Before we start, I ask all leaders to adhere to the time limits in order that I do not have to keep interrupting them. I thank them in advance.
Ceisteanna ó Cheannairí - Leaders' Questions
In recent days the Taoiseach has sought to pit nurses against nurses by claiming that student nurses are being exploited by other nurses on hospital wards. That statement is simply not true. The reality is that student nurses are plugging the gaps in a health system that is under severe pressure. Student nurses do amazing work. The Tánaiste has worked in hospitals and I am sure he has seen that at first hand.
The Irish Nurses and Midwives Organisation, INMO, is crystal clear on the issue. It notes that it is no use pitting nurses against nurses, whether they are in training or not. Phil Ní Sheaghdha, the INMO general secretary, recently stated:
Our students are being taken for granted. They are facing huge workloads and risking Covid infection. And while they are doing indispensable work, they are getting no financial recognition for their efforts.
She went on to state:
Extra work, serious risk, and other sources of income being cut: student nurses and midwives are getting a raw deal. It is beyond time to respect their contribution and pay them. The message is simple: stop exploiting student nurses and midwives.
The Tánaiste can see that the INMO is very clear on this issue. It is not nurses who are exploiting nurses, they are being exploited by the system.
The Taoiseach also said that he wanted examples of student nurses performing specific duties. Let me recount one of the many examples that we in Sinn Féin have received from student nurses in recent days. One nurse, Marie, contacted us to say:
As a first-year nurse, I would work all morning getting patients washed, showered and dressed alone, as there was often no healthcare assistants. Then I had to record vital signs for a whole ward, which was usually up to 30 patients.
In second year I remember one specific time, after a patient of ours sadly passed away, we had to get the patient ready for the family to see them. I washed the patient with the nurse, cleaned his face, dressed him in a new gown and lay him out comfortably so he looked peaceful and ready for his family. That was my first time of many doing that. I carried on with the rest of my day, caring for other patients. I drove home that night in silence.
Marie goes on to say:
I remember in third year dealing with a patient who had a major haemorrhage on the general medical ward, that was waiting for a bed to open in ICU. The patient went into cardiac arrest. I ran for the crash cart. I alerted the nurse's station to call the cardiac team and I did chest compressions to try and keep the patient alive. The patient, unfortunately, died. I drove home in silence that night and couldn't talk to my mother.
Is any of that not real work? That is what student nurses are asking. In particular, they are asking that of the Taoiseach following the comments he made.
The Taoiseach indicated that a review is under way. I had a look back at the replies given by the Minister for Health to questions on this issue. In October, he responded to a parliamentary question by stating that the review would be concluded in the coming days. It is now the middle of December. Why has it taken so long for this issue to be addressed? It is one that must be addressed.
If any additional payments are to be made to student nurses and midwives, will they be backdated to the beginning of the new academic year? Could the Tánaiste respond to the student nurses who may be watching, to other nurses on the wards and to the people who genuinely believe that this exploitation of student nurses must come to an end? Will the Government reverse its decision and ensure that they are properly remunerated?
I thank the Deputy very much for raising this important issue. From my time working in the public health service and as Minister for Health, I am very aware of the contribution student nurses and midwives make to the health service. I am also aware of the limitations regarding what a student can do and provide in the health service, whether it is a therapy student, a nursing student, a medical student or any other student.
There has been a lot of debate on this issue in the past week or so but there have not been as many facts as there ought to have been, so let me set out five facts of which we ought to be aware. The motion in the Dáil last week was party politics. It was non-binding. It was unfunded. If it had passed, it would not have been worth a single euro to a single student nurse. It was designed to make the Government look bad, the Opposition look good and do nothing at all for student nurses. Public pay is not voted on in the Dáil, ever. Public pay is negotiated between the Government and trade unions and negotiations are now under way on the next pay deal.
Student nurses are paid for their fourth year, for 32 weeks, and they are counted as part of the staff. In the first wave of the pandemic, with the then Minister for Health, Deputy Harris, and I, as Taoiseach, took a decision to take on student nurses in the early years of their course as healthcare assistants. We did so because we thought the hospitals might be overwhelmed on foot of the surge we were anticipating. Thankfully, that surge never happened, but it was still the right decision to take them on as healthcare assistants. That was only ever supposed to be on a temporary basis and we said so at the time. We have provided the pandemic unemployment payment to student nurses who worked as healthcare assistants in nursing homes and who had to give up those jobs because we asked them not to be in two clinical settings. The pandemic unemployment payment is being paid.
