Dáil Éireann debate -
Tuesday, 21 Jul 2020

Vol. 995 No. 3

Ceisteanna ó Cheannairí - Leaders' Questions

Deputy Mary Lou McDonald

The woman we have just respected, Ruth Morrissey, passed away on Sunday. As the Taoiseach is aware, Ruth was one of hundreds of women impacted upon by failures in the CervicalCheck screening system. She has paid the ultimate price for those failures and is now grieved by her family, including her heartbroken husband, Paul, her devastated little girl, Libby, and her wider family and circle of friends. There are no words I can offer that can adequately convey the magnitude of the loss felt by her death, but suffice to say, the State grievously failed Ruth Morrissey. Tá mo chroí briste ar son clann Ruth. Is tragóid é cás Ruth, agus nílim in ann glacadh leis go raibh uirthi dul chuig na cúirteanna.

Instead of holding up its hands and admitting liability, the State joined the US laboratories that were at fault in this case in dragging a terminally-ill woman through the courts and fought her tooth and nail every step of the way.

Even when Ruth won her case at the High Court, she was hauled before the Supreme Court to suffer one final indignity before she was vindicated. Ruth's solicitor, Mr. Cian O'Carroll, has described this as "deathbed litigation".

All this happened despite the then Taoiseach, Deputy Varadkar, giving a promise to the women concerned that this would never happen. The truth is that this adversarial and aggressive approach has been maintained. I understand there are approximately 203 active claims relating to the CervicalCheck matter, of which eight have been concluded. I would like the Taoiseach to confirm those facts.

This is entirely wrong. The Government should not be joining with negligent laboratories in fighting these women. A decent Government would stand up for them, protect them and ensure justice is done. A decent Government would be acting to ensure none of this happens again. We need to fix the system, and that is the only lasting tribute that can be made to Ruth and the other women involved. As the late Ms Emma Mhic Mhathúna once said, talk is cheap and action must follow.

Will the Taoiseach now intervene and ensure the State accepts and acknowledges its responsibility and liability and stops dragging very sick women through the courts? Will the Taoiseach accept the outsourcing of screening has been a disastrous failure? He has committed to the establishment of a national laboratory for cervical cancer testing and this must happen as a matter of urgency, as 90% of Irish screening is still done in US laboratories. Astonishingly, despite everything that has happened, this is still unsupervised by an Irish inspector. Will the Taoiseach commit to fast-tracking the establishment of the national laboratories for cervical cancer testing as a matter of absolute urgency? In the meantime, will the Taoiseach instruct the HSE that Irish inspection of US laboratories must happen urgently?

The Taoiseach

The apology by and commitment from the then Taoiseach and now Tánaiste on this matter were made in good faith. As the Deputy knows, the previous Government agreed that the High Court judge, Mr. Justice Charles Meenan, would be requested to review, in the cases of women affected by CervicalCheck issues, mechanisms that would avoid, where possible, women and their families having to go to court. That is the objective of the Government. Emerging from that report, a tribunal was to be established, and it will be established. The legislation paving the way for the establishment was passed into law last year in this House.

There have been delays in the establishment of the tribunal. It was to be established in March and it is the most effective mechanism to enable the women involved to resolve these matters without having to go before the courts. That said, one cannot prevent people from going to court to establish and secure their rights. Every step has to be taken to remove obstacles in the pursuit of the entitlements of women in these positions.

In general, the screening programme has saved many women's lives. Many lives have been saved by the national cervical cancer screening programme. This must be said in fairness to all those who work on the programme, and it has also been acknowledged by many women throughout the country. It is my sense that if we were to remove immediately the outsourcing of screening, we would not have a national cervical cancer screening programme, and we would not have had one from the very beginning. Perhaps it is a debate for another day but we must put this in perspective while acknowledging the failings that occurred. Quality control is essential to achieving the highest standards of oversight of screening programmes and ensuring this highest standard.

That is why the move to HPV cervical screening for the medium term and into the future has already occurred. That is the key to improving the programme from a quality and safety perspective and reducing error and optimising the standard and quality of that screening. Ireland joins a small group of nations that employs what will be the best in class testing to screen their populations for cervical cancer into the future. Others are Australia, England, the Netherlands and Wales. Along with the continued roll-out of HPV vaccinations, that is the key road forward. It is the roadmap for the future in terms of reducing death and grief and also making sure that the quality of the overall programme is much better and more precise for women in this country.

