Covid-19 Vaccine Roll-out Programme: Statements (Resumed)

Everybody in this Chamber, all of our Deputies and all of our Senators desperately want this vaccine roll-out to be delivered as soon as practically possible to our people across the State. We are all in this together. We really desperately want this to succeed. Therefore, the Minister should take my comments in the time ahead constructively.

When I saw the list of vaccination centres across the country, I saw one vaccination centre in Letterkenny, and the Minister knows the geography of Donegal. We then learned there would be two vaccination centres in Kerry, which has a similar population, in Tipperary, in Westmeath and in the Minister's own county of Wicklow, and five in Cork. When I questioned this, I was told that GPs and pharmacists will be delivering this. Why is just one vaccination centre in Letterkenny enough for the entire county of Donegal when there are two or five in other counties? That is the first issue.

The next issue is that I am told the GPs will be delivering this. The GPs in Carndonagh, a town on the Inishowen peninsula which I represent, were without the vaccine to deliver to their patients in recent days. We understand the vaccine is on the way soon, but it has caused great distress. I got a telephone call today from an 89 year old woman. Her vaccination was booked and then cancelled. She does not know when it will happen. GPs are speaking out across the State. As we speak, there is a real problem with the logistics, whatever about the supply issues. Will the Minister reassure the people of Donegal? The Minister will appreciate that people are looking across the nearby Border, which is obviously under the different regulatory system of the UK, and seeing that the North might open months ahead of society in Donegal. What assurance can the Minister give them?

The Deputy's questions are absolutely appropriate to the people he represents. The short answer on the vaccination centres is that they were operational decisions of the HSE based on population analysis. If it is the case that a second, bigger vaccination centre is appropriate for Donegal, it will be set up. I will give a commitment to the Deputy that I will ask the HSE after this debate to take a second look at Donegal specifically and see if it is warranted. The point the Deputy made in his question, however, is the answer. Every GP clinic and every pharmacy will have the opportunity, and they might not all opt in, to be part of the vaccination programme. Nearly every GP clinic is part of it. Every town and most villages across the country will have options. Most of us will never go to one of these mass vaccination centres. We will simply go to our local pharmacy or GP, get one or two jabs in the arm and then go home. That will be it, and particularly through April as we seek to scale up to approximately 250,000 per week. That will be much more common, so it will not be the case that people will have to travel from Inishowen to Letterkenny or further south.

With regard to the GPs, I know they have been contacting Deputies and have been on the media. There is frustration. Part of the frustration is because it is a three-week programme. Some GPs got their vaccines in the first and second week while GPs quite close to them are only getting them this week. That was due to various operational reasons. It caused a certain amount of frustration, and that is partly unavoidable. There has been repeated contact with the entire GP cohort across the country, but I understand why a GP would say that the GP down the road got the vaccines two weeks ago while that GP's patients are still waiting.

I only have 30 seconds left. The Minister mentioned pharmacists. All the Deputies in Donegal have been contacted by the pharmacists in Donegal. They say they need to get the vaccine for their workers. They are front-line health workers and have been carrying major responsibilities. The pharmacists want to deliver and play a big role in the roll-out of the vaccine, but they are asking if their staff can be vaccinated as well.

Acting Chairman (Deputy Bernard Durkan)

The Minister has only three seconds.

I will get the Deputy a written response.

Could I get it verbally?

It is just ten seconds.

Acting Chairman (Deputy Bernard Durkan)

The Deputy should think about that beforehand. However, I will give the Minister ten seconds.

First and foremost, the pharmacists are being vaccinated because they are front-line healthcare workers. It is more complex when it comes to other people working in the pharmacy, but if they are deemed to be within the cohort of front-line healthcare workers based on a detailed set of protocols put together by the HSE, they would be included.

Acting Chairman (Deputy Bernard Durkan)

Deputy Shortall has six and a half minutes.