Student nurses who are in years 1, 2 and 3, like all other students on degree courses, are not paid. They spend a lot of time in lectures, laboratories and libraries and on supervised work experience or placements. When one pursues a degree course, it is not the norm to be paid for that. This is a degree course now; it is not an apprenticeship or a cadetship. That is a very different and older model. We decided we wanted to move away from that model 20 years ago after the Commission on Nursing reported. However, I do think that student nurses should be paid where they are acting up, filling in for staff nurses or doing the work of staff nurses because wards or clinical areas are understaffed. That does happen in education, for example, where students are doing the higher diploma in education, HDip. Student teachers do not get paid for their work experience, but they are sometimes paid when they supervise or take over for a teacher who is absent. In those circumstances, it is right that student nurses should be paid for the work they do. That includes those in first, second and third year.
This is an issue on which the Government is engaging and we want to continue to engage on it. We will speak to the INMO and SIPTU's health division about this. As Deputy Doherty stated, a review of allowances is under way. As is always the case, matters of public pay will be negotiated between the Government, on the one hand, and the unions, on the other. That is how it is done. That is how we all want it to be done. It is the best way to do it. It is not based on a motion in the Dáil. That is just pure politics.
It is politics that have left student nurses unpaid. The Tánaiste's coalition party in government put out a statement on its Facebook page suggesting that student nurses are not involved in real work. It was very hurtful. Many student nurses have contacted Deputies across the Chamber, particularly those in opposition, to outline the real work that they do in hospital wards.
Other staff nurses have also contacted us, along with doctors and consultants, as I raised with the Tánaiste last week, and they acknowledge that if it was not for the student nurses, the system would simply collapse because it is under severe pressure.
Last week, a motion was brought forward by Teachtaí Dála, messengers of the people, and they carried a clear message to this Parliament that the public wants to make sure that our student nurses, who have stepped into the breach in the middle of a pandemic and put themselves and their families at risk, should be rewarded, and should not be expected to staff our wards during this pandemic and be paid nothing for it. That is what was contained in the motion put forward by Teachtaí Dála. The Government proposed an amendment that gave no commitment to paying student nurses for the work they have done.
This is a political issue because the Government has decided to turn its face against it. The Government is now coming under sustained pressure. We will not give up until student nurses are properly remunerated for the work they have done. The Government should hear the calls loud and clear from the public right across the State that they fully back the student nurses in this demand.
The Deputy has gone over his time.
The Deputy's response is again emotion over the facts, which is the typical conduct of populists, and it in many ways proved the veracity of my response. I set down five facts and the Deputy questioned none of them. The way he spoke almost implied that he was talking about a Sinn Féin motion but it was not. It came from People Before Profit and Sinn Féin had little or no role in it but it is trying to take over the issue for political gain.
As I mentioned, the vote last week was on a non-binding and unfunded motion. Had it passed, it would not have been worth a euro to a single student nurse. Public pay is negotiated between the Government and unions. That is the way it is done and that is the way it should be done. Student nurses are paid for their fourth year. We paid student nurses in their first, second and third years during the pandemic as healthcare assistants because we thought hospitals might be overwhelmed. Thankfully, they were not and they are not now. We pay the pandemic unemployment payment to student nurses who were asked to give up jobs in nursing homes.
It is not the norm for people doing a degree course to be paid for their years as students. It is the case for apprentices and cadets but not for people doing a degree course.
As I stated, where student nurses are filling in for staff nurses, doing the work of a staff nurse or acting up and filling in, I strongly believe they should be paid for that work-----
We are over the time allowed.
-----just as student teachers are paid for substitution duties. We are happy to engage in a grown-up, fact-based and mature way with the unions, as we always have, to come to a resolution on this.
I can keep interrupting or I can ask the Tánaiste to keep to the time allowed.