Deputy Mary Lou McDonald

The apology, when it was made, was for the non-disclosure element of this scandal. The family of Ruth Morrissey have made it very clear that they are not interested in apologies. That ship has very sadly sailed for Ruth Morrissey. What we need is action. The tribunal to which the Taoiseach referred is an adversarial mechanism. If I can quote Ms Justice Mary Irvine on the matter. She stated that the claims before the tribunal are to be heard in the same manner as the High Court hears and determines personal injuries actions for negligence and the High Court determines such claims in what is described as an adversarial process. That is the fact. In addition, the tribunal mechanism has no means of fast-tracking cases, bearing in mind that we are dealing with very sick women. The truth is that this State has not made available to these women a mechanism that is non-adversarial or a mediated mechanism for the State to acknowledge and to carry its full liability for the damage to these women's health and, in many cases, for the loss of their lives and the loss of them as women and mothers to their families.

At the heart of this scandal is another scandal, and it is that of the outsourcing of screening services. I wish to recall that when that decision was made the House was warned of the many dangers of proceeding in that direction and, tragically, those warnings have come home to roost. It is essential that the national laboratory to which the Taoiseach has committed is established and resourced as a matter of urgency.

An Ceann Comhairle

The time is up, Deputy.

Deputy Mary Lou McDonald

It is also absolutely essential that while screening continues in the United States that it is invigilated. I cannot believe, after everything that has happened and on the day that we mark the passing of Ruth Morrissey, that the Taoiseach cannot accept the absolute necessity for Irish inspection of what is 90% of screening.

An Ceann Comhairle

Please, Deputy, you are way over time.

Deputy Mary Lou McDonald

I ask the Taoiseach to address the questions. How will he provide a non-adversarial mechanism for these women; what is the timeline for the national screening laboratory; and will he insist that there is supervision and Irish inspection of screening, which continues in the United States?

The Taoiseach

First of all, a compensation tribunal is far less adversarial than any court system. We know that from experience in a variety of medical scandals going back to the various scandals relating to blood products and so on. In my view the tribunal is far more effective than a courts process. Ms Justice Mary Irvine is no longer in a position to take up the position as chair having been appointed President of the High Court, therefore, the Minister for Health is working with the Attorney General to make sure that the positions will be filled to allow us get the tribunal under way as quickly as possible.

Regarding outsourcing, we need to be honest with ourselves and everybody here that we must be clear about our objectives. As Minister for Health, I was involved in setting up BreastCheck. That took quite some time - four years or more - and we built it up nationally to world-class standards. I recall the huge waiting lists for testing for symptomatic cervical cancer patients. They were waiting for a long time. Outsourcing at that stage became an intervention that almost eliminated those waiting lists.

Following on from that, the whole idea of a screening programme using that model was developed. I accept the Deputy's point that it is not optimal, but we simply would not have a national cervical screening programme if that was not pursued. We need to be honest. The capacity simply was not there at the time and is not there now. We have a decision to make if that is the route people want to pursue. We simply will not have a national screening programme for the foreseeable future. It has saved many lives. That has to be said. Many women are alive today because of the programme. I certainly take the point on oversight and quality control. I answered that in reply to the first question. That should be the case and it has to happen.

Deputy Mary Lou McDonald

Will the inspectors be Irish?

The Taoiseach

The national cervical screening programme is responsible for ensuring quality and providing regular oversight of the screening programme itself and the test.

Deputy Alan Kelly

Ruth Morrissey was a national hero. She fought the State not once but twice. I received news of her passing from Vicky Phelan on Sunday morning. My condolences go to Paul, Libby and all of her family and friends. The Taoiseach's predecessor, the current Tánaiste, said on "Six One News" after Ms Phelan came forward that no woman would have to go through this again. It has never happened. He should never have said that. He could not deliver it. Ruth Morrissey subsequently spent 36 days in the High Court while terminally ill. She won. Mr. Justice Kevin Cross uttered a now famous phrase referring to "absolute confidence" in testing. In the High Court, the State never contested or even commented on this famous phrase which caused so much consternation.

