Ceisteanna ó Cheannairí - Leaders' Questions

There are 500,000 family carers in this State. They provide 19 million unpaid caring hours per week and they save the State €20 billion every year. They do their work looking after vulnerable loved ones with compassion and love and their value is immeasurable. The challenges and the risks they face during the pandemic have increased dramatically.

I want the Taoiseach to listen to the words of Mike Molloy who cares for his mother who suffers from Parkinson’s:

I'm part of an army of hundreds of thousands of people in this country, the forgotten frontline if you like; who do what they do because of the most basic and yet the most beautiful of human emotions, Love. I am a Family Carer!

We may care for different people. In my case it's my elderly mother who suffers from Parkinson's but even though the condition or vulnerability of the person we love is different, our daily lives are similar. From early morning to late at night we ensure that the person we love is well and safe.

This is challenging at any time but the pandemic has made it nearly impossible. The gripping fear we have of the virus somehow managing to slip into our homes through the only few activities...grocery shopping and pharmacy deliveries, that we can and must partake in, is huge.

We live largely like prisoners under some form of house arrest with people for whom the consequence of Covid can easily be serious illness or even death.

Mike goes on to express the heartache and anger felt by family carers at not being given a place in the vaccine roll-out queue. He powerfully outlines the reason why this needs to happen. It is something my colleague, Deputy Cullinane, has raised with the Minister for Health on a number of occasions. The Minister, Deputy Donnelly, has announced that the vaccine allocation groups are to be reconfigured and it is absolutely essential that family carers are given their place as part of this reconfiguration.

The Oireachtas Committee on Health has unanimously agreed to write to the National Immunisation Advisory Committee on prioritising family carers for the vaccine because family carers are frontline health workers and deserve to be recognised as such. Carers employed by the HSE are included in the rollout and it only makes sense that family carers are given their place too.

Indeed, family carers have been prioritised for vaccination, as the Taoiseach knows, in the North. It is high time that we followed suit.

We have all had a tough year, but family carers have walked a particularly hard road during this pandemic. I held a meeting with hundreds of them last week and they told me that the prospect of the vaccine is the light at the end of a long and dark tunnel. They said that it was like a punch in the stomach to be told that they would have to wait to be vaccinated along with the general population. They feel their lives and the clear risks they face do not matter.

Yesterday the Taoiseach referred to the Johnson & Johnson vaccine and described it as a "game changer". Today, I am asking for a game changer for family carers. This means ensuring they are prioritised for vaccination. I ask the Taoiseach to give family carers the certainty they need and to confirm that they will have a place on the priority list to be vaccinated.

I thank the Deputy for raising this issue. I have received very moving correspondence from Mike Molloy. As Deputy McDonald said, he wrote the moving piece about a year trapped in fear. It brilliantly and emotionally captured the enormous stress and strain being felt by family carers and those who care for their loved ones, which in Mike's case is his mother who has Parkinson's disease. Obviously, because of Covid-19 and the ease with which it spreads, those carers must be extremely careful in their lives so that they do not in any way inadvertently spread Covid-19 to their loved ones. The mobility of those carers is impacted. The fear that their loved ones for whom they care will contract the virus is one they live with daily. I empathise fully with the plight that Mike Molloy has articulated and conveyed so eloquently. I share many of the sentiments which he articulated in that article in respect of the need for a global approach to vaccination and his hope that the election of President Biden will in itself bring a greater unity of purpose among the global community in that regard.

Regarding the Irish context, Deputy McDonald knows the national immunisation advisory committee, NIAC, has given clinical advice on the cohorts and the sequencing of who is to get the vaccine first. The first group included residents of nursing homes, the staff in nursing homes and front-line healthcare workers and that is where we directed the volume of vaccines we got in quarter 1, particularly the Pfizer-BioNTech vaccine, which was key. The vaccines went to that cohort. It is now being administered those aged over 85 years old.

