Ceisteanna ó Cheannairí - Leaders' Questions

Due to the limited time that we have, I appeal to Members to adhere to Standing Orders and the times allowed.

I extend my thoughts and sympathies to the families of the 93 people whose deaths from Covid-19 were reported yesterday and to all those who have been bereaved in the course of this pandemic. We are living through what are difficult times for many families.

The Government has abandoned plans to reopen special education schools and facilities this week. The Minister for Education, Deputy Foley, has twice promised that they would reopen. She has twice failed to deliver. The promises have fallen apart due to Government incompetence. The Minister's approach in the media over the past 24 hours of finger pointing and seeking to scapegoat SNAs and teachers is fooling no one.

Everyone wants to see children and young people with additional needs back at school. That has been and remains a shared objective because they are the cohort of students that missed out most when schools closed in the spring. The regression that was experienced by many as a result of the loss of their supports and routines was alarming. It caused incredible distress to them and their parents. Now, these children and young people are losing out again and their parents are distressed once more.

The responsibility for this mess lies squarely with the Government. It told anyone who cared to listen that education during the pandemic was a priority, yet it has failed to put together anything resembling a plan B. No thought was given to how education would continue if schools had to close due to high rates of infection. Such a plan B could have been, and should have been, on the shelf, having been discussed with all stakeholders - unions, management bodies, students and parents. The Government has had since August to put in place these contingencies.

By the way, special education is up and running in the North and across Europe. People are left wondering how and why it is that the same cannot happen here. The truth is that, instead of being prepared, the Government scrambled at the last minute to put together a plan. It fell apart because there had been no consultation and the Government sought to bounce stakeholders. The Government has a tendency to dictate policy by press release. We saw the Minister, Deputy Foley, and the Minister of State, Deputy Madigan, racing to gazump each other in the media. That approach has resulted in serious implications for children and young people and their families.

The Minister now claims that her plan collapsed because of bad faith. Let me tell the House what bad faith is. It was bad faith to give these children, as she did, the impression that they would be back in school when the work was not done to ensure that schools were safe and all the people involved in delivering the plan were on board. All of this happened because the Minister made a big promise and has not done the work to deliver it.

Children with special educational needs should be priority No. 1 in education. They should be the first back into the classroom, but that must happen on the basis of agreement and of ensuring that schools and staff are safe. The talks that I hope are ongoing today need to take some serious shape now. SNAs and teachers want to be back in school. I recall clearly how, in September, they moved heaven and earth to get their classes open again with little notice. The Taoiseach might advise the Minister of State, Deputy Madigan, that comparing these professionals - teachers, SNAs and others - to mother and baby homes is not just crass and clueless, but a vain attempt to shift blame.

The truth is the outstanding concerns have to be addressed. The other truth is this cannot go on forever. We need to see a result. We cannot allow this to drift into the general reopening of schools.

Thank you, Deputy. The time is up.

These children and their parents do not have the luxury of time. What we need now is a real, concrete and deliverable solution.

First of all, I want to sympathise with the families and all those who have been bereaved as a result of Covid-19, particularly those 93 families that we heard of yesterday. It illustrates the extraordinarily devastating impact that the virus has had on our entire society and community.

May I also take the opportunity briefly on behalf of the Government and on behalf of the Oireachtas to wish President-elect Joe Biden the very, very best as he begins his journey as President of the United States? He is a very loyal friend to Ireland and has made no secret of that affection for this country. We look forward to welcoming him to Ireland during his Presidency.

It is with regret that I heard Deputy McDonald's contribution. I think it is overly partisan. It is overly political. It seeks to attack the Minister and the Government for seeking to work in good faith with all the partners in education to provide for children with special needs and their families. When we closed all schools at once, the Government took the decision originally not to reopen schools because we did not want 1 million people on the move, given the very high level of community transmission of the virus and the high levels of it in our community, but we wanted to provide for children with special needs. Everyone in the House did. I can quote every Deputy, and every spokesperson, saying we must do something to provide for children with special needs and that it cannot be all closures and no openings. Some Deputies suggested that maybe we could open on alternate days or particular parts of the week and that we needed to make some provision. The Government worked in good faith to do that. I can go back through what Deputy McDonald and other Deputies said during the first lockdown in terms of the necessity of having schools open for children with special needs. Everyone commented after the first lockdown on the degree of regression and the very negative impact on families. That idea or principle was shared by the education partners on good faith as well.

