Ceisteanna ó Cheannairí - Leaders' Questions

I want to read a quote to the Taoiseach:

Under our proposals, people aged 65 will receive a State pension...which will be paid at the same rate as the State pension of €248 per week. This payment will not be means tested but entitlement will be based on an individual's employment record. In contrast Fine Gael will only pay those who are 65 a payment of €203 per week, which will result in an annual loss of €2,340 for this age group.

Those words should sound very familiar to the Taoiseach because they are, as he knows, an official Fianna Fáil statement made by Deputy Willie O'Dea, when he was the party's spokesperson on social protection, three days before last year's general election. The Taoiseach knew at that time the strength of public feeling as regards the right to a State pension for workers when they reach the age of 65 but he seems to have forgotten that in the meantime, because his Government's announcement on the State pension on Monday was exactly what Fine Gael proposed in the course of that election 12 months ago.

Only enormous public pressure has stopped the Government from raising the pension age to 67 for now, and it is not restoring the State pension (transition) payments, as it promised. The Government will continue to pay 65-year-olds what is, in effect, a jobseeker’s payment of only €203 per week, which is a loss of €45 a week, a loss, as the Taoiseach knows, of more than €2,000 a year when compared with the State pension. This cohort of workers also stands to lose out on a range of secondary benefits, including fuel allowance, as the Taoiseach well knows.

In summary, the Taoiseach has adopted the Fine Gael policy, hook, line and sinker and this is a real blow for 65-year-olds, who will rely on a decent pension to get by. The lack of fairness, the lack of respect, is absolutely breath-taking, particularly in these times when people are under such enormous pressure.

The Taoiseach should know that, by the age of 65, workers will have worked hard, paid their way, paid their bills, provided for their families and paid their taxes to this State. Many of those who now look for their pension entitlement at the age of 65 may have begun their working lives at the age of 14 or 15. They have more than paid their way. Many more have spent their working lives on their feet in very physical jobs in factories, on building sites and in retail. By the time they reach the age of 65, they are entitled to this because they have earned the respect and entitlement of their pension, should they wish to retire.

The Taoiseach's failure in this now means that many 65-year-olds who may wish to retire will have to continue working. Many will head back to their places of work, even in these very difficult and treacherous times. I recognise there are those who would wish to work beyond the age of 65 and, of course, that right must be upheld, but it is wrong that, at the age of 65, those who wish to retire are forced out the door to work because they cannot afford to retire, because the State and the Government do not respect their working lives.

This is actually very straightforward. The Taoiseach is either for the right to a State pension at the age of 65 or he is not. Will he confirm that, under his plan, 65-year-olds will be out of pocket by €45 per week? How on earth does he stand over this, particularly given his election commitments?

I thank the Deputy for raising the issue. It is quite extraordinary the two-dimensional thinking and approach from Deputy McDonald and the Sinn Féin Party more generally.

They say one thing in this House and do the exact opposite in Northern Ireland on the Executive, for example. The Deputy calls for a pension age of 65 years here, yet in Northern Ireland last October the exact opposite happened after Sinn Féin voted for the pension age to be increased from 65 to 66 years. Everything the Deputy has thrown at me can be thrown at her with respect to what her party supported in Northern Ireland.

Deputy McDonald says the rate is too low when a 65-year-old on €203 in the Republic is still receiving a higher payment than every single pensioner in Northern Ireland regardless of age. Where is the fairness or respect for people there? I have noted in the last week alone, between Sinn Féin's proposals on fuel allowance and the pension, that it has essentially looked for about €4.5 billion in spending in only seven days, and that is only from one Department. We can discuss on another day how the Deputy or her party believes all that can be sorted.

In the context of the election and subsequently, we did not win a majority but we did decide to go into government and form a coalition with the Green Party and the Fine Gael Party. Pension issues formed part of those negotiations. The programme for Government was very clear that those aged 65 years who are required or choose to retire early can receive an early retirement allowance or pension at the same rate as jobseeker's benefit without a requirement to sign on, partake in activation measures or be available for and genuinely seeking work. We introduced that new payment and we have fulfilled the programme for Government commitment on that to bridge the gap for people who were required to retire at 65 but do not qualify for the State pension until aged 66.