I will put my questions quickly and, hopefully, get the Minister's response. I agree with the point made by earlier speakers about the need for transparency. That is very important. All the information relating to the number of vaccines that are delivered here, the number available, the number being held back and the number administered should be public information. Everybody understands that the supply is volatile. The more open the Minister is about that, the better. People can then understand the situation. We had to wait until the last few days, when we received a reply to a parliamentary question from Deputy Catherine Murphy, to find out how many vaccines had been delivered up to the end of February. We should have that information on a daily basis. Instead it is weekly. Every time the Minister has come to the House I have asked him to make that information available, and I am asking him yet again. Will he issue the daily figures for the vaccines? Everybody would know where we stand. We would also be in a position to assess the performance of the programme, which we all should be entitled to do. Data is essential for that.

On that basis, an interesting and concerning figure has emerged. More than 40,000 doses of the Moderna vaccine have been delivered, yet up to the end of February only 9,300 of those were administered. Does the Minister know the explanation for that? Why are we using only one quarter of the Moderna vaccines?

Can the Deputy give me those two figures again?

Yes. With regard to the Moderna vaccine, the Minister said that 40,200 doses have been delivered to this country up to the end of February, yet before 28 February only 9,300 were administered. I do not know if the Minister can give me an answer today, but perhaps he will provide it to me as soon as possible. It is puzzling why that is the case.

My next question relates to what will happen when we get large quantities of vaccine. We know that 1.2 million to 1.3 million doses should be coming into the country in each month of April, May and June. We are currently administering an average of 12,500 doses per day. If 1.2 million to 1.3 million vaccine doses arrive from April, we will have to ramp that up to approximately 40,000 vaccines per day. That is a huge step up, and it is due to happen only four weeks hence. I and others would like to know what centres will be used, who the staff will be and if they are ready to roll as soon as April. Will the Minister publish a plan for the centres to be used and the staff, so we are in that position from 1 April?

The next question relates to representations we have received from the Irish Cancer Society regarding the reordering of the priority groups. In that reordering, the position of people under 64 years of age who are at high risk of severe disease has not changed. They remain in category 7. The Irish Cancer Society is concerned specifically about people with haematological cancer who have not been brought up to category 4. The society says that there is a comparable risk of death for those patients. Perhaps the Minister would clarify that. If he could send me a note on it, I would appreciate it.

The next point relates to messaging. About three weeks ago, the Minister said the vaccination of people over 70 years of age was starting. He referred to that programme again today. When the Minister says it will start with people over 70 years of age, those people expect they will be getting the vaccine shortly. However, there are sub-categories within that. It would be much more helpful if the Minister just broke it down and said vaccination was starting with people over 85 years of age or with people over 80 years of age, because it will be some time before people between 70 and 75 years of age get their vaccines. Again, the Minister should be clear about the messaging and not raise people's hopes that they are going to get it soon. There should be a little more clarity about the time the different age cohorts or different cohorts generally are likely to get the vaccine. It would be helpful if those types of forecasts could be provided.

The deliveries to date have now been published. The Deputy will be able to get them on her telephone now or after the debate. I have asked the Department to provide regular updates. I believe daily updates could lead to a great deal of anxiety. One could see 80,000 arrive in on a single day and if one just took that day, and there are some people who will use the information to try to undermine the programme, it would like there was a huge gap.

Let me just think through that. I certainly agree that regular updates would be very useful. I ask for the co-operation of the House if that is possible. I gave the September figure and when the AstraZeneca figure changed people were saying we may not meet the September figure. I was accused in the Chamber of over promising. I was accused outside of the Chamber of making false promises, which essentially is being accused of lying. In fact, all I was doing was providing exactly what everyone is very reasonably asking for, but in the context of the fact that these figures will change. All I ask, if possible, is for the co-operation of colleagues in that.

With regard to Moderna, I believe those are not the figures. I understand that quite a significant amount more than that has been given out. I will double check and get a detailed note on it for the Deputy.

It is on the data hub.

Let me take a look. The last time I checked the majority of the Moderna doses had gone out. We will look at that.

On the April date, there is absolutely a lot of focus on this. We are going from 86,000 this week up to, hopefully if the supplies come in, 250,000 in four weeks' time.

What about the plan-----

The plan has been published. We have the 40 vaccination centres, which are the 37 centres and the three GP hubs, and the pharmacies and the GP practices. I will get a more detailed note for colleagues on exactly that. I will also revert to Deputy Shortall in writing on the rest.