On 3 May, Ruth said she was proud that no other woman would have to go through this. I know because she said it to me. However, a frenzy followed, led by some people in the medical profession, some people in politics and a small minority in the media. We heard that screening would collapse if this was to be the standard. Despite not even commenting in the High Court, the State contested this clause. As we all know, Ms Morrissey won again. Chief Justice Clarke said it was obvious that many people had not read the judgment.

The State should have apologised after Ms Morrissey won, not today. I know some people's words are well-meaning, but today is not the time. It is too late. Paul Morrissey made that quite clear. The Taoiseach's statement the other day, saying that it was very sad that Ruth had passed away but he had made an apology, was a crass statement. The Tánaiste's statement was a crass statement. The apology that was issued in this House in October of last year did not apply to Ruth Morrissey, because the State was taking her through the courts at the same time. That should never, ever have happened and we as a body politic need to reflect on it. Some professionals in our health service need to reflect on it, as do a small number of people in the media. Testing did not fall apart. In fact, Ruth Morrissey's biggest legacy is that she enforced the standard that applies in the UK for the women of Ireland.

That is her legacy.

A number of people have asked what would be the best way to ensure that legacy. I can tell the Taoiseach that the best way to ensure her legacy is to do three things. The first one is to change the Civil Liability Act to enable dependants of a dying person to claim for losses in one action rather than having to go through the courts again after the person has passed away. I know this is what Ruth Morrissey wanted because she told me so on 19 March. The second thing to do is to ensure testing is brought home. Third, we must ensure that the tribunal, which is not functioning, is not an adversarial tribunal, which it quite evidently will be unless it is changed.

The Taoiseach

I appreciate the Deputy's comments fully. I know the sincerity with which he makes them because he has been involved in this issue for quite some time and has been engaged with a number of the women who have been to the forefront of the campaign for greater disclosure and transparency around the programme itself and, above all, to enhance the programme in order that it can serve women in this country for the better into the future. Without question, as I have said, the programme failed women in this country. I agree with the Deputy that in situations like this one, non-adversarial approaches should always be the first to be pursued and the State should be very proactive in providing the mechanisms, be they compensatory tribunals or other non-adversarial fora, where the issues can be dealt with in an honest and transparent way. However, that is challenging and it is easier said than done. At this particular point, I think it is important that the tribunal gets established quickly, and appointments be made to the tribunal to enable it to get up and running. I will work with the Deputy in regard to the Civil Liability Act. I think it is a fair point that where someone passes away in such a situation, the family would have an entitlement to pursue those issues.

In terms of the testing being brought home, I am in favour of developing our own capacity on the testing front. We hope, with the passage of time and being in a position to deal with Covid once and for all, that we can then restore the national cervical screening programme, because its overall impact has been to prevent many cancers and prevent many women from dying. We cannot undermine that kind of work, which was ongoing prior to Covid. It is important that we be very clear collectively in terms of the route we want to travel on this. In other words, I have no issue with building up - in fact, I would support building up - our own capacity in terms of laboratory testing and being able to do it here. Moving to the HPV programme means testing is now far better and will give far better outcomes and give certainty and precision around testing. Once the threat of Covid recedes, we must be in a position to make the programme available to as many women as we possibly can. That has to happen in the short term. Over time, I take the Deputy's overall point about the importance of developing the capacity within the State to do the programme here.

Deputy Alan Kelly

There is a famous song by Mike and the Mechanics called "The Living Years". I think we all know the lyrics and can apply them to our own lives in many ways. We need to apply a little bit of them to politics and what happened to Ruth Morrissey. There is no use in apologising now. Her family has made that clear. They do not want an apology. What they want - I know it is what Ruth wanted, as she told me so - is the Civil Liability Act to be amended to do as I just said and as the Chief Justice himself outlined. The Labour Party is going to bring forward that legislation in her honour and I expect the Taoiseach to support it. I expect the House to support it and I expect the Taoiseach to support it.

Not too long ago, the Minister for Health stated the women involved and their families should be put at the heart of the State's response. He stated that this should be done, regardless of whether we think it is the right message, and that, for once, we should just do what they want and put them at the centre of matters. We need to put them at the centre of this.