The increase in the pension age to 67 years, which was proposed prior to the general election and which we opposed, did not go ahead in January. The pension age was kept at 66 years. That was an outcome of the negotiations between the three parties in the formulation of the programme for Government. The decision not to allow the pension age to go to 67 years will cost €453 million.

Obviously, there is a wider issue around pension sustainability into the future. The Department of Social Protection will spend about €25 billion this year. Over 40% of that, about €9 billion, will be spend on pension payments alone. The Pensions Commission has been established to examine a range of issues and Deputy McDonald's party can make a submission to it. The commission is examining mandatory retirement ages in employment contracts where that age is below the State pension age. It is due to report back to Government later this year. It is important to be honest with people that the sustainability of pensions over the coming decades will be challenging for the State. That is why the Pensions Commission represents a very good context to try to outline how the State will meet its obligations and organise society into the future as we live longer and our demographics change significantly.

To make another key point, the State pension age has never been at 65 years. There was previously a transition pension which was abolished by the then Minister, Joan Burton, in 2014. The State pension age is 66 years. That has been the case since 1977.

Let me say very directly to the Taoiseach that he is in no position to make arguments to working people about the sustainability of very modest pension payments for them when, at the same time, the gold-plated pensions that the Taoiseach and his predecessors enjoy are not to be touched. There is a central hypocrisy in his approach - big pensions for the big boys and crumbs for working people. It is a mark of decency in any affluent society - in any civilised society actually - that working people have the right to retire with their pension at the age of 65 years. These are people who have worked long and hard in manual labour, retail and as carers. I could go on and on. Yet, rather than addressing that issue and leading from the front as Dublin and the sovereign Government here ought to, the Taoiseach dodges and prevaricates.

The Deputy's time is up.

I ask him again to confirm that the Government's proposal will see pensioners left out of pocket by €45 a week and more than €2,000 a year? I want him to justify that for those working people.

I am disappointed that the Deputy's party saw fit to raise the age to 66 years in Northern Ireland and voted for it. The Deputy did not even respond to that point. That is what Sinn Féin did. It is just hypocrisy and double standards. Historically, Fianna Fáil was responsible for significant increases in the State pension down through the decades, particularly in the late 1990s and early 2000s when very substantial increases happened. Successive Governments have done that, with the result that the Republic has strong State pensions in comparison with other jurisdictions. We need to improve if we can but we must have sustainability underpinning that as well. That is why the Pensions Commission has been established. As I said, the State pension age has been at 66 years since 1977. That is the reality. We need to change a broad range of areas around pensions and the Pensions Commission will bring forward a range of recommendations to respond to people's needs in this area.

I raise with the Taoiseach this week, as I did with the Tánaiste last week, the issue of the women and families who are suffering as a result of the CervicalCheck scandal. We all know of the case of Lynsey Bennett last week. I am sure everyone in the House wishes her the best in her travels for immunotherapy.

I am genuinely asking these questions, as someone who has been involved in this issue for some years. Have we learned anything? Are we doing everything we possibly can for these families who were let down by the State? The Ruth Morrissey judgment in the Supreme Court changed everything. Ms Morrissey was an amazing woman. The HSE is now primarily liable for these cases where negligence is found. Why are these cases not being dealt with beforehand? Why are they not being dealt with far quicker? I know there are a large number of cases coming down the line.

Following the recommendation made by the Chief Justice to us as legislators, why is it not a requirement in the Government's legislative programme to change the Civil Liability (Amendment) Act to ensure that women are not faced with having to choose between taking cases or allowing their families to do so after they pass? This is not a tolerable or fair choice.

Why, in response to the issues raised by Ms Bennett and others, did the Taoiseach, the Minister for Health, Deputy Donnelly, and the Tánaiste state last week that the tribunal was the solution? We now know, because I asked a question and the information suddenly appeared in the media, that nobody has applied to the tribunal. It is not fit for purpose for reasons that the Taoiseach and I have discussed both publicly and privately. These cases will not end up at the tribunal and the majority, if not all, of them will end up in the High Court.