The Minister for Health has written to NIAC regarding re-examining that cohort and the sequencing of vaccination for those contained in the group. My understanding is that NIAC will be responding to that query today regarding sequencing those people who in its view should be prioritised for vaccinations. The overwhelming clinical view has been that senior citizens should be the first to be vaccinated because they are the most vulnerable. Equally, however, the Minister and the Government have put that request to NIAC to consider the situation, because we are of the view that those who are immunosuppressed or have particular conditions, like Parkinson's disease and cystic fibrosis, should be prioritised. Clearly, if those people contracted the virus they would be more vulnerable to severe illness and potential mortality. We are awaiting the response from NIAC in that regard, and then the Government will consider further the sequencing and order in which vaccines will be administered.

At the moment we are still very much dependent on volumes of the Pfizer-BioNTech vaccine for the cohort of those aged over 70 years old, in addition to low volumes of supplies of the Moderna vaccine. The AstraZeneca vaccine is being used for the remainder of the front-line healthcare workers to be vaccinated. That is where we are right now. The volumes will increase significantly in quarter 2 and we are awaiting authorisation of the Johnson & Johnson vaccine. I understand that may happen sooner than was originally envisaged, which would give us considerable hope. I am not using the word "game changer" anymore. I used a different word as Gaeilge last night to suggest that life should change with the higher volumes of vaccines coming in and that we should be able to deal in a more timely manner with the many people in the situation of Mike's mother who need a vaccine.

Family carers are among the forgotten people during this pandemic. We must remember they carry out the work they do with little support, and in some cases with no support from the Government. The work they do is unseen. It is hidden away in the privacy of their family homes and they do not get to clock in and out. It is a 24-7. It is a commitment undertaken day in, day out and it is done with a spirit of love and care, as I am sure family carers have told the Taoiseach. The risk they face during this pandemic is enormous. It is just unacceptable that they have been forgotten again and have been left with the general population for vaccination as and when it is possible. That is wrong. I put it to the Taoiseach that NIAC is wrong to have left family carers in that position. As Head of Government, what does the Taoiseach propose to do about this situation? Does he agree that family carers must be recognised and that they need to be given their place of priority in the roll-out of this vaccine?

I genuinely regret the politically-charged manner in which the Deputy is presenting this issue. I did not think that the Dáil on its own was going to decide on who gets vaccinated first, in a political way. To juxtapose the vaccination programme so far with suggesting that 500,000 people are the "forgotten people" is wrong. No one here wants to forget anybody regarding vaccination. The Government's agenda is to vaccinate as many people as quickly as we possibly can, which is dependent on getting the requisite volumes of vaccines into the country. That is our objective, like everybody else's in this House. I am not forgetting anybody in respect of vaccination. I do not think that charge should be made. There can be wider political issues around supports for carers, and the Government has provided a whole range of supports for carers.

Regarding the vaccination programme, however, of course we want to vaccinate those who have been prioritised on medical and age grounds. Why? We want to do that because the vaccines prevent severe illness and mortality. The evidence base so far from doctors and public health clinicians is that senior citizens in nursing homes should be first and then the front-line healthcare workers dealing with Covid-19 in their daily interactions on the front line. Regarding many cases, we have said to NIAC to reconsider the cohort. We have formally written to it regarding those people with conditions and those who are more vulnerable to falling victim to the virus in terms of severe illness or mortality.

In an interview in last Sunday's The Sunday Times, the Taoiseach said that, "The government will introduce retrospective contact tracing of Covid cases for the first time once daily case numbers fall to manageable numbers". He went on to say that he believed that, "a robust approach to tracking the infection pathways of each case of Covid-19 backwards from the point of diagnosis [...] will help to suppress the [virus]". It is quite extraordinary that is only talking about that approach at this point. Some 12 months into the Covid-19 pandemic, the Taoiseach is talking about tracking down where the virus is being transmitted. Some of us have been asking for that to be done for a very long time.

Retrospective tracking and tracing, of course, goes back 14 days, it establishes where the virus was picked up, whether it has come from abroad and if the transmission occurred in restaurants, family gatherings or workplaces, for example.

It is absolutely essential information for the management of a pandemic. NPHET called for that last August. Who does the Taoiseach think is going to do that work? It is essential work, but who is going to do it? Public health doctors are the people who have the expertise to carry out this work. We should, of course, have a properly resourced public health doctor service but unfortunately we do not have that at the moment. Properly resourced public health doctors are an important part of any health service but in a pandemic they are absolutely essential. Yet this service has been starved of funding for many years.

