therefore has no support. She is petrified that she will be infected. She is concerned about the older child who is in school and might bring the virus home. She has no idea where she would turn to in the event of falling sick with Covid.

Those are just a sample of the cases that have been relayed to me daily but, in particular, over the past couple of weeks. We need to do what is right by these people who provide an enormous service to the State. They usually ask for nothing. They carry their burden with dignity and always in silence. It is time we recognised their plight and prioritised their vaccinations.

Photo of Anne RabbitteAnne Rabbitte (Galway East, Fianna Fail)
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I thank Senator Dooley for raising this matter. He is right. He and I and Senator Byrne have had these conversations. For a few minutes, it felt as if we were having a parliamentary party meeting, with just the three of us having the conversation until Senator Conway came along. To be honest, I have to read this answer as it is the answer from the Minister for Health. However, I hope time will allow me to give my personal input because, ultimately, I am representing people with disabilities and that vulnerable group the Senator spoke about so eloquently. He has laid out the position very clearly. All of us recognise the invaluable work that carers do and if we take them out of their role as the cog in the wheel, so to speak, who will look after the most vulnerable? That is the concern. We can talk about the child who might never be vaccinated because he or she is under 16 years of age. The parent who is under 65 years of age is happy and healthy but if that parent or, God forbid, the two adults in the house, were to contract the virus who will mind the child? The child might not be an only child. There may be other siblings in the house. The complexity of issues within a household is unbelievable.

The daily needs of the older relatives of the teacher the Senator mentioned are different but they must also be attended to. If that teacher comes down will the illness, not only is a classroom down a teacher but, importantly, the vulnerable relatives who are dependent on her from a feeding, shopping, going to the post office and medication point of view are also affected.

I acknowledge that what the Senator has outlined is very important. I will give him the answer but I wanted to explain to him my understanding of what I am articulating daily with NPHET. I met Paul Reid only two weeks ago about this issue. I have spoken also to the Minister, Deputy Stephen Donnelly, and the Minister of State, Deputy Butler. I have to lay out the position in the answer.

The Covid vaccination allocation strategy sets out a provisional list of groups for vaccination. The strategy was developed by the national immunisation advisory council, NIAC, and the Department of Health, endorsed by the public health emergency team, NPHET, and approved by the Government on 8 December but it is important to say that a lot has happened since 8 December.

Vaccination allocation is a matter for the Department of Health and it is rolled out by the HSE. The aim of the Covid vaccination programme is to ensure that the vaccines will become available over time to vaccinate all of those for whom the vaccine is indicated. Given that initially there will be a limited number of vaccines available it will take some time for all to receive them and it has necessitated an allocation strategy. All of us recognise that because the most need was in the nursing homes and our front-line staff. However, we are now into the parallel approach.This is very welcome. What we have managed to see is the reprioritising of the medically vulnerable and of the 60- to 65-year-old citizens within the disability groupings or under other conditions. What the Senator is saying here today is that as the allocation of vaccines comes on stream, perhaps the National Immunisation Advisory Committee, NIAC, will need to come go back and look at this again. The Minister, Deputy Stephen Donnelly, is continuously doing that. When we have 250,000 vaccines arriving from 1 April, with the help of God, perhaps we can have another parallel group. If I am hearing the Senator correctly, that is the group that he is speaking about. Senator Byrne and I have always said that the vaccine could be allocated to them as key workers. They should be moved to the current cohort 6. It is not in my discretion but I have a clear understanding of the request that Senator Dooley has made. As NIAC undertakes reviews and as allocations of vaccines become available, we should continue to make the case that the carer group should be within that grouping.

Photo of Timmy DooleyTimmy Dooley (Fianna Fail)
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I thank the Minister of State and welcome her very honest appraisal. I am not for a moment suggesting that this is simple. The numbers may not be that great when it comes down to it. There are many family carers who are elderly. A husband or a wife who is looking after his or her spouse is likely to be in or around the same age, or a little younger in some cases. These people will be addressed in the over-70s grouping. They are being addressed. That is being resolved. I am aware that in certain medical practices where there may be a little vaccine left over at the end of the day's vaccinations, there is a practice of looking after spouses who are within or close to the age group.

We must target those who might be considered to be younger carers. Those who could be waiting for the next two, three or four months to get vaccinated do not see light at the end of the tunnel. We need to help them because they are the people who will suffer most.

I will conclude by returning to the comparison between a key worker and a healthcare worker. Healthcare and front-line workers were vaccinated in order that they would be in place to deal with people in hospitals. That was the right thing to do. If we do not address these carers, the people for whom they care will create an intolerable burden on our hospital services. I thank the House for its patience.

Photo of Anne RabbitteAnne Rabbitte (Galway East, Fianna Fail)
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We have all spoken to the Minister, Deputy Stephen Donnelly. To be fair, he has been very open in his approach. As we are limited in our supply, there has to be a strategic approach. The Minister and the Minister of State, Deputy Butler, have directed the supply towards the areas of greatest need, as demonstrated over the past 12 months. Of the 110,000 medically vulnerable people who have been moved to cohort 4, some 10,000 will get a vaccination this week. This is very welcome progress. As supplies come on board, the next step is for the cohort of people who give support to, for example, children who might never receive the vaccine to be deemed to be a significant priority. We must signal that we recognise the valuable work they do and the contribution they make. I will bring this question back to the Minister, Deputy Stephen Donnelly.