Why are women who are affected by this scandal having to fight to get immunotherapy drugs? Vicky Phelan was promised by then Minister for Health, Deputy Harris, that pembro would be paid for, rightly so. I worked with her to ensure that all other women who were affected would also get it. Why did Patricia Carrick, whose family the Taoiseach apologised to in this Dáil, have to fight for months to get pembro, despite being clinically approved? Why, last Friday, did I have to contact the HSE to ensure that Lynsey Bennett would get pembro, even though she has passed her tests and was clinically put forward?

Amazingly, because she was appearing on "The Late Late Show", all of a sudden it was approved.

Why is the Government going to take medical cards away from the families of all the women who have been affected? Would it not be more fitting to ensure that the medical cards for those family members who are affected by this are given to them for their lifetime? I do not believe anybody would say that that is not warranted.

I thank the Deputy for raising this issue. We wish Lynsey Bennett the very best as she travels to Mexico. I spoke with Lynsey on the telephone over two weeks ago with regard to her devastating situation. It is devastating for all of the women involved and their families.

In terms of the issues relating to the establishment of the tribunal, prior to this Government being established, legislation was passed in this House. All parties, including the Deputy's party, participated in that process. The issue for this Government was to establish the tribunal in line with both the Meenan recommendations and the legislation that was enacted in the House, which had the support of all political parties at the time. The nominated members were appointed to the tribunal with effect from 1 December last. This has facilitated the tribunal in starting its work.

Liability and negligence are two very important but distinct issues. Negligence has to be proven in all situations, be it before a tribunal or in a High Court setting. The laboratories in all of these cases have been proven to be negligent and the State has indemnified them. There has to be the establishment of negligence. I think that was agreed-----

That is an important issue. The Deputy raised the issue about liability and negligence and I want to make the point that it is an important distinction and it is an important issue.

There is no Government edict stating that pembro should not be available.

Why is it not being issued?

I will pursue the point that the Deputy has raised. There should not be an issue. Neither should there be an issue with the medical cards, and I will pursue that also. What has been committed to should be honoured and I will undertake that it will be honoured in respect of those two issues.

What the Deputy says about the Morrissey case changing is contested. That is not accepted legally. In respect of the Civil Liability (Amendment) Act, that would have a broader remit, as the Deputy knows. It applies not just to the CervicalCheck situation but to a wider area involving personal injuries.

The tribunal is receiving queries. The Deputy would have been aware of the statement yesterday.

There are-----

No. I was speaking in terms of queries coming through about transfer of cases and so on.

It is zero - no cases.

I believe the tribunal offers a better forum than the High Court. It gives a great opportunity for mediation and in my view would be more expeditious and effective. It is a forum that should be given a chance in light of all of the work that has been put into it.

I do not have time to go into it but what the Taoiseach is saying in respect of the Chief Justice and his recommendation should be dealt with. I would have a different view on what he is saying about the Ruth Morrissey judgment. I welcome what the Taoiseach said in respect of pembro and people keeping the medical cards, particularly as they are about to be taken from them.

I want to raise one other issue. The national screening service issued a new edict yesterday regarding changes to the pathway for women who have cervical concerns, bleeding, etc. They must now be triaged instead of going to colposcopists. The recommended time for referrals to be dealt with was four weeks and it now seems to be a standard eight weeks. Local HSE groups will now be asked to put in place their own rules and procedures around that. Since this whole crisis erupted, what extra resources have been put in place to ensure that women could have their issues addressed and that there will be enough colposcopists and other resources? What has been learned?

I want to ask the Taoiseach a very clear question. Dr. Gabriel Scally compiled a report on all of this, as we all know. We all welcomed that report. Does he agree with the new pathways that were put in place yesterday? Considering that he was retained by the Government post his report, was Dr. Scally consulted on this matter? Has anyone asked him? I dare say that if he was asked, he would not agree with this.

First, these are clinical pathways. That is what the Deputy is referring to.

I am referring to was announced in public yesterday.

I am not a clinician. I am not going to attempt to presume expertise in an area in which I do not have expertise.

The framework was in place. Was it followed?

The point I am trying to make is that there is no issue with resources from this Government's perspective. Four billion euro has been allocated to the health service this year - €2 billion for Covid and €2 billion for non-Covid matters. I ask the Deputy to hear me out. There can be no question, therefore, of any financial resources being pulled from any particular sector.

Have we enough-----

More than 7,000 additional staff have been recruited to the health service-----

Will the Taoiseach get to the specific point?