The fantastic breakthrough with Covid-19 vaccines has given terrific hope to people the world over. In this country, everybody is anxiously awaiting tomorrow's Government announcement on the proposed roll-out of the vaccine. Last Tuesday, the Minister for Health released the first report on the proposed priority groupings for the vaccine. I note the list is referred to as a provisional list so I hope it means there is potential to make changes to the list. I want to make a case for that now. This relates to people with underlying health conditions. We know from analysis done on cases in terms of mortality, admission to hospital and admission to intensive care units that having one or more underlying health condition is a very significant factor. For that reason, it was quite surprising and disappointing that on the list of 14 cohorts of people, people with underlying conditions in their late 60s are fifth and adults with health conditions under 65 are seventh. It is very hard to understand why those cohorts are so far down the list. The Tánaiste should explain that to us and I hope the Government can revisit the list.
I am particularly concerned about the final cohort, which is the 14th grouping, and these are due to get the vaccine last. These are people under 18. I want to make the case for the very many people under 18 in this country who have serious underlying health conditions. I take the point that the vaccines have not been tested on children under 12 but I am talking about teenagers, or those aged between 12 and 18. A significant number of teenagers in this country have serious underlying health conditions. I spoke to the mother of one of them this morning, a 17-year-old girl who is a transplant recipient. Her mother explained what an awful year she has had since last March, when she had to cocoon, and how her life has been so drastically affected. Just yesterday the House discussed the mental health effects on young people in particular but this is especially pertinent in the case of young people with serious health conditions, as the impact is multiplied several times over. In this girl's case, her 19-year-old sister had to move out of the home because of the high risk involved. The girl is being homeschooled and this is having a major impact on her mental well-being.
It was a terrible blow to people in such circumstances to hear that they are last on the list of people to get the vaccine. I earnestly appeal to the Tánaiste and Minister for Health to please consider those categories of people who have had such a difficult time and bring them up the list to ensure they are early recipients of the vaccine.
I thank the Deputy for raising this important matter. She made a valid case that must be listened to. The task force report on the deployment and administration of the vaccine is expected to be completed tomorrow and it will go to the Cabinet on Tuesday.
Last Tuesday, the Cabinet approved the prioritisation of the vaccine, including which groups will receive it first and last. That was based on advice from the National Public Health Emergency Team, NPHET, and the national immunisation advisory committee. It is based on medical and scientific advice and we did not make any modifications to it. We accepted it as it was presented to us, starting with the highest-risk group, which we all accept that comprises people aged over 65 in nursing homes, before moving to healthcare workers in direct contact with patients. We all know the reasons for that. It then moves to other groups.
This is not set in stone and can evolve as new information emerges and we learn more about the virus and vaccines. As more vaccines are approved, the list may need to be modified. We expect one vaccine from Pfizer BioNTech to be approved within weeks but, within months, six could be approved and they will not be same. They will have different characteristics and profiles, and we may need to modify the advice in respect of that.
There are two reasons the last group comprises people under 18 and pregnant women. The number of people under 18 or pregnant women who have become very sick or died as a result of this virus is very low and such people are in the safest group in that sense. There is also the obvious reason that not many children or pregnant women have been involved in the clinical trials. People engage in clinical trials voluntarily and not many people would offer a well child or themselves if they are pregnant unless there was a particular reason to participate. It is not that we think it is unsafe at all for children or pregnant women; it is just that it is not often that children and pregnant women are involved in trials for a new vaccine or medicine.
The Deputy's case that older teenagers with an underlying medical disease may be a high-risk group is valid and should be considered. I will certainly take it up with the Chief Medical Officer, CMO, the next time I see him, which will probably be next week.
I thank the Tánaiste and I appreciate that positive response. It was suggested there would be an announcement by the Cabinet tomorrow but I note the Tánaiste's indication that it will be next Tuesday. I hope this allows time for the Cabinet to reconsider the matter.
I am not making the case for everybody under 18 to be brought up the priority list at all but I refer to a particular category of people under 18 - teenagers - in this very difficult position. I very much appreciate that the Tánaiste will discuss this with NPHET and reconsider the matter because it has been desperately hard. It is hard for young people with an underlying health condition. The past year has been appalling and it has had a major impact on them. I ask that the Government also considers raising up the list the other group of people with underlying health conditions who are under 65.
On the vaccine task force report, we expect to receive it tomorrow but it has not been decided yet whether it will be published tomorrow. The Taoiseach is in Brussels on other business and it is unlikely that we will be able to convene a Cabinet meeting. We believe the report should be seen and approved by Cabinet so it may be Tuesday before it is published. However, that has not been decided yet. The report does not deal with prioritisation, which is a separate matter that has been decided based on the advice of scientists and doctors. As I said earlier, it is not set in stone and it can evolve. The case Deputy Shortall makes for people who have chronic diseases and who are at risk, even those in their teenage years, needs to be considered. I will certainly raise that with the CMO next week.