The volume of cases coming through means that we need to amend the legislation. I will be asking the Taoiseach to honour the Government's commitments to the nth degree when we bring forward the legislation. I will also be asking him to ensure that the process by means of which the tribunal will operate will be changed to make it less adversarial. It cannot be a carbon copy of previous models. There are too many cases out there. If the Taoiseach honours those two requests, it will mean something has been done in memory of Ruth Morrissey.

The Taoiseach

As already stated in the context of the legislation the Deputy has identified, I will commit to working with him on going through the legislation on the Government side. Obviously, one needs to see detail of legislation before one commits to anything in that regard.

Deputy Alan Kelly

The detail is there.

The Taoiseach

I agree with the principle, as I already stated. I am mindful that I would like to follow through on whatever I say in the House.

Deputy Alan Kelly

I will take the Taoiseach's word on that.

The Taoiseach

Equally, I am also stating that we will want to see the Bill the Deputy is bringing forward and so on.

The whole idea of the tribunal was to create a less adversarial environment as an alternative to the courts. People will wish to access the courts as well and that is their entitlement and their right. We cannot take that either away from them.

One lesson that must be learned from the entire CervicalCheck scandal relates to disclosure. The absence of disclosure was, in my view, a significant failing. The results of the audit that took place should have been disclosed. That, in itself, would not have saved lives, but it is a very important principle that people are entitled to information relating to their medical situation at all times. That is why it is particularly important to follow through on the commitments we have made in that regard.

Deputy Róisín Shortall

On behalf of the Social Democrats, I wish to extend our deepest sympathy to the husband, daughter, family and friends of the late Ruth Morrissey on her tragic passing. She was a woman who was failed as a result of the negligence of the State. Regrettably, the apology to her has come too late.

What is the current strategy being pursued by the Government in respect of Covid-19? Until recently, the State followed public health advice, went into lockdown and largely succeeded in avoiding complete catastrophe. There have been many tragic deaths, but matters could have been so much worse. There is now widespread concern among the public that there is drift and that we risk undoing the hard work that has been done and sacrifices that have been made by so many over the past four months. In recent weeks, while we have been getting to grips with community transmission and opening up the country, it has become clear that the big weakness is the failure to control the importation of the virus from abroad. There is now major confusion about international travel. Promising to announce a green list of countries regarded as safe while at the same time advising against all non-essential travel is inherently contradictory. Of far greater concern is the Government's ambiguity regarding travel from countries that will not be on the green list. I refer to those countries that are regarded as unsafe due to a high prevalence of the virus. Not only has the Government operated a self-isolation policy which has been largely unenforceable in recent months, but, inexplicably, in the past couple of weeks the travel advice has changed.

It has been weakened for those countries. Incoming travellers are now advised merely to restrict their movements. This poses a great risk to our health, the lives of our vulnerable and to the economy. The priority now must be to create the circumstances which will allow us to reopen the schools in September and get our domestic economy fully operating. Controlling inward travel would allow us to do that. There are many good models of that kind of approach around the world, New Zealand being the most obvious example. That kind of approach has been called for by our Chief Medical Officer and by Professor Gabriel Scally, several other doctors and a great many in the scientific community. Phase 4 has been delayed because the numbers presenting with the virus have been rising. On what basis does the Taoiseach now expect the case numbers to reduce?

The Taoiseach

The strategy of the Government in the context of the roadmap that was outlined some weeks ago was to reopen society while at the same time suppressing the virus and keeping community transmission as low as possible. Societies and countries all over the world are experiencing difficulties in reopening, some a lot more severe than ours so far. The Government has taken a very cautious approach.

Deputy Róisín Shortall

What is the Taoiseach's strategy now?

The Taoiseach

The Deputy has asked a question and is going to get the answer. I have made it clear, and I agree with what the Deputy has said, that the reopening of our schools at the end of August is the priority. The resumption of services for non-Covid illnesses and strands of health is a priority and it is challenging and very difficult. As the Deputy has said, aiding the recovery of our domestic economy as best we can is a priority and that is why the stimulus programme will be published, to outline a whole series of measures to make sure the economy can come back and recover in the context of a very severe pandemic. I am just back from the European Council meeting and have talked to other Ministers who have had far greater problems than we have had in terms of reopening and then having to lock down again. We are taking a very cautious approach and that is why we delayed phase 4. Understandably, we took some heat from people in rural Ireland when the pubs in particular were not opened but we did it because we felt it was the right thing to do in respect of public health.