It is absolutely untrue to say there was no consultation. I just do not understand how Deputy McDonald can stand up and say something like that. It was just so untrue and it illustrates that this is a partisan political attack by Deputy McDonald, not a helpful or constructive approach to this issue.

I can go through it. Even last week on the public airwaves, the general secretary of the INTO said there would definitely be schools open this week and there would be members of the INTO and Fórsa in the schools. I think he said that in good faith. I think the leadership of the unions genuinely wanted and were anxious to try to get some provision for children with special needs. There has been an extraordinary degree of consultation on public health. That the webinar saw up to 14,000 or more participating illustrates the concerns and interest out there and the genuine contribution of many special needs assistants and teachers across the country. My sense of it is that there is a real and genuine anxiety out there. Notwithstanding the sharing of the objective of opening schools for special needs children, the wherewithal was not there to get a critical mass back into our schools right now. That is my sense of it without apportioning blame to anybody, but I can go through all the quotes. I can go through all the meetings that have taken place between the Department and the education partners.

I can go through all of the responses-----

I thank the Taoiseach. The time is up.

-----of the Minister for Education on a range of issues that were raised by the unions on behalf of their members, all of which were acceded to and received positive responses.

I thank the Taoiseach.

I stand by the Minister's and the Government's sincere commitment to open schools for children with special needs. It is wrong to play politics with children with special needs, which is what I witnessed this morning in the Deputy's contribution.

As the Taoiseach very well knows, holding the Government to account is not playing politics. I point to the irony of a Government that itself has played politics and rushed very quickly to point fingers at SNAs, teachers and anyone bar itself for this fiasco.

There is a shared objective for special education to function. The Minister says that she is committed to that, but she has twice announced its reopening and has twice failed to deliver. The consultation that happened was clearly insufficient and the Minister jumped the gun. She made the big announcement, to considerable fanfare, that services would resume, but she did not have the plan in place. She had not settled or reassured teachers and SNAs, the caring, wonderful professionals who deliver the services and support to these wonderful children and young people. The plan had not been finalised. By any calculation, that was a gross misjudgment on her part.

I thank Deputy McDonald.

What is worse is that after the fact, there was an attempt to lay the blame, scapegoat and be incredibly divisive among the special education community.

The time is up.

That is not good government. Is the Taoiseach telling the Dáil that he is reassured that the Minister, Deputy Foley, and the Minister of State, Deputy Madigan, can deliver an agreed return to school and services-----

I thank the Deputy. The time is up.

-----and that it can be done in the short term with the agreement and the necessary, reasonable assurances that SNAs and teachers are looking for and rightly deserve?

I mean this in the best of good faith. I do not detect anything of substance in Deputy McDonald's contribution this morning on this matter. She has been going on about a plan B for a long time, with no concrete fleshing out of what that is. Schools reopened in September through partnership involving the parents, the unions, the Department and the Minister, and with a lot of resources provided by the Government. It was a successful reopening from September to Christmas. Public health played a very significant role in that, in particular Dr. Kevin Kelleher and Dr. Abigail Collins from the HSE, who were available every week to consult with leadership teams in education in respect of public health guidance and responses. The whole journey up to now has been a shared one between the partners in education and that engagement will continue.

On 15 January the INTO general secretary made the point that a significant number of Fórsa and INTO members would be going back into special classes and into mainstream education. He said he believed that every single school in Ireland would be opening its doors late next week-----

I thank the Taoiseach. His time is up.

-----to children with additional needs. I think he meant that in good faith, but the point I am making is that it is clear that the Minister, Deputy Foley, equally felt that that was the trajectory of travel. What issued on the Friday evening was an agreed guidance, which was agreed by all the partners, to go out to the school management and principals because they needed to get an advance guidance framework prior to 21 January.