Public health is the only discipline in our health service that does not have the grade of consultant, in spite of having exactly the same qualifications. If the virus numbers are to be brought down and brought under control, a fully staffed, consultant-led regional public health team service is absolutely essential. Will the Taoiseach explain what is the delay in addressing this issue? Three major reports have recommended an upgrading of that service: the Scally report from nearly three years back; the Crowe Horwath report in December 2018; and last year's nursing home expert panel recommendation. Everybody is saying it is essential that a properly resourced public health service is put in place. Is it any wonder that doctors will not come back to work in that service here? Is it any wonder that other countries are recruiting our public health doctors? What will the Taoiseach do to resource this essential service properly? The Taoiseach has been making promises for a very long time and yet no action has been taken. Can the Taoiseach tell us when he is going to do this?

I thank Deputy Shortall for raising the issue. When the pandemic began, testing and tracing capacity within the country was virtually non-existent, in terms of the requirements to combat a pandemic. It was literally built from scratch. The Deputy is correct that for quite a number of years there has been a lack of resourcing of public health medicine in general. The Deputy will know that from her own time in government as well. I support what she has just said. In my view, very rapid progress has been made in developing a testing and tracing capacity, and particularly from the summer onwards, so much so that our testing and tracing capacity more generally is up there in the top tier of the European Union member states. It is a more independent workforce now than at the start of the pandemic when a lot of people were redeployed, of necessity, to engage in testing and tracing.

In relation to public health, the resources have now been provided in the budget. Resourcing has been provided to the HSE to recruit personnel and to double overall the staffing within the public health domain.

I agree with the Deputy on the need for a consultant-led approach to public health. A consultant-led public health model is a priority of the Government. There have been ongoing discussions between the Department of Public Expenditure and Reform and the Department of Health, and also involving the unions and the partners. I hope that those would be brought to a conclusion quickly and that the process would conclude in terms of the consultant issue in particular. The plan is to double the current workforce in public health, including an additional 255 permanent staff at an annual cost of more than €17 million. This was included in the €4 billion allocated to Health for 2021 - €2 billion for Covid and €2 billion for non-Covid - which allows for the embedding of a permanent workforce in a number of areas into the future. It is not just a pandemic era investment in public health; it is for the long haul. Engagement has commenced with the Irish Medical Organisation. There are issues, while doing this, so that we also reform the public health model in line with Sláintecare. A lot of work has been undertaken by the Department and the HSE in terms of a detailed framework for the future public health model. That, of course, includes consultant level roles. That engagement has begun between the IMO, the Department and the HSE going back to January. I have asked that this would be brought to a timely conclusion. The Government is committed to doing this.

It is disappointing for the Taoiseach to portray this as engagement that began in January. This has been recommended for 15 years. Three major reports have recommended it. Since last summer, various Government spokespersons have been saying that we are nearly there and nearly reaching a conclusion. The Taoiseach drove public health doctors to the point of threatening strike action in January because of his failure to respond to this need and to actually take action on it. That strike action was called off at the last minute on the understanding that the Government would actually deliver on its promises. It still has not happened. Is the Taoiseach going to force those doctors to the point of strike action again? How long do they have to wait for action from the Government? People are fed up with these promises. This is an essential service. It should, of course, be properly resourced. It is critical that it is properly resourced when we are trying to respond adequately to a pandemic. Will the Taoiseach give us a timescale on when agreement will be reached and when funding will be made available to upgrade those doctors? They have the same qualifications as every consultant in every other discipline of medicine. Why will the Taoiseach not do this? Let us not have public health doctors going on strike in the midst of a pandemic. It would be unforgivable.

The Deputy is correct that this has been going on for 15 years, but this is the first Government that has allocated the necessary funding required to action it and to give concrete reality to all of the reports and aspirations. This Government has decided to do that and this Government has allocated the funding. The issue now is structure, framework and how it is done for the future. It must be done properly with a view to making sure not only that we have a heavily resourced service, but also that we have a very well worked out and high-quality public health service into the future that is expanded significantly on what we have today. Yes, the public health doctors are working under significant pressures and constraints right now. Of that there is no doubt. I thank them for the work they have been doing. There is engagement with the unions and their representatives. This will have to intensify. From our perspective, and from my perspective as Taoiseach, this needs to be brought to a timely conclusion.