We have never banned travel as a country since the beginning of this pandemic. However, if we look at the figures, travel has reduced dramatically compared to where we would have been last year. The Government will be meeting to decide on this issue. We actually postponed this idea of the green list of countries at the same or a lower level of the incidence of the virus than us. That was to come in some weeks ago but we postponed it in a cautious approach. We will take a cautious approach in that regard. We have made masks mandatory on public transport. We are now going to follow through on the advice from NPHET that we make masks mandatory in retail and other environments like that because it is important. This is an evolving virus.

The big question for all of us is how we live with Covid-19 for the foreseeable future. We have really tough issues, not just the Government but all of us as a society. We must try to maintain a level of economic activity that sustains employment, companies and jobs and gives them a fighting chance to emerge intact from Covid in 12 or 15 months' time. It is very challenging. That is why at 6 o'clock this morning we witnessed an unprecedented decision by Europe collectively to make €1.8 trillion available to try to recover and to provide the capacity to engineer a European economic recovery.

No one is certain that that will happen. The most effective way of keeping the economy going is to keep the transmission rate of the virus very low indeed and that is the objective of the Government.

Deputy Róisín Shortall

With all due respect, delaying phase 4 is not a strategy. I asked the Taoiseach what the Government is actually doing now which will make the numbers go down. This seems completely ad hoc. We cannot revert to lockdown every time the numbers go up. Last Tuesday's official letter from NPHET to the Government was very clear about foreign travel. It said that there has been a 12% rate of travel-related cases, but more importantly, NPHET took note that there have been several clusters associated with that travel-related 12%. It went on in that letter to say that NPHET recommends that all measures are utilised to minimise and discourage non-essential travel from overseas to Ireland. The Taoiseach has not told us about any action that the Government is currently taking to discourage travel to Ireland. That is the key thing. We have to prevent the importation of this virus. Unless we do that, we are simply not going to be in a position to reopen our schools and to get the economy up and running again. I am asking the Taoiseach yet again what exactly the Government's strategy is in relation to, as the Taoiseach puts it, living with the virus. What steps is the Government taking to reduce the importation of the virus and to ensure that we can move forward to open the economy and get back to some kind of normality? Is the Government prepared to learn from New Zealand in terms of its success?

The Taoiseach

I do not think New Zealand is entirely comparable to Ireland. Let us be straight about that. It is not comparable in geography and many other issues. We should go behind the headlines sometimes. For example, people talk regularly about mandatory quarantine. It is not a great idea actually, and in some jurisdictions it actually led to a spread of the virus. This is not simple, and there are no easy answers. Travel into Ireland collapsed. There is very little travel into Ireland since the pandemic.

Deputy Róisín Shortall

But the Government is not doing anything about the red list.

The Taoiseach

We have been discouraging travel since the beginning of the pandemic. The numbers are there to show it.

Deputy Róisín Shortall

The Government has actually eased the restrictions in the past two weeks.

The Taoiseach

We did not ease the restrictions.

Deputy Róisín Shortall

It did.

The Taoiseach

No, the restricted movement is very severe. It essentially says someone can go to a shop. It is pretty clear, but it is very restricted

Deputy Róisín Shortall

It is very far from quarantine.

The Taoiseach

Quarantine is a word that is bandied about the place with great ease and simplicity, but the Deputy knows and everybody here knows there are difficulties with enforcement around it. In response to the travel issue, the Government will strengthen our presence and strategies around the airports, the airlines, putting the passenger location form online and other measures.

Deputy Róisín Shortall

What is the Government doing-----

An Ceann Comhairle

Please, we cannot have a conversation about it.

Deputy Róisín Shortall

What is the Government doing that is going to make things change, to get the numbers to go down?

The Taoiseach

Ireland has done very well with the virus.

Deputy Róisín Shortall

The numbers are going up. How is the Government going to get them to go down?