I join the Taoiseach and others in expressing the Labour Party's sympathy to the families of those who lost their lives yesterday, one of whom was 41 years of age, which should be a reminder to everybody in society that this is a virus that can affect all age groups. I also join the Taoiseach in congratulating, if I may say, one of our own in becoming President of the United States on his inauguration today.

The Labour Party is attempting to de-escalate the tensions that have been involved in the special education issue. We do not feel at this point that it is going to benefit anybody to point the finger, to blame or to join the attempt to create division between special education teachers, SNAs and parents. However, I put it to the Taoiseach that it is now time for him to get involved because it is clear that the Minister, Deputy Foley, and the Minister of State, Deputy Madigan, have lost control of the situation.

We were quite supportive of the Minister and the Minister of State in investigating the possibility of reopening schools, as the Taoiseach rightly said, for certain cohorts. We believe that the closing of schools is a profoundly negative thing to happen to children and it profoundly negatively affects the most vulnerable children, including those with additional needs and those in areas of disadvantage as well. However, from the start of this year, 6 January, an announcement was made on school reopening with no consultation. The Taoiseach should please not make liars of trade union leaders who say that they were not consulted about the flat announcement on 6 January. On 14 January, another announcement was made, before an education debate in this House, on the reopening of special schools and special classes. Again, there was no agreement.

On 15 January, at 8 o'clock on a Friday evening, a letter was sent to every school in the country on the reopening of special schools. Again, there was no agreement. Even since last night, we had an extremely ill-advised communication from the Department, with quotes from both Ministers, pointing fingers all over the place. Both unions issued a joint communication saying that they were still at the table and willing to talk. Comments from the Minister, Deputy Foley, this morning, suggested that comments made about one of the union leaders was disingenuous. The Minister of State, Deputy Madigan, made a comparison between this situation and the mother and baby homes, and last week she made a comment about non-SNA students being normal.

We have been doing our best as a political entity to try to be constructive. In the spirit of being constructive, could I ask the Taoiseach if his office would get centrally involved in this situation? Does he appreciate the severity of the situation and how dangerous it is for young people to be out of school for this length of time? Does he recognise that the entire reopening of schools is now in jeopardy because of the bad faith that has been shown by Ministers in their public comments? Will the Taoiseach also comment, please, on the potential for the next round of vaccinations to be centred on this area because that would give some comfort to those who are expected to be involved in this process? I put it to the Taoiseach that the Minister, Deputy Foley, and the Minister of State, Deputy Madigan, are now part of the problem and the Taoiseach and his office can be part of the solution. It is important for the Taoiseach and his office now to step in.

I accept the constructive nature of the Deputy's contribution, but I do not accept the premise on which he has based his question. I believe the Minister, Deputy Foley, has successfully led the reopening of schools in September to the Christmas period, and did so in partnership with management bodies, the teacher unions, the unions of special needs assistants, the representative body of students, and all of the stakeholders in education. It worked very well. There was a strong underpinning of that by the public health advice from the Health Service Executive dealing with the many anxieties various school communities had. It must be said that 75% of all schools in the country did not need to avail of public health support during that period. That said, it must be acknowledged that there is a very high level of community transmission right now and we are in a different phase of this pandemic in that regard.

It is not fair to say there has been no consultation. There has been extensive consultation between the Minister, Department officials, the unions and the representative bodies. Last week, various spokespersons were of the view that we would be in a position to open schools on 21 January. This was said publicly by some of the union representatives. Comments have been made about the Minister, which do not stack up, in terms of this being a rushed decision. It was not. What emerged on Friday was a shared agreement on the guidance framework.

If we reflect on the webinar, with perhaps 16,000 people participating, what does it show? It illustrates the genuine anxiety out there among quite a number of the workforce, and we must take that on board. It has filtered its way through to the representative organisations as well and a reassessment from their perspective and a recalibration of their approach.