Next is the Government slot and Deputies Cowen, O'Connor and Alan Farrell will share 11 minutes. Do the Deputies wish to divide it up into three separate sections for reply of two and a half minutes? Is that agreed?

It can be nine and two one minutes. No, four and-----

Whose mathematics is that? We will play it by ear.

It is not very often I get an opportunity to speak on this issue. I want to use the brief time available to me, on behalf of myself and my constituents, to convey again my great thanks and appreciation and to commend key workers across the country for their ongoing dedication and commitment to their roles, which has allowed us to be in a position to respond effectively and to deal with the recent onslaught. I am especially mindful of the healthcare workers in care settings, in homes and in our hospitals and of the doctors, nurses, care assistants, cleaners, porters and everybody associated with that mammoth effort that has saved many lives and who helped and assisted those who passed on to the next life in the absence of their families. We commend these workers and appreciate them. I hope in a post-pandemic atmosphere that the Government will be in a position to build on the alliances and relationships it has had with the private sector in its bid to help and assist in meeting the demands of the non-Covid setting and the non-Covid care that is required thereafter and the huge waiting lists.

Data on vaccines, and the scientific evidence from those countries with more advanced vaccination programmes to date, is encouraging. Of course it is a great source of help and hope to many of us and our wider population. That is despite the great frustration, anxiety and fear that exists. It is despite the acknowledgement of the mistakes and mixed messaging associated with our programmes over the last months. They accept that in the knowledge and expectation of learning lessons from those mistakes.

I specifically want to comment on and question the result of the huge and profound commitments made by the Minister, the Taoiseach and the Government, which of course we welcome, that 80% of the adult population can and will be vaccinated by the end of June. The commitment, the expectation and the belief on foot of those commitments that up to 250,000 vaccinations per week will take place in the coming weeks and months is of course to be welcomed. It offers hope and light at the end of a very dark tunnel, which was a lot longer than we expected when we stood in the Chamber one year ago with this problem in front of us.

Those commitments were surely made against the backdrop of knowledge and information via NPHET, via NIAC, around supply issues, vaccination roll out and logistics. Yet, we see some problems in the GP roll out. I hear the explanations emanating from the Minister and others and I hope that is resolved soon.

I am sorry for interrupting, but does Deputy Cowen wish the Minister to reply to his individual-----

If he can, or if not in writing thereafter.

There are seven and a half minutes left in the slot and there are two more speakers.

Yes, but the Acting Chairman has interrupted me for a minute there.

I could not resist the temptation.

There is a commitment on the other cohorts, one of which was mentioned by the Minister today, which thankfully we will see next week. All I ask is for consideration to be given, considering that huge and profound commitments have been made, to a means and mechanism by which indications can be given on start dates for the 15 different cohorts. All that I and my constituents want, when they contact me or anyone else in government or any Member, is for us to be able to say to them their cohort is due to commence vaccination on such a date. If it has to be amended, then so be it, but that is the sort of simple and easy to relate information that we would like to see emanating from the processes we engage in, such as this.

I thank the Minister for coming before the House. I welcome the move by the Department and by NIAC for immunosuppressed individuals across the State. That was the right decision. I do not want to perpetuate some of the doom and gloom from the course of this debate, but I thank the Minister for that because it was absolutely necessary. Deputy Shortall referred to the issue of providing clarity for persons under the age of 70, for example. The scenario at the moment is that people between the ages of 65 and 69 who have no conditions are in cohort No. 6, while some younger people who are high risk are in cohort No. 7. Will the Minister please clarify that?

I did a straw poll in my constituency on how GPs felt about it. From the feedback of seven or eight surgeries we contacted today, all but one had a complaint. That was about their administrative staff not being vaccinated. It was my understanding that they were to be vaccinated. We will provide them with clarity on that and perhaps the Minister will comment. In general terms they stated that their position on the information that was made available to them was a qualified "Fine". I think that is a compliment so I will take it as such.

I appreciate all the responses given by the Minister to my colleagues over the last hour. As Deputy Cowen said, it is necessary for us to recognise that when we have this vaccine in stock it is provided to citizens across the State and that there is very little vaccine sitting in fridges. That is to be welcomed. More than 9,000 individuals have been vaccinated in the State, presumably in addition to other personnel. I do think we will be able to hit those targets of 250,000 per week a month from now. This is welcome.