I am getting to the specific point if the Deputy would not interrupt. In comparison with January 2020, there were 7,000 additional healthcare staff in place last month. The point I am making to the Deputy is that where staff can be recruited, they are being recruited. That is across all categories. I talked to the CEO of the HSE this morning, not specifically in respect of this issue but the Deputy gets my point.

There can be no argument that resources are not available to recruit-----

Where are the resources to-----

-----the specific personnel that are required in this area, no more than any other area. All healthcare personnel that are out there are being recruited by the HSE. It has recruited 7,000 additional staff in one 12-month period alone. In terms of-----

Did the Taoiseach ask Dr. Scally if he agrees with this?

I am sorry. There is an existing clinical team within the HSE and so on. The Deputy referenced the Morrissey judgment in terms of the tribunal and so on.

I am afraid the Taoiseach is over time.

Okay. I will come back to Deputy later on that.

I want to raise with the Taoiseach a very important issue in respect of which clarification is needed. Last week, my local radio station, LMFM, made a number of claims in respect of the HSE temporary accommodation programme. It claimed that the HSE is using a local hotel under the scheme to accommodate healthcare workers who are Covid positive and those who are not Covid positive. It has also claimed that a healthcare worker who contracted the Covid virus while at work was told to stay at the hotel to isolate as they live with people who are considered to be vulnerable.

I contacted the HSE but we need full transparency and clarification on this matter. The HSE, in its reply, stated: "Under no circumstances are Covid-19 positive healthcare workers accommodated in hotels by the HSE." The HSE also confirmed that the temporary accommodation scheme is available to: healthcare workers who are living in shared accommodation with other health service workers; those who work in potentially Covid-positive environments; and individuals who may have people who are in high-risk categories and who are vulnerable to infection in their home settings and who, therefore, cannot return to those settings between shifts. The scheme is also available to healthcare workers who live with people who have been instructed to self-quarantine or who are required to work longer than usual shifts or overtime and who will not have time to return home between shifts.

It has also been confirmed by the HSE that there are procedures in place for those workers who contract coronavirus and who are housed under the temporary programme. In these circumstances, a healthcare worker must inform his or her line manager of the situation. The latter can, in turn, inform the hotel and the worker must vacate the hotel at the earliest convenience. The HSE has also confirmed that healthcare workers who test positive for the virus and who are accommodated under the programme will be transferred to the Citywest self-isolation facility by medical doctors.

As the Taoiseach can see, the claims made by LMFM are totally at odds with the HSE's stated position. in order to get to the bottom of this, we need a detailed statement from the HSE confirming that the claims made by LMFM are either incorrect or that there has been a breakdown in systems in this instance. This has the potential to be a very serious situation and clarification is needed as a matter of urgency. We cannot have a situation where Covid-positive healthcare workers are sharing accommodation with other non-Covid-positive healthcare workers.

I have also been contacted by a healthcare worker who contracted the virus at work. She lives at home with her elderly parents, who are deemed to be in the "vulnerable" category. In this case, the healthcare worker was not offered the opportunity to self-isolate at the Citywest facility. This is also at odds with the statement from the HSE. I ask for the Taoiseach's assistance in this matter in order to get clarification from the HSE.

I thank the Deputy for raising this very serious matter. I appreciate fully the concerns expressed following the reports in local media. I will ask the Department of Health and the HSE for full clarity on this, although I believe they have been in touch with the Deputy. I will ask them to contact the Deputy directly about some of the specifics in these matters. The HSE has stated that under no circumstances are Covid-positive healthcare workers accommodated in hotels by the authorities. The HSE is very categorical in its statement that it does not do it. That, however, runs contrary to the story in the local media.

Up to 3,000 staff per week are availing of the HSE temporary accommodation programme. This programme is available to healthcare workers who are currently living in shared accommodation with other health service workers; work in a Covid-positive or potentially Covid-positive environment and may have a person in the high-risk categories vulnerable to infection in a home setting and therefore cannot return to the home setting between shifts; live with a person who has been instructed to self-quarantine; or are required to work longer than usual shifts or overtime and would therefore not have time to return home between shifts. Staff who are Covid-positive or who need to self-isolate cannot and will not be accommodated under this service.