I accept that we need to go forward on a shared basis. The Minister for Education will lead that with her Department and continue the engagement. I know that today the Minister, Deputy Foley, is meeting many of the groups representing the children with special needs and their families. I take the Deputy's point that we must not allow divisive fallout from this involving those who provide education services and look after children, including various interest groups. We must stand back from that. One of the most effective things we can do now, given my observations, is for all of us to do as much as we can collectively to get down community transmission. We are on the right pathway that way and in the next while, it might give us an opportunity to re-engage effectively and get the outcome that everybody in the House desires.

I appreciate the Taoiseach's response but he underestimates the damage that has been done in public commentary by the Minister and Minister of State. The Taoiseach mentioned the webinar last Monday, but I am aware of a webinar that took place last night. While this process was falling apart, the Minister, Deputy Foley, took it upon herself to attend a Fianna Fáil-sponsored webinar at 7 o'clock last night. We had a press statement from her yesterday evening and media comments this morning from her and the Minister of State in the Department that have been deeply unhelpful.

Other school reopenings are now at risk because of the bad faith exhibited and bridges being burned all over the place by the Minister and Minister of State. Their commentary is ill-tempered and must be de-escalated. It is now the responsibility of the Taoiseach and his office to step in because the Minister and Minister of State are not in control of the situation.

I do not take the same interpretation as the Deputy of the interview he mentions. If we get down to the nuts and bolts of this, much of what was proposed in this House formed the substance of the talks and the engagement between the partners and the Minister. On 4 January the Deputy said that if schools are to close, the Department must assess a middle course between having all open and all closed and asked if we could find in-school solutions for certain categories like in other countries. He mentioned children of front-line workers, DEIS and special needs students, as well as leaving certificate students, and sought vaccination as soon as possible.

I support much of what he says and it was discussed and agreed between the Minister and others. It included 50% attendance on alternate days, medical grade personal protective equipment, PPE, and special arrangements for childcare. The full range of requests made of the Minister were provided. That must be said and the Minister must reflect her position in all of this. I know she wants to go forward in the spirit of co-operation.

On the vaccination question, we are guided by the national immunisation advisory committee. The fundamental benefit of the vaccination is to prevent and reduce mortality and severe illness, and that is best applied to nursing home residents and front-line healthcare workers. That is a live and active issue.

The Government's failure to follow public health advice is responsible for Ireland having the worst rate of Covid infection in the world. It is responsible for hundreds of tragic deaths and these tragedies were avoidable.

On 26 November, NPHET wrote to the Government and stated, unambiguously, "NPHET therefore recommends that the hospitality sector remain closed ... over the eight-week period". The Government broke with that advice under the pressure of business lobbying and decided to open pubs and restaurants. At the time I said this was a recipe for seeding the virus across Dublin for a couple of weeks and then spreading it throughout the country. The Taoiseach ignored me and other socialist Deputies. Most important, he ignored the public health advice.

With cases then clearly out of control, Dr. Tony Holohan wrote to the Government on 21 December, calling for measures as set out in level 5, including the closure of retail. On 23 December, after a NPHET meeting, he wrote again, calling for the "full suite" of level 5 measures to be introduced. It was not until 31 December that retail was finally closed.

The question is whether the Government will learn any lessons from the disastrous and deadly mistakes it has made so far. Will it finally abandon its failed living with Covid strategy which has resulted in yo-yo lockdowns? Instead of delivering us a fourth and fifth lockdown before we have sufficiency vaccination, will the Government seek to ensure this is the final lockdown by implementing a zero Covid strategy to eliminate community transmission while investing in finding, testing, tracing and isolating to deal quickly with any cases that occur?

Will the Taoiseach agree to ban non-essential travel to Ireland and implement a 14-day mandatory quarantine for those people who must travel here, with all the appropriate safeguards? Preventing the import of the virus has been a crucial approach of those countries that have successfully implemented zero Covid strategies. It is especially important now, given the different strains of the virus.