The Minister may wish to comment on the fact we are being constantly benchmarked with the UK, which is very unfortunate. Are there lessons to be learned from the UK procurement process about when the vaccines were ordered versus other nations such as the US and the UK, who we have always looked to? It is only right that we should address that.

Does the Deputy want answers now?

If I could have an answer to the question on cohorts Nos. 6 and 7, and then maybe a general comment.

There are three minutes and 45 seconds left in the slot.

How long have I got to answer?

The Minister has not very long. There are three minutes 39 seconds left in the slot now.

I will be very quick.

I will first address the query on cohorts and I will revert in writing on the rest.

The short answer on cohorts 5, 6 and 7, and it is a fair question, is that they are in that sequence because NIAC has determined, using the clinical evidence available, that that is the prioritisation of risk in terms of vulnerability. For example, the Minister of State, Deputy Butler, has just pointed out that 93% of fatalities in Ireland to date were people aged 65 and older. Unfortunately, age is a very strong determinant.

I thank the Minister for being here. On the issue of vaccinations, I want to use this opportunity to highlight the extreme frustration being felt by many people who were expecting to be vaccinated in the past number of weeks. Our office has been inundated with calls from people who want to know the status of their vaccination and when they will get the vaccine. I understand there was some concern in the east Cork municipal district - the Midleton local electoral area to be precise - about that. I ask the Minister to focus on that area. Out of respect for the officials who I know are under enormous pressure I did not want to put down parliamentary questions as per the request from the Department.

We spent a lot of time developing the Covid app which people could use to indicate if they were or were not symptomatic but that app could be utilised much more than it is currently now that we are trying to figure our way out of Covid over the coming months. Hopefully, we will be in a situation by the end of the year where the worst of the pandemic will be behind us. We could utilise that app and put proper planning in place in the next number of weeks when a larger quantity of vaccine will be available to people to inform them exactly when they can expect to be vaccinated. We have seen that being done in other countries and there is a real and interesting opportunity for Ireland to do that, as the leading technology country in Europe. Some of the largest multinational companies in the technology sector are located a couple of hundred metres from where we are sitting in this Dáil so there is no reason we could not lead the fight here on that. I would like the Minister to comment on that.

I want to pay tribute to the Minister of State, Deputy Butler, who is doing an enormous amount of work in her portfolio. She deserves great credit because she has been a shining light in this Government. I wish her every success in her role, which is critically important to the older people in our community.

I thank the Deputy for his very constructive ideas. I will engage with him. If he would like to meet up or send me something on exactly how we might use the app that would be great. We were a world leader in terms of the app. I believe it was the first multijurisdictional app anywhere in the world and I would love to see it used more. As he knows we have put the number of doses administered onto the app so if the Deputy has ideas about how we could expand its use I would love to hear them.

In terms of those aged 85 and older, there is no question that there has been anxiety because some GP practices got their doses in week one and some of them got them in week three. It was always going to be a three-week programme and there is a minor spillover of about 65 practices that will get them next week. We have to acknowledge that that has caused anxiety. There is no question about that. All I would say is that while we must listen to and respect the anxiety of those who did not get the vaccine exactly when they thought they would get it, we should also bear in mind that the silent vast majority in this case have got it and it has gone very well. However, we must make absolutely sure that we get it right and that we listen very carefully to those criticisms and constantly do better.

I am sharing time with Deputy Barry. We all acknowledge that the roll-out of the vaccine is logistically extremely challenging so we wish those who are on the front line of the vaccine roll-out well because this will get us out of the pandemic.

I raise an issue with regard to the revision of the vaccine schedule which was conducted last week. That was very welcome to those who are immunocompromised, particularly in terms of underlying conditions. Many people had great hope that the revision of the schedule would put them in cohort 4 of the vaccine strategy. I speak about those who have cystic fibrosis in this country. Unfortunately, a distinction has been made between severe and stable cystic fibrosis. Those who have severe cystic fibrosis have been put into cohort 4 rather than cohort 7 but those who have stable cystic fibrosis are still in cohort 7. That does not make sense because there are 800 adults in Ireland who have cystic fibrosis so splitting them into two different cohorts does not make sense. I call on the Minister, NIAC and the powers that be to consider reviewing the position of those who have cystic fibrosis because there seems to be a type of apartheid approach to that condition. Those who have the condition are very keen to get access to the vaccine as soon as possible. I call on the Minister to use his power, as Minister for Health, to review that position.