I wish to raise the disgraceful and diabolical decision to close St. Brigid's District Hospital in Carrick-on-Suir that was made on a whim yesterday morning. On 27 April, I raised this with the Tánaiste. I raised it in the House again on 1 July, 11 August and in September, October and November. At 7.20 p.m. on Sunday last, I got an email from Ms Barbara Murphy indicating that the HSE was considering reopening the hospital subject to the building being okay. That was the first time there was any question mark about the building. What kind of deceitful untruths - I would use a stronger term if I was allowed - were given to us? Councillor Kieran Bourke, a hard-working councillor who has worked on behalf of the town for years, as well as members of his family before him, came to Dublin and met the Minister for Health, Deputy Donnelly, who promised him that the hospital would be reopened. I had commitments from the previous Minister for Health, Deputy Harris, and from the current Minister that it would be reopened.
A hard-working local committee has been seeking to make sure that the hospital is reopened. The local community in Carrick-on-Suir, as well as the people of south Kilkenny, east Waterford and south Tipperary have raised funds to provide three hospice beds in the hospital. All of the staff in the hospital were exceptional, including the caterers, nurses and members of the palliative care team. There are only two other hospice beds in south Tipperary. These are located at a wonderful facility in Clogheen, 30 miles from Carrick-on-Suir. Where are people supposed to go? Is it a case of to hell or to Connaught?
It is outrageous that the HSE and the Department of Health could treat people like this. They are having a meeting this evening with local Deputies to tell us about it. We have replies in writing from them but we cannot believe a word they tell us. What a shameful way to behave. They closed the hospital under the auspices of Covid-19 initially, saying that they needed it and we accepted that. I do not think any patient went there for Covid step-down care but a huge number of patients have been denied step-down and recovery time because the hospital is closed to them. I know of patients who could not get access to the hospital and they died at home, supported by the hospice in Tipperary, which is excellent. This is shocking.
The hospital has been in Carrick-on-Suir since 1835 or 1840 and has served generations. Many townspeople were born in the hospital. The HSE and the Department should not treat people like this. There is a new primary care centre in front of the hospital which cost €10 million. Less than 50% of that centre is occupied but the HSE is telling us that it wants St. Brigid's hospital for community care. This is deceit and a blackguarding of the people of Carrick-on-Suir and surrounding districts. It will not be accepted by me, by the people on the hard-working committee to which I refer, namely, Ms Catherine Foley and Mr. Eddie Reade, or by Councillor Kieran Bourke, who met the Minister. What kind of politics or democratic system do we have when a Minister can tell a councillor, in writing and to his face, that a hospital will reopen and then he learns, summarily, that it is to close? Who is in charge of the HSE? It has too much power and has done so much damage. It was not fit to handle the Covid crisis and is not fit to handle anything. We lost Tipperary Community Hospital in 1987. We lost St. Michael's mental health beds under the so-called A Vision for Change but got nothing in return. We are lucky to have saved Clogheen and thanks are due to former councillor Mr. Con Donovan for that.
When we had health boards, we had accountability. Shockingly, there is no accountability in the HSE or the Department of Health regarding the money that has been spent on St. Brigid's. There is a new lift in the hospital. The Minister of State, Deputy Butler, told me yesterday that there are no showers upstairs. but there are. The HSE and the Department are using HIQA now. They wheel out the vehicle of HIQA, which is not fit for purpose either, when they want to do damage, destroy a community and destroy a wonderful facility that is badly needed and that was fought for by the people. This will have far-reaching repercussions. We want the hospital kept open. This decision must be reversed immediately.
I spoke to the Minister of State, Deputy Butler, and the Minister, Deputy Donnelly, about this earlier today and am happy to set out the current position to the House. St. Brigid's hospital is a short-stay unit with 16 beds, including three palliative, two respite and 11 convalescent beds. The HSE-operated activity at the hospital and the design and layout of the building are largely reflective of a small hospital from the time period in which it was built, namely, 1837. In March, admissions were suspended and the hospital was designated as a Covid-19 step-down facility. Arrangements were put in place for patients requiring convalescent, emergency respite and palliative care to be accommodated elsewhere in the HSE's services in south Tipperary.