Will the Taoiseach ensure the recommendation that workers who can work from home are allowed to do so is actually implemented? We have very many reports of workers who are not being allowed to work from home by their employers. When they contacted the Health and Safety Authority, HSA, about it, they were told this is at the employer's discretion. This is simply not good enough. Does the Taoiseach agree that the HSA must be empowered to enforce working from home, and employers who refuse to allow their employees to work from home should be fined?

Will the Taoiseach take action to close the loopholes in the list of essential services, which means that many workplaces closed in the first lockdown have been open in this third lockdown? An example is the national car test centres. I speak particularly about non-essential construction sites, including Intel at Leixlip, that continue to open and put workers in danger. I wrote to the Taoiseach about that on 8 January.

On the zero Covid approach, the Deputy has been very clear that the advice of NPHET should be followed, and the advice of NPHET and the Chief Medical Officer has been consistently against a zero Covid approach on the basis that they do not think it practical or that it could work. The most recent discussion on that was between Deputy Boyd Barrett and the Chief Medical Officer at the leaders' briefing that we had the week before last on the Covid strategy in general.

I have been very clear and open on the specific strategy I believe we should adopt. I do not believe in the herd immunity approach, for example, and I think no one in the House does. I also said I did not believe we could achieve a zero Covid strategy and deliver it. Even now, in the context of dealing with Covid, the situation in Northern Ireland is problematic. For example, even when we banned flights from the UK to the Republic of Ireland, people flew into Belfast. The prospect of sealing the Border between the North and the Republic of Ireland is not a reality or something anyone has suggested we should do. It would be the only realistic way of having a zero Covid strategy. Alternatively, there could be a two-island approach between the UK and Ireland. We are so integrated into the EU and UK economies that there are practical considerations around the application of a zero Covid strategy.

The Government has followed, broadly speaking, NPHET advice from the get-go. Since the beginning of the pandemic, Ireland has been in a phase of restrictions with different levels of severity from the beginning, except for the summer months. That is the reality. The Deputy spoke about his correspondence, and I am open to a full evaluation of all of this, from the beginning to the end of the pandemic, when it is over.

My absolute priority now is to focus on managing and dealing with the impact of Covid-19 on our society, our hospitals and our critical care systems, as well as on the vaccination programme, which is the light at the end of the tunnel. That programme will enable us to get back to some normality towards the latter part of this year.

The extraordinary levels that we witnessed over the Christmas period, with 6,000 new cases per day, were not predicted by anybody. Even the letter quoted by the Deputy makes it clear, based on the modelling, that if the R number was maintained at 1.2 the numbers would remain low but if it went above 1.4, we would exceed 400 cases per day in January 2021. The letter also says that threshold would be reached sooner if we started with higher case numbers. The letter also refers to the UK SAGE evidence on hospitality in terms of reducing the R number by between 0.1 and 0.2, which accords with our national data, and points out that the prevention of mixing between households might have an equivalent effect on the R number. We decided not to have mixing of households from 1 to 18 December which everybody forgets. To suggest that the problem was hospitality alone is to miss the other elements relevant to this particular wave of the pandemic. Seasonality was a factor, as was the new variant. Undoubtedly, socialisation was a factor as we moved into level 3 from a six-week lockdown at level 5.

I find the defence that nobody said it would be this bad to be bizarre. It is like saying, when one's mother tells one not to put one's hand into the fire, "Mummy, you just told me I would burn my hand; you did not say my whole body would burn". The Government was warned about what would happen. It is simply not true to say that the Government broadly followed NPHET's advice. The Government broke from that advice in October when it refused to go into lockdown and the Tánaiste set out to undermine NPHET publicly. It also broke from the advice in a very serious way at the start of December when NPHET said it should not open the pubs and restaurants but the Government proceeded to do so. The Government also broke from NPHET's advice close to Christmas, when the team recommended the closing of retail but the Government failed to do so.