Where a staff member tests positive, he or she would be referred to the Citywest self-isolation facility by a medical doctor. The Deputy indicates that in a certain case the person was not referred. If we can have the details, I will certainly follow through on that. There is a need to reconcile the story as published by local media and the very categorical position that has been articulated by the HSE. I will follow that up.

Late last night, the HSE contacted the local radio station and confirmed that the incident it had raised was true. This is a very serious breach. We have healthcare workers who are putting their lives in danger for other people. They are being put in hotels with others who are positive for coronavirus. I am a wee bit disappointed. Yesterday, I gave the Taoiseach's assistant the full details of the question I would ask today and I thought at the very least the Department would contact the HSE for an update. I am very disappointed as this must not have been done. The HSE came back to the radio station to confirm the story.

This is very serious so what can be done? I ask the Taoiseach to contact the HSE straight away and ask why its representatives did not have the decency to come back to the leader of the country on this matter, especially if his Department contacted the HSE for an update. I am astounded. A healthcare worker contacted me during the week to say she is living with her vulnerable parents and she cannot afford to go out and self-isolate. People positive for coronavirus are mixing with those who do not have the virus. It is a complete and utter mess.

Three or four weeks ago, I asked the Taoiseach about a case in County Louth and I was promised by the Taoiseach that his Department would contact me in three or four days. It did not happen. That was before Christmas. This is very serious. Healthcare workers are being put in with others who have tested positive for the coronavirus.

Please, Deputy, the time is up.

It is very serious. The Deputy has said the HSE confirmed-----

Yes. It was confirmed to the radio station.

We have to get this reconciled, in terms of getting the truth. The HSE has said it was unaware at that time of any positive case going into the hotel and it did not arrange for healthcare staff with a positive diagnosis to be accommodated in that hotel.

The station was contacted.

We need this matter resolved and reconciled. The Minister for Health is here and I undertake to have this investigated. The Deputy will be contacted about that investigation and be notified of the outcome. As I stated, this needs to be reconciled, in terms of what the actual situation is and what happened. Up to minutes ago, the HSE was saying it was unaware that two positive cases were going into that hotel.

Organisations representing healthcare workers, namely, the Irish Nurses and Midwives Organisation, the Irish Medical Organisation and the Irish Hospital Consultants Association, made presentations to the Oireachtas Joint Committee on Health yesterday, describing what I can only relate is the appalling position of front-line workers in the health service. A properly funded, well-run health service would have struggled with this pandemic but as the Taoiseach is no doubt aware, as a former Minister with responsibility for health, a properly funded and well-run health service is something we do not have and never have had. The only reason we do not have an absolute disaster in our hospitals is the self-sacrifice, hard work and double-shifting of our healthcare workers.

Last night, we saw healthcare workers responding to the third wave of the pandemic on the front line in Tallaght hospital with the "RTÉ Investigates" programme. The same healthcare workers are predicting a tsunami of lack of care and missed care post Covid unless there is a radical change in terms of funding, staffing, recruitment and retention, extra beds and serious resourcing of public health specialists and facilities. We knew before Covid-19 and we certainly know now that the "make do" attitude at the top of the HSE, the Department and successive Governments will not do; it is not acceptable and it must change.

The inability to provide good quality healthcare, regardless of income, is one of the many shameful failings of this State. We are one of the richest countries in the world per capita but we continuously fail to provide for essential needs of citizens. Many issues were raised at the committee meeting yesterday, including a lack of protection in workplaces, where 12% of Covid cases are in healthcare workers. It is still an issue. There is abuse of trainee nurses and the random nature of the vaccine roll-out for healthcare workers because we are not targeting the most affected reasons. There is a lack of testing in hospitals, aside from when there is an outbreak. There is also the issue of childcare. It is appalling that the HSE has said childcare is not its problem and people had to deal with it individually. This must change and there must be a childcare allowance for healthcare workers.

I specifically raise the demand from the Irish Nurses and Midwives Association for compensation to its members due to overwork, long shifts, etc. This is in addition to the recent claim from the health service staff panel. In England and Scotland, a once-off payment of £500 has been paid to healthcare workers and in France there has been a payment of €1,500. The key question is about post-Covid leave, respite and a chance to recover from fatigue and burnout. Will the Taoiseach give a commitment, on behalf of the Government, to facilitate this measure and start planning for it now?