The Taoiseach

The challenge is living with Covid for the foreseeable future, and we will be. The Deputy is correct in saying we cannot shut down for the next 12 months, but equally we must, in a balanced way, ensure we can get our schools reopened, get the non-Covid strand of medicine resumed, and make sure that we keep our domestic economy going.

An Ceann Comhairle

Thank you, Taoiseach. We are way over time.

Deputy Róisín Shortall

The Government is not doing anything differently-----

An Ceann Comhairle

Deputy Shortall, please.

The Taoiseach

We already have made efforts.

Deputy Róisín Shortall

-----which will allow that to happen.

An Ceann Comhairle

Please, Deputy Shortall. I call Deputy Boyd Barrett.

Deputy Richard Boyd Barrett

I want to challenge the Taoiseach's assertion that he is on top of dealing with the Covid-19 crisis. His Government has already lost its way in dealing with Covid-19 and if things do not change we are facing a very serious situation and the likelihood of a second wave and we will not be in a position to prevent that becoming a very significant problem if not a disaster.

As well as the obvious need to state simply that non-essential travel into this country will not be allowed and that people will be checked on the way in, the other key area, the front line, which we seem to have completely forgotten about, is the capacity of our health service to deal with a second surge and, possibly, with influenza outbreaks, which are likely to increase in the autumn.

I do not know if the Taoiseach heard the pretty alarming, frightening testimony of Siobhán Murphy, a young nurse, at the Covid-19 committee this morning, who had no underlying health conditions, was working in a Covid-19 ward, was infected with Covid-19, as were 12 of the 19 nurses on her ward, a number of whom were hospitalised with very severe symptoms, and who described her psychological trauma as a result of having to work in these conditions and the impact of Covid-19 on her. She was absolutely clear, as was Phil Ní Sheaghdha from the Irish Nurses and Midwives Organisation, INMO, that chronic understaffing and a lack of capacity in our health system was at the root of us having the highest infection rate among healthcare workers of those infected anywhere in the world. The global proportion of healthcare workers infected of all of those infected is 10%. Here it is 34%, and in the past two weeks it is 46%. Nearly half of the infections that have happened in the past two weeks are among healthcare workers, and this is even with personal protective equipment, PPE, because they are working 12-hour shifts, are not getting breaks, and are fatigued, frightened and traumatised by the situation. Critically, they are chronically understaffed. We have 1,000 fewer nurses in the health system than we had in 2007. We need 5,000 additional nurses to drive up the capacity of our system.

We are desperately under-resourced and under capacity to deal with a possible second wave, yet all we hear about this week is guarantees for banks and big economic stimulus. It seems as if the Government has forgotten about the health pandemic and all it is concerned about now is business. Will the Taoiseach heed the call of the healthcare workers to embark immediately on an ambitious campaign of recruitment to drive up the capacity in our health service, to double the ICU capacity, and to make Covid-19 infections in our hospitals a notifiable issue so that the Health and Safety Authority, HSA, can be called in to assess the health and safety conditions that our health workers are in? Will the Taoiseach support our health workers not just with words but by resourcing them and preparing for what is coming if we face, as we very likely will, a second wave of this infection in the autumn?

The Taoiseach

I do not agree with the Deputy’s initial remarks on the overall Covid-19 strategy. As I said earlier, societies all over the world, as they reopen, are experiencing huge issues with the virus and very significant clusters have emerged in many locations in Europe and elsewhere. We are very anxious to avoid that. We are working with the CMO and with the National Public Health Emergency Team, NPHET. Non-essential travel has been the advice from the very beginning.

The Deputy said that tests should be carried out at airports. NPHET does not agree.

Deputy Richard Boyd Barrett

I am talking about checks.

The Taoiseach

What does the Deputy mean by checks?

Deputy Richard Boyd Barrett

Actual checks are essential.

The Taoiseach

NPHET and the medical experts are very wary about doing randomised or other testing. Everyone has spoken about the importance of NPHET advice and it believes that there are many complications around this which could create issues for the contact tracing and isolation system within the country. It is very easy to say that we should do this or that. We have examined these issues and continue to examine them. It is important to say again that the focus now is on the health capacity. With the winter flu in particular coming our way, great work is being done within the Health Service Executive on capacity issues, as they relate to staff, physical capacity, ICU and the acute hospital system, and on the flu vaccination programme.