On the zero-Covid strategy, my understanding of what Dr. Holohan said to Deputy Boyd Barrett at the meeting is that NPHET would like to see the elimination of the virus and if we could pursue that, it would be excellent but he did not believe it was politically feasible. On 4 August, NPHET wrote to the Government pointing out that the team had previously recommended mandatory quarantine for all passengers travelling to Ireland from overseas and that this remained NPHET's preferred recommendation. NPHET has been arguing for mandatory quarantine but the Taoiseach did not answer the questions I posed on that and on workers working from home. Current traffic levels are way above those seen in the first lockdown. What is going to be done about it? Are employers going to be allowed to flout the laws or will there be enforcement of the rules? The Taoiseach should not hide behind the North when he is not even in favour of a zero-Covid strategy. Such a strategy can be implemented even without agreement with the North, although it would be better with such agreement. The starting point is to agree it here, argue for it and then argue for it in the North.

All workers who can work from home should do so and all employers should facilitate that. That is Government policy and has been the Government message to the employer representative bodies. Only essential workers should have to leave their homes and the overwhelming message is for people to stay at home unless they are engaged in essential services.

I did not ever hear the CMO say that zero-Covid would be politically impossible and it would be wrong to infer that he was taking a political position on this. He said very clearly, and repeatedly, that the practicality of going to a zero-Covid strategy was something that he could not see. That has been the consistent position for quite some time, if not since the onset of the pandemic.

People are adhering to this lockdown but the Deputy makes a very important point. Irrespective of what restrictions are in place, whether on households or particular sectors, adherence to the guidelines is key. There were many superspreader events that had nothing at all to do with hospitality, although hospitality had a few too, no question. There is a need for all of us to adhere to the guidelines. Thankfully people are doing so and the numbers are coming down but with the UK variant, the issue will be how low they can fall. That can only happen if all of us, individually and collectively, work to get the numbers down by adhering to the guidance issued and the regulations that are in place.

This week I spoke with a community nurse manager who works for a private company contracted to care for HSE patients. She co-ordinates a large team of nurses and carers. The professional services they provide make it possible for elderly and often terminally ill patients to remain in their homes rather than being admitted to hospital or to a nursing home. These community-based workers carry out their work alone, without the assistance of other professionals. Not only do they care for patients, but they also provide support and guidance to family members. Their work is invaluable but these highly committed workers feel totally abandoned. The nature of their everyday work takes them from house to house. Increasingly they are faced with cases of Covid-19. Numerous times each day nurses and carers have to put on PPE gear in their cars or in house porches. It has become impossible for them to get back-up support from other medical services. If a housebound patient displays Covid-19 symptoms and requires a test, it can take up to seven days for paramedics to arrive to carry out that test. Family members are instantly quarantined in the house or forbidden to enter if they live elsewhere, yet the community nurses and carers must continue to visit, provide care to the patient and support their families. As it stands, these private-company nurses and carers have not been notified of when they will be vaccinated and neither have the hundreds of family carers in every county across the country. These are front-line workers in every sense, except when it comes to vaccination. Community healthcare would collapse without these people and they must be protected as a matter of urgency. Older people living at home are terrified. They have heard nothing from their doctors about when they will be vaccinated. Family carers and those who provide home help feel forgotten. Residents in sheltered housing at Sue Ryder House in Holycross and Nenagh remain vulnerable. It is imperative that these people be given the same level of priority as those living in nursing homes.

To counteract this destructive virus, which has caused havoc, we need a deliberate, calculated and co-ordinated plan to vaccinate as much of the population as possible in the shortest possible timeframe. This is the most urgent and crucial task to be undertaken since the foundation of the State. It is a major project but the roll-out of the vaccine lacks scale and ambition. We are in the midst of a national crisis or emergency which is having a disastrous effect on our society and economy. Restrictions and lockdowns give only temporary relief. The policy of suppressing and containing the virus has failed in Ireland and across Europe. We need to break the cycle of opening and closing and the only lasting solution is inoculation. However, there are already serious doubts and reservations about our vaccine roll-out programme. Many people are concerned that the vaccine programme is sluggish. While we can now be more confident about vaccine supply, big questions remain around the number of vaccinators available. The projected time it will take to vaccinate 70% of the population is deeply disturbing to many people.

