Fergus O'Dowd (Louth, Fine Gael)
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1479. To ask the Minister for Health if he has progressed discussion on the provision of a public inquiry into Covid-19 deaths in nursing homes to examine the nursing homes with high and low Covid-19 death rates in order to learn from their experiences and provide answers for the many loved ones who lost family members; and if he will make a statement on the matter. [63370/21]

Mary Butler (Waterford, Fianna Fail)
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There has been significant and ongoing consideration of the impact of COVID-19 and the evolution of the response to it since the start of the pandemic. Various examinations and development of reports have been undertaken, with a focus on COVID-19, its impact on nursing homes and on the lessons from the pandemic that can inform future policy, regulation, and the model of care for older persons. 

There has been a very clear national commitment to continue to learn from the pandemic as the national and international understanding of the virus evolves and, where necessary, to ensure that the public health-led approach evolves as evidence and learning materialises. 

Findings of these reports, including the Expert Panel report, confirm that the very infectious nature of COVID-19 makes it difficult to prevent and control in residential care settings. The reports produced nationally identify findings consistent with international evidence, which have highlighted that the probability of COVID-19 introduction into nursing home depends on the levels of the disease circulating in the community, with a higher risk associated with higher incidence rates in the community. 

The independent COVID-19 Nursing Homes Expert Panel was established, on foot of a NPHET recommendation, to examine the complex issues surrounding the management of COVID-19 among this particularly vulnerable cohort in nursing homes. This Expert Panel report has added to our knowledge and learning. This report clearly outlines the key protective measures that we must ensure are in place across our nursing homes. These actions are based on learning from our own and the international experience of COVID-19 to date. 

The report also recommends additional analysis and examination of the relevant public health and other data sets in order that further causal and protective factors for COVID-19 clusters are identified. HIQA and the Health Protection Surveillance Centre (HPSC) jointly published an “Analysis of factors associated with outbreaks of SARS-CoV-2 in nursing homes in Ireland”, delivering on recommendation 6.7 of the Expert Panel report, to further the learning from the pandemic. Further data analysis work and learning will also continue, in line with other recommendations of the Expert Panel and HIQA, and the HPSC is developing a further update to this analysis. 

Work to progress the recommendations of the Expert Panel report, particularly those recommendations requiring a priority focus in the response to COVID-19, is ongoing across all of the health agencies and stakeholders. Continued learning and understanding of progression of the disease in Ireland is an integral part of those recommendations.  

Many of the short- and medium-term recommendations of the Expert Panel report have been implemented, including the ongoing provision of a range of supports to Nursing Homes. Almost €123 million was provided to nursing homes under the Temporary Assistance Payment Scheme up to January 2022. The outbreak assistance element of the Scheme continues to be made available to end of March 2022.  

In addition to the prioritisation of first round and booster vaccination among nursing home residents and staff, the substantial provision of State supports to nursing homes continues, including access to clinical supports through COVID-19 Response Teams (CRTs) and Outbreak Control Teams, supply of PPE free of charge, public health guidance and training resources, and temporary accommodation for staff. Supply of PPE also includes FFP2 masks. Serial testing was reintroduced to all nursing homes for two cycles as part of a targeted intervention to provide important information on the distribution of cases and risk across nursing homes. The first cycle, running for 2 weeks, commenced in early December and the second cycle commenced in early January.  As part of Budget 2022, €17.6 million will be allocated for the continued implementation of the Expert Panel Report.  

Significant work is ongoing to develop both a policy on adult safeguarding in the health and social care sector, which will be the basis for related underpinning legislation and on a regulatory review to enhance HIQA’s enforcement and oversight powers for nursing homes, building on the robust structures already in place.  

The Government and the relevant agencies continue to have a priority focus on managing the response to COVID-19, especially in respect of nursing homes. 

As you are aware the booster vaccination programme is continuing its successful rollout and nursing home residents were prioritised for boosters. The prevalence of the more transmissible Omicron variant has rapidly increased in Ireland, and this poses an ongoing risk.  

It must be recognised that the pandemic has not concluded and at this time a priority focus of Government remains on the ongoing management of the COVID-19 response, to ensure that the positive gains now been experienced are preserved, and that those most vulnerable to the virus continue to be safeguarded, having regard to the residual risk. 

The Government is continuing to look at options which may be available to the State in relation to listening to the voices of those who have lost a loved one. I have had ongoing engagement including a number of meetings with family members to listen to and consider their experiences and have communicated/shared their views with relevant agencies.