I visited the HSE on the Friday before last with the express purpose of speaking to people there about the prioritisation of the winter initiative right now so that we will be in a position to have the capacity to deal with whatever comes our way in the autumn, particularly within our hospital settings.

It must also be acknowledged that front-line healthcare workers have been key to dealing with the virus. The Deputy spoke about Siobhán Murphy. I did not hear her testimony, other than a small part of it on the news on the way in. This is a terrible, dangerous and deadly virus. We have to do everything we possibly can to prevent people from getting it. We cannot understate its impact on individuals' health. People can have it for a long time, they can be debilitated and it can create issues for their long-term health. That is why we need to continue to maintain our current behaviour in terms of social distancing and respiratory etiquette. Those are the essentials that will keep this virus down. People congregating indoors in large numbers has been a significant factor in the increase in numbers over the past two weeks. Those are important issues that we need to address and keep working on in order to ensure that we can keep down the spread of the virus by practising the kinds of behaviour to which I refer. I am under no illusions about how dangerous this virus is to the health of any individual and to all of us in general. That is why we have to do everything we possibly can to keep it low.

Deputy Richard Boyd Barrett

Words are simply not matched with deeds. The major source of infection in the context of Covid-19 is now among healthcare workers. After all that we went through, healthcare workers are getting the virus. Siobhán Murphy described what they are having to deal with. They are working 12-hour shifts and are not getting adequate breaks. Health facilities are chronically understaffed, which means that there are not people available to take over and reduce the number of hours that others are working. Even when people are identified as contacts of those who test positive, they are still encouraged to come to work sometimes because of staff shortages. That is the reality we are facing when infection levels are quite low. What will happen if a second wave arrives? There does not seem to be any focus on this. As I understand the reports, the July stimulus is money to guarantee banks and for big businesses, but there is nothing about building up capacity and recruiting healthcare workers in large numbers in order to reach safe staffing levels and create additional capacity in the health service.

The matter has not received much coverage, but I note that the budget of the EU for health was slashed during the recent negotiations. The money that was supposed to be used to pay for stockpiles of ventilators and to assist national health services to deal with Covid-19 was slashed. As stated, this matter has received no coverage. That seems to be reflected in the priorities of this Government, which is not supporting the healthcare workers and the health service that we need to protect us and that will comprise the front line against Covid-19 in the autumn.

The Taoiseach

The Government will prioritise healthcare and healthcare workers in the context of getting through Covid. We will get through it. We do not just acknowledge but know full well the incredible role that healthcare workers have played in helping the people of this country to come through Covid and that will continue to be the case. We will have a €30 billion deficit at the end of this year because of the enormous expenditure on health. That expenditure will continue right through 2021 as well. Testing has increased significantly, including of all healthcare workers. For example, the HSE has been operating a programme to test all healthcare workers in nursing homes. That will continue on a systemic basis to make sure that we can avoid what happened with the spread of the virus in the nursing home sector and, similarly, in the acute hospital sector.

The stimulus is not about big business and banks. The stimulus is about workers. I am sure the Deputy wants workers' jobs to be preserved and their livelihoods to be improved.

Deputy Richard Boyd Barrett

The Government is cutting their payment.

The Taoiseach

The reason we will have a €30 billion deficit and a substantial stimulus programme is to keep jobs going for workers and to create opportunities, for young people in particular, in terms of activation and work. We are a global economy. Ireland develops well when it can export its goods and services abroad and people buy them. The international scene is not good. It is very important, therefore, that we take measures that can enhance the domestic capacity of our economy during this period, which is all about workers and giving workers a chance. Yes, small companies will benefit and companies will benefit to a certain scale because we want them to survive. Why do we want them to survive? It is because they provide employment to people. There are too many simplistic catch-cry slogans emanating. I have great respect for Deputy Boyd Barrett as a thoughtful parliamentarian, but every now and again we get empty rhetoric that everything is about big business. It is all about workers.

Deputy Richard Boyd Barrett

The nurses-----

The Taoiseach

It is all about workers and it has to be.

An Ceann Comhairle

I thank the Taoiseach. We are way over time. That concludes Leaders' Questions. As I have said, we are way over time. We need to adhere to the allocated times from now on, please.