I pay tribute to the "RTÉ Investigates" programme last evening, which revealed the extraordinary work of front-line healthcare workers in protecting our people and achieving incredible outcomes for a significant number of patients whom we saw on the programme. Unfortunately, a number of those patients passed on, which was very traumatic for the staff and all those who work in the hospital. It underpins the importance of all of us sticking to the guidelines and adhering to regulations in order to get down case numbers and reduce significantly the pressure on front-line healthcare workers in hospitals and nursing homes. It is a critical effort to get those numbers down and relieve the pressure we saw in last evening's programme.

The programme also illustrated the fillip and morale boost that the vaccination programme provides to staff and front-line healthcare workers in the hospital. The phrase was used that it provided "hope" with an "end in sight" and there was a great buzz around the place when the vaccinations were taking place. More generally, we must say that the only issue impeding vaccinations so far has been the supply from the manufacturers. We are administering vaccines as we get them.

The two priority groupings have been front-line healthcare workers and residents and staff in nursing homes. That is the truth of it. That is what has happened. In many respects, the personnel, all of the clinicians, everybody working in nursing and all of the staff who appeared last evening represent the HSE. From a policy perspective, when the Government did the budget this year, we increased overall resources by about €4 billion. Some €600 million was put in before the budget for a winter initiative, which has yielded results in terms of the flow through hospitals outside of Covid. As I said earlier, 7,000 additional staff have been recruited to the health service and many more will be recruited during the course of 2021. Coming out of Covid, one of the key lessons is that there will have to be significantly higher investment in our health service. The challenge now is to embed the increased levels of investment that we have experienced during Covid, while identifying and evaluating what works, and to make sure that this stays in the base of our health service funding into the future. However, it must be coupled with reform as well.

The idea of a national Health Service Executive has come into its own in the context of the pandemic. A single national entity that could, for example, resource PPE and administer it, operationalise a vaccination programme and deal, in a national context, with countering the global pandemic, has been an important point that we should register and acknowledge, despite all of the criticisms. The outcomes in our hospitals are on a par with if not better than the outcomes in the other European health systems. It is time to acknowledge that, too. While acknowledging criticism and limitations, there are quite a significant number of positives emanating from the performance of our hospitals and acute services, and of the HSE, in the context of a once-in-100-year global pandemic.

I agree with the Taoiseach. The response from healthcare workers has been absolutely phenomenal. However, they have done it through hard work. They have been working double shifts, they are in the hospitals and they have made sacrifices in respect of their family life. In the case of one couple shown in the hospital last night, while one was working the other was at home looking after the children. They then turn around in the following week and do the same again. The fact that the HSE has not given a childcare allowance to healthcare workers is astounding and shameful. It must be changed immediately. The Taoiseach should come to the House today and say that it will be reversed.

Specifically, what I asked the Taoiseach concerned compensation for members of the Irish Nurses and Midwives Organisation, INMO, as well as of the health service staff panel, that is, workers right throughout the health system, and the care they will need after the pandemic. I am not criticising the nurses and doctors. I am criticising the lack of targeted resources going into these areas. Yesterday, it was pointed out that 2,000 beds are needed in the healthcare service. Where is that money coming from and where is it being targeted? We must fight for the workers after the pandemic.

The Government will respond to and recognise the extraordinary efforts that front-line healthcare workers have made. The Government will do that. The precise timeframe obviously has to be considered. We are not out of this pandemic yet. There are just over 1,000 people still in hospital. The numbers are still 25% higher than the April peak. There are 175 people in intensive care. The pressure is still on our hospitals, and we need to get that pressure down. That is why we need to adhere to the regulations. That is why we are in favour of prolonged suppression of the virus to get the numbers down to very low levels and to keep them there. That will inform our approach to the period post 5 March, when there will not be a significant reopening of many sectors of our economy. We will focus on a phased return of schools.

In respect of non-Covid health services, there has been significant utilisation of the private sector deal on this occasion, with up to 2,300 bed nights alone used, and 30% of ICU beds used for non-Covid urgent procedures.

What is the Government doing to compensate workers?

That concludes Leaders' Questions for today.