From 2017 to 2020 Kerry County Council delivered 159 units of housing. These houses are built to an exceptionally high standard by local builders in good locations. From 2021 to 2022 Kerry County Council, under the stewardship of our CEO, Ms Moira Murrell, and the director of housing, Mr. Martin O'Donoghue, plans to deliver a further 278 units. As of November 2020 there were 2,183 households qualified for social housing in Kerry, more than 80% of which are waiting for one-bedroom and two-bedroom style housing units. Over the next two years more than 40% of Kerry County Council's new builds will be one-bedroom and two-bedroom housing. Kerry County Council could do a lot more if given more resources. It could construct further housing. It could buy housing units that might become available from the private sector if they could be bought at a prudent and affordable price, which might actually be a lesser price than it would cost to build new. In other parts of the country, one might hear other politicians from all sides of the House objecting to houses in their constituencies. In Kerry, we need housing and we want it. Our politicians are all of the one voice. Our local authority members and county councillors, from all parties and none, are of the one voice.

They want to take care of the housing needs of the people of Kerry which are immense. In a county the size of Kerry to have 2,183 people awaiting housing is not the fault of our local authority. Whenever the Kerry County Council housing department has been given funding, we spent it expeditiously and got value for money, either through purchasing or new builds.

As I always say, Kerry is better than everywhere else. We have better building contractors than anywhere else. We have extremely efficient local builders and companies that employ local people which in turn generates money for the local and national economy. I ask the Taoiseach to take into account that we must focus. Great strides have been made on three-bedroom houses and other such family units. We now need to concentrate on one-bedroom and two-bedroom accommodation in County Kerry to take care of the great need we have.

I thank the Deputy for raising a very important issue, one on which I share his thoughts. He knows that as a humble Cork man, I have always been a great admirer of the literary creativity and innovative character of Kerry people. I have been in awe of the genius of the Kerry DNA for a long time, as a neighbour across the county bounds.

The Government has a target of 255 direct builds in County Kerry and 70 leases for 2021. If the Deputy can go back to Kerry County Council and it can do more, I will talk to the Minister for Housing, Local Government and Heritage who really wants local authorities to come back to him saying they can do more. The more shovel-ready projects on housing there are, the more responsive the Government will be in getting them done.

The Deputy is right; the housing lists are too long. Too many people are waiting too long for social and private housing. It is a crisis that has been compounded by Covid, meaning that for the moment construction has slowed down considerably. There is a big budget this year for housing. We will be responsive to what the Deputy has just said regarding the capacity of the council to do more than the targets. It is a target at the moment; the council allocation is not a capped at 255. Last year the Minister cut through a significant amount of red tape by introducing a single-stage process with up to €6 million which will help accelerate delivery. It means that the local authority can devise projects up to that scale without needing to get sanction from the Department at every stage.

Kerry County Council may have more capacity in terms of voids. Last year the Minister allocated €56.4 million to bring 3,607 vacant homes back into productive use across the country within the social housing stock. That was the highest ever yearly spend on voids and the highest number of homes to be refurbished under the voids programme. It was done under the July stimulus programme. Kerry County Council got approximately €991,000 under that voids programme. That enabled the refurbishment of about 50 extra social housing units for the purpose of re-letting them out to individuals and families on the list. We expect similar measures this year on voids across the country, including in Kerry. Again, the Deputy could alert his local authority to that allocation. We need to make up lost ground now because of Covid-19 which was unavoidable.

I appreciate the prioritisation the Deputy is giving to this issue. We are open to any innovative schemes. For example, I note that in some instances, houses are falling by the wayside for various reasons. I do not understand why we cannot sometimes intervene to acquire a house and refurbish it. It might have been idle for a year or two and getting into disrepair. We have all passed them on boreens and roads throughout the countryside and they would make fine homes for people. We are very much open to respond to initiatives from the local authority.

I welcome what I consider to be a very positive and sound response from the Taoiseach. It certainly will be relayed to the management of Kerry County Council. When we are talking about statistics, I like to humanise them. We have 770 males and 422 females. We have 336 females with a dependant and 98 males with a dependant. We have 165 couples. We have 298 couples with dependants or two or more adults with or without dependants. These are all people who need housing and that is why it is right for us to raise the issue here today and to talk about it.