With regard to St. Brigid's hospital and its infrastructure, having considered the current infection control advice, it is with regret that the decision has been made to discontinue short-stay services at St. Brigid's in Carrick-on-Suir. Unfortunately, I am advised by the HSE that it is no longer feasible nor sustainable to continue to operate St. Brigid's as a district hospital given the layout of the premises, the narrow hallways, inadequate space, the facilities available in the two five-bed wards and the risk of cross-infection. It is now proposed to use the premises as a base for the newly-created community healthcare network, CHN, in south Tipperary, along with serving as a base for members of a chronic disease management team, with a particular focus on diabetes. It is ideally located adjacent to the primary care centre and co-location of these buildings will enable integrated and multidisciplinary working. The repurposing of St. Brigid's will provide the HSE with the opportunity to develop community healthcare services in south Tipperary for the better, with a particular focus on the management of chronic diseases like diabetes.
That is a typical reply. It is waffle from the HSE. Why were we not told that in the email that I received last Sunday evening? The wonderful staff that were there have been deployed elsewhere because of Covid. They put their shoulders to the wheel in the belief that they would be sent back to St. Brigid's. The building might be old but it is in pristine condition, with a new wing added for the hospice some years ago. This building will still be standing when many of the prefabs and quick-build units the HSE is putting up are rotten and decaying. We want the people of Carrick-on-Suir to be able to use it. They are a proud people but they have gotten nothing but kicks from this Government. There are no factories and no support but they are not accepting this. I spoke to Ms Catherine Foley this morning who will be pushing a bed to Dublin next week, all the way from Carrick-on-Suir. She is one of the activists in the town and is a non-political person. Councillor Kieran Bourke will be fighting, might and main, as will I because this is wrong. Why did the Tánaiste stand up and read out balderdash from the HSE? He is supposed to be in charge, along with the Taoiseach. This is being hived off and HIQA is being blamed. HIQA is not fit for purpose. It gets wheeled out when the Government wants to do something disastrous. The dishonesty and deceit that has been perpetrated on public representatives and the people is shameful and that is why politics is the way it is in this country. All the Government wants is big jobs and powerful positions and to hell with the little people but the little people will rise up in the spirit of C.J. Kickham of Tipperary and will not accept this from the so-called coalition.
If there is one thing nobody would mistake Deputy Mattie McGrath for, it is a little person; he can be sure of that. We all recognise his stature.
On the questions raised, I am advised by the Minister and the Minister of State that there are currently no residents or patients in the hospital. They are all being catered for elsewhere in higher-quality, more modern accommodation. The staff have been redeployed and there have been no job losses. Following some minor works, seven whole-time equivalent staff members will initially be based at St. Brigid's, including a CHN network manager, an assistant director of public health nursing, a clinical nurse specialist in diabetes, a senior dietician, a staff dietician and two administrative staff. A podiatrist will also be providing in-reach services at St. Brigid's hospital. While it is regrettable that it is no longer feasible or sustainable to continue to operate St. Brigid's as a district hospital in the way it operated in the past, as part of the modernisation of our healthcare service, this building will be repurposed to provide chronic disease management and better diabetes care for many more people than are currently receiving it in south Tipperary and the south east more generally. Overall, this will represent an improvement in healthcare services in the area.
I am sure the Tánaiste is aware that today is International Human Rights Day and in that respect, I draw his attention to the survey by the Vienna-based European Union Fundamental Rights Agency, FRA, on conditions for Traveller, Roma and Sinti communities across six EU countries. On Monday, the results of this survey were published. They point to a truly awful situation, with 31% of Irish Traveller households and 28% of Traveller children living in acute poverty. The rate of poverty here is the highest across the six nations surveyed. One in ten Travellers are in households where at least one person went to bed hungry in the past year. A full 65% experienced discrimination, again one of the highest levels in the six countries studied. The survey found that 70% of Travellers aged between 18 and 24 were not in further education and just 17% of women and 13% of men were in employment, mainly in part-time or precarious jobs.