I thank the Deputy for raising this issue but I assure him that there is no need for people not to have confidence in the vaccination programme. It will be very comprehensive and will be ramped up as further vaccines are authorised and made available to us. The only limiting factor at the moment is the supply of vaccines. The only significant volumes we have received to date are from Pfizer BioNTech, which have enabled us to prioritise front-line healthcare workers and residents and staff of long-term care facilities. That will be the priority up to the weekend. By Sunday, all staff and residents in nursing homes and long-term care facilities will have been vaccinated with their first dose, as well as potentially up to 70,000 front-line healthcare workers. My understanding is that we have received approximately 152,000 vaccines and by next Sunday, 142,000 of those will have been administered. We are literally getting the vaccines out as we get them in to the country.

We have a much more comprehensive and detailed plan for ramping up the volume of vaccinations in the next phase, particularly after the authorisation by the European Medicines Agency of the AstraZeneca vaccine which, all going well, should be on 29 January, with delivery expected in mid-February.

This will be followed by the Janssen vaccine, which we expect to be authorised a month later. We will also be getting more supplies from Pfizer-BioNTech and Moderna. There will, therefore, be a very significant ramping-up. The Deputy has correctly identified the workforce issues. GPs and pharmacies are now ready to distribute the AstraZeneca vaccine and others. We are also working to expand that workforce so there can be a full national campaign to vaccinate the nation as soon as possible. The Deputy should be in no doubt about that. The workers he has represented and whose concerns he has articulated are on the front line, particularly in home care settings. I will feed his comments back to the national task force. We take advice on clinical priorities from the National Immunisation Advisory Committee, which is headed by Dr. Karina Butler, and from the National Public Health Emergency Team, NPHET. It is on the basis of this advice that we decide the sequencing and priority of those who are to get the vaccine. The evidence base suggests that the existing vaccines reduce illness and mortality. It is necessary to vaccinate the eldest and most vulnerable in our society, as well as those on the front line. If we do that, we will reduce mortality, risk and illness. I will take on board the representations the Deputy has made.

My concern is the number of vaccinators we have. HSE services are already overwhelmed. Some 6,500 healthcare staff are out of work due to Covid. We simply cannot divert further front-line staff for the purpose of acting as vaccinators. We need to assemble a task force of vaccinators. We need to recruit outside the obvious circle and build a national team to dispense the vaccine. We need a battalion of vaccinators working around the clock. We need to utilise community centres in every town and parish as vaccination centres. If people are asked to turn up for appointments during the night, so be it. They should get the jab and get the job done. This has to be our mentality and approach.

At present we have 1,700 people administering the vaccine and they are doing an excellent job. To be effective and to expedite the roll-out, we will require 5,000 to 6,000. I welcome the engagement of GPs but we must realise that they are already overworked and snowed under. We therefore have to ask whether they have time to be central to the campaign. I welcome the agreement reached with the pharmacists. Has the Government considered using the resources of the Army, particularly its medical resources? Has it considered inviting all retired doctors and nurses to answer the call? Should we consider enlisting medical students or even using dental practices or skilled scientific laboratory technicians? We have to think outside of the box and to be creative. This is a once-in-a-lifetime emergency and our response has to be bold, brave and imaginative.

I agree. Every category the Deputy has just enumerated is not only being looked at, but worked on. A vaccinator workforce of scale, over and above existing hospital vaccinators, GPs and pharmacists, is needed. We need to draw upon resources. Some who are retired will be able to come forward, for example. There will be vaccination centres in different communities across the country. The national task force is working on this right now. We will be in a position to give a more comprehensive account in the future. The key game changer with regard to the availability of vaccines will be the authorisation of the AstraZeneca vaccine. We envisage a significant ramping-up across February, March and April. May and June will also be significant because we will have very significant amounts of vaccine. It will no longer be an issue of the supply of vaccines but a workforce issue, as the Deputy has identified. That work is well advanced. A lot of work is going on in that regard.