I use the opportunity to thank several people who go above and beyond the call of duty every day in our local authority. I refer to the people who work in our housing department, including the clerk of works who oversees projects on the ground, the engineers working in the housing department, and the ladies and men who deal with the processing of housing applications, disabled persons grants, essential repair grants and mobility aids grants. They know every day when they answer the phone, they are dealing with a human being who needs help. I thank the workers in the housing department in Kerry County Council. I also compliment the private contractors, their foremen, workers, subcontractors and tradesmen who work to very high standards and whose work also deserves to be recognised.

I thank the Deputy for his affirmation of all those who work in the housing department in Kerry County Council and in the construction industry more generally. Yesterday I met representatives from the industry to discuss the degree to which they have developed innovative approaches to safety in the workplace, particularly during the Covid pandemic. The return-to-work protocol became the benchmark for other sectors. The unions were particularly proactive in that regard and made a very positive contribution to that forum under the Labour Employer Economic Forum, LEEF, process which is a very good example of partnership.

The Deputy spoke about the need for one-bedroom and two-bedroom units. At the moment we are making some progress in taking families out of homelessness, but overall the majority of those who are homeless are single people. We need to accelerate very significantly the number of one-bedroom and two-bedroom units across the country. That would help many single people or people with smaller households to secure housing. There is a need for much more of that type of provision to deal with homelessness in an effective and critical-mass way and also then to deal with the wider issue of the social housing list.

Baineann mo cheist leis na hionaid máithreacha agus leanaí. Is féidir a rá d'aon ghuth nár caitheadh go maith leis na máithreacha ná leis na leanaí seo agus nár taispeánadh meas riamh orthu siúd a bhí ann. Ghlac an Taoiseach céim shuntasach breis agus mí ó shin chun fáil réidh leis an dímheas sin nuair a thug sé leithscéal ar a shon féin, ar son an Rialtais agus ar son mhuintir na tíre do na máithreacha agus do na leanaí. Cheap mise gur chéim iontach a bhí ann chun fáil réidh leis an dímheas. Faraor ghéar, táimid ag leanúint ar aghaidh ag caitheamh anuas ar na máithreacha agus ar na leanaí seo. Baineann mo cheist le taifead na fianaise atá scriosta.

Just over a month ago the Taoiseach took a very positive step by apologising and for the first time taking a step away from the terrible disrespect, to put it mildly, that was shown to the mothers and children in the various mother and baby homes. Trust is of utter importance and the Taoiseach's apology was the start of that. Since then on every level that trust has been repeatedly broken, specifically regarding the evidence that was given on the audio tapes. I raised this with the Taoiseach as have other Deputies. I would like a very clear answer from the Taoiseach today as to why that evidence was destroyed. Can it possibly be retrieved? I ask the Taoiseach to publish all the correspondence between him or the Minister and the commissioners on this matter.

Please do not tell me the commission is independent. More than anyone else, I am acutely aware of the independence of the commission. This has nothing to do with its independence. It has to do with the way it works.

Page 11 of the report states clearly that the commission destroyed the evidence and that this was always understood. That may well be but based on what most Deputies have heard, none of those who came forward understood that. Nowhere in any of the documentation that I carefully scrutinised before standing up here today is that made clear. I tried to table questions on this through the system for ordinary Dáil questions and they were ruled out of order. I appeal to the Taoiseach today beart a dhéanamh de réir a bhriathar and to take some meaningful action to give meaning to his apology. I ask him, first, to tell us what exactly the commission has said in this regard; second, to publish all of the correspondence; and third, tell us how this could possibly have happened. People came forward to give evidence, took their courage in their hands, believed in the system once again, or tried to believe in it, and are left now in a situation where there is no recording of their evidence. That was done on the basis that the commissioners knew best and were trying to protect them, with no evidence that this was communicated to them in any manner other than the commission's word.