This is an indictment of a society with what can only be called racist attitudes towards Travellers and Roma. It is an indictment of a State that has failed 7% of its population and of the political parties that have dominated government and local authorities since the foundation of the State. The treatment of Irish Travellers can be compared to the scandalous and inhumane treatment of women and children incarcerated in mother and baby homes and industrial schools. At the very least, they are entitled to an apology from Fianna Fáil and Fine Gael and a clear and precise condemnation of those politicians who, if not fostering it, are accommodating anti-Traveller bias.
This is particularly the case in the appalling record of local authorities in providing Traveller accommodation. On Monday morning, in response to this survey, Mr. Michael Collins of Pavee Point said that €69 million of funding for Traveller accommodation has not been drawn down since 2000. At least 45% of the funding for this year has not been drawn down by local authorities. While the Travelling community make up 7% of our population, some 15% of that community are homeless. The facts speak for themselves. Local authorities are not prepared to stand up to anti-Traveller sentiment. The issue needs to be taken out of their hands. We need a central government agency to take on this key question and to deliver. I will support this issue in the Joint Committee on Key Issues affecting the Traveller Community.
I repeat my call for the Tánaiste to give an apology to the Travelling community for the fact that this is still happening three years after 1 March 2017, when Traveller ethnicity was recognised. I also call for serious action to tackle the multitude of issues the survey has identified.
I thank the Deputy for raising this issue on a very appropriate day. I have not seen the survey. I will take a look at it. I have no doubt that its contents are correct. It certainly rings true for me, given my experience, and I am sure it rings true for many in this House. There can be no doubt that Irish Travellers have, for generations, faced a huge degree of disadvantage and discrimination solely by reason and virtue of their birth. They have suffered discrimination in employment and in housing. This is reflected in higher levels of poverty and lower levels of educational attainment.
I do not think it is fair, however, to say that no action has been taken or that Government has done nothing in recent years. I am proud to have been a member of the Government that took the decision to recognise Traveller identity and ethnicity three years ago. That was not done by a party of the left or a different government but the Government led by my party, Fine Gael, alongside the Labour Party. We have also announced some changes in the way in which Traveller housing funds are to work. These were announced by the Minister, Deputy Darragh O'Brien, only the other day in acknowledgement of the fact that local authorities perform very poorly indeed in providing Traveller accommodation. The Minister has indicated that the system is going to change. Instead of money not being drawn down every year, as it often is not, a new system is to be put in place which will make sure that more Traveller-specific accommodation is provided in the years ahead.
A lot is also being done to ensure a greater focus on Traveller and Roma health and on providing educational opportunities for people from the Travelling community. While the numbers may be small, it is good to see more and more Travellers finishing secondary school, making it to third level and availing of those educational opportunities.
Professor Michael O'Flaherty, director of the Vienna-based European Union Agency for Fundamental Rights, described the issue of housing for the community as very worrying. Some 73% of Travellers surveyed said that they had experienced housing discrimination. Professor O'Flaherty has said that "EU-wide Roma and Travellers are experiencing a perfect storm of fundamental rights deprivation and challenge" and that the findings of the survey pointed to a "profound underachievement of strategies". In some ways, the Tánaiste has made my case. There have been reports, submissions and recommendations with regard to the Travelling community but very little has been implemented. He is right that some areas, such as public health units for Travellers, have improved a bit, but not to the level they should have. The fact that this report indicates that Ireland is probably the worst in all areas is a damning indictment of the State and its attitude towards the Travelling and Roma communities for decades.
The Tánaiste has not given an apology. I expected one. I will continue to pursue such an apology from both Fianna Fáil and Fine Gael now and in the Joint Committee on Key Issues affecting the Traveller Community. The fish rots from the head. Unless we get leadership from the top, we will not get change at the bottom. That has to change.
I believe we have seen that leadership, namely, the decision made by the last Government, led by Fine Gael, to recognise Traveller ethnicity and identity, greater investment in public health, which the Deputy has acknowledged, more educational opportunities and the decision made by this Government, first to appoint a member of the Travelling community to the Seanad, which we all welcome, and the decision to change the system in respect of the allocation of housing moneys because local authorities have not been delivering the goods with regard to this issue. I absolutely appreciate that much more needs to be done and that the progress made in recent years has been inadequate. There are many different reasons for this. It is a bit simplistic and populist to just blame it on the Government. The discrimination Travellers face in our society is deeply ingrained and there are a lot of reasons for it. It is wrong, however, and it is the duty of Government to respond to it.