Aontaím leis an Teachta maidir leis an méid dímheas a léiríodh do na máithreacha agus na leanaí a bhí sna tithe seo i rith na mblianta agus ó thosach. Is olc an scéal é ar fad ar fad agus níl aon dul as sin. Dá bhrí sin, caithfimid uile ár ndícheall a dhéanamh sa lá atá inniu ann ardmheas a léiriú do na máithreacha agus na leanaí, agus gach aon ní gur féidir linn a dhéanamh. Sin an fáth go bhfuil an tAire ag déileáil leis na grúpaí atá ann agus leis na daoine atá fós ag maireachtáil chun cóir agus tacaíocht a thabhairt dóibh agus, mar aon leis sin, níos mó a dhéanamh chun eolas a thabhairt dóibh maidir leis na records agus mar sin de.

Specifically, the Minister has written to the commission in respect of the audio recordings and tapes that were destroyed. The Deputy is correct that the commission says it guaranteed anonymity at the time and that, as part of that, it decided to destroy the records. The commissioners are saying that they made that clear to the survivors. However, I spoke to the Minister this morning and we noted that in the leaflets that were issued to the survivors there is no reference to the destruction of tapes at all or that tapes would be destroyed. The Minister has written to the commission asking if it is in a position to retrieve the tapes or if there is some technological way of doing so. He has not, to my knowledge, gotten a response yet.

My understanding is that the commission is engaging with the Data Protection Commission on this issue and parallel to this, the Minister is very anxious to be in a position to get the archives from the commission in order that he can accelerate access to personal information. People may request their own personal information or the rectification of records and the Minister is anxious to facilitate that as quickly as we possibly can. That is something that is part of this process as well. The Minister was eager, prior to this emerging as an issue, for the archives to move over to him in order that he could give people access to valuable personal information, which is a very basic and urgent request, and for the right to rectification under Article 16 of GDPR to be vindicated and facilitated as well. He is awaiting a response to that correspondence and I will speak to him about his capacity to publish it. That is essentially what he has written to the commission about these tapes. Meanwhile, he is working towards the legislation on information and tracing, which will be ready by the end of March or early April and the interdepartmental group will report on redress by the end of April.

The purpose of an apology is to give meaningful action. A commission has destroyed evidence and yesterday the Minister told the Joint Committee on Children, Disability, Equality and Integration that the commission has said there is no way of retrieving it. Did he not make the Taoiseach aware of that letter? Second, I am asking that all of the correspondence be published. Third, we have again an imbalance of power. We have the powerful telling the powerless what they think is in their interest and that they should be protected by getting rid of the tapes. I see no basis for getting rid of the tapes. In fact, all the tapes from a previous commission on child abuse were preserved. At this point, there is absolute urgency. As the Taoiseach knows well, the commission comes to an end at the end of the month. We want clear answers. I ask him please to stop giving me filling in pieces and specifically to tell me if the correspondence will be published and what action he will now take in view of the fact that the evidence cannot be retrieved. People went forward, took courage in their hands and gave their evidence and now we have a summarised version of that evidence by commissioners who see nothing wrong with that. The report was leaked and the Taoiseach promised an investigation into that but we did not get that either. I am conscious of time but this is a really serious issue. I ask the Taoiseach please to give straight answers and to stop telling me about anything else. This is one specific issue. How did this happen? On what basis did it happen? Did the commissioners look at precedents from previous commissions where the evidence was preserved? I ask him please to publish the correspondence.

I do not know how it happened.

The Taoiseach should know.

I should not, actually.

He should, by now.

I am not a member of the commission. The commission decided to do this and I do not know why it did so. It is making assertions that it did this on the basis that it guaranteed anonymity to those who came forward. No member of Government was involved obviously in the commission's work, as the Deputy knows. That is important, because the impression is being given that the Government could do something now about how the commission operated; it cannot. What the Minister has done is written to the commission. The commission is saying it is irretrievable but the Minister is still pursuing it from a technological perspective to see if it can be retrieved in some form.

The decision was taken by the commission in advance of the publication and so on. I will be very clear. The Minister has written. Unfortunately, there are limitations to what the Government can do here and the Deputy knows that. The Government is very focused on what it has committed to doing as regards access to information, information and tracing legislation, reporting on the redress situation by the end of April and other matters. The Minister is also engaging with the Attorney General right now to see what further measures can be taken and to see if he can indeed effect the retrieval of these tapes or a reconsideration of this matter by the commission.