How much time have I got? Is the Deputy sharing time?

There are two minutes for Deputy Mick Barry.

I fully appreciate where the Deputy is coming from on those with cystic fibrosis. As he said, it is a relatively small cohort. NIAC looked very carefully not just at conditions but at the range of conditions and it had to make clinical judgments based on the impact that Covid appears to have on those groups. It did that with cystic fibrosis. It has identified different severities of cystic fibrosis and put them in as very high risk or high risk. It has done the same on obesity, diabetes and across different diseases and underlying conditions. It was trying to identify those at very high risk. When Professor Butler and I were presenting some of this, she was asked a very similar question to the one the Deputy has asked. From memory she said that the international evidence was that the severity of those with cystic fibrosis in the high-risk group was less than one might have originally thought, which is good news. The only reason the group was split was on the basis of how vulnerable they are to the disease. I can assure the Deputy that NIAC will keep that under constant review and if new evidence emerges on cystic fibrosis or other underlying conditions we will be updated accordingly.

I was sent up to this place by the people of Cork North Central to give voice to their opinions and concerns, which is an important part of my job. The people on the ground feel that they are doing a hard shift. For many, lockdown number three is the toughest of them all but the vast majority of people are sticking with the guidelines and to the plan. There is some scepticism about the vaccine and there are some people who say that they will not take it but my sense of it is that the vast majority of people will decide to go with the vaccine. They are hoping in their hearts that the vaccine programme will work and deliver. I believe it can and I would encourage everyone to take that vaccine because it can save their life.

People heard the Taoiseach saying that the only delay factor or problem that we will be dealing with is on the supply side. AstraZeneca did not deliver last week. I was concerned to hear the Tánaiste say that we will get it back at the end of the month. I was hoping that it would be next week or the week after but I will leave that to one side. There are issues now with communication.

Does the Deputy want the Minister-----

No. I am making a statement. We all heard the story today about the Connemara GP racing around in the dead of night getting the needles and syringes because he was informed of the delivery at the very last minute. Leaving that aside, the story that is heard across the country and that I have heard in Cork North Central is of the old people who were asked to go to their GP surgery.

There is excitement about the big day, they arrive in the morning and the vaccines are not there because the GP surgery has been told at the very last minute. Then there is upset and disappointment. People were hoping for better from the situation. There is room for improvement here. We are not talking about AstraZeneca; we are talking about communications for which the Government and the HSE are responsible.

I have 12 seconds left so I do not really have time to ask a question. I wish to register the point that people are watching this situation in desperation in some cases. People are willing to make it work, but it is a two-way thing and there has to be improvements in that regard.

Next is a Government slot of four Deputies sharing time. This goes back to whether Deputies want to have a question-and-answer session in each case or whether we will take all four Deputies and then have one reply. Which do the Deputies want to go for? We will play it by ear then and see what happens. The Deputies have two and a half minutes each and are into borrowed time after that if they want a reply.

The Minister is in a really difficult spot. He is listening to everybody here today and everybody has the exact same concerns. We are trying to get answers for constituents, people such as family carers and people who are not quite sure whether they are in cohort four or cohort seven. Completely reasonably, we are coming with these questions. If there is anything the Minister can do to help us have a single point of call to be able to get reasonable answers for such people reasonably quickly, I think it would alleviate an awful lot of concern, so I urge the Minister to do that. In addition - this is really more a general question than one that requires an answer now - I ask the Minister to help us to communicate with people as much as possible in that way. Today's debate is very helpful. We have good questions and we have Deputies present, but there are people coming through the doors wanting to have their vaccinations.

It is probably worth the House's time to take just one second to recognise two things about this vaccination that we did not know would happen. First, the vaccinations work. They work better than we had expected or hoped they could. That was absolutely not a given, and it is important just to recognise that. Second, it is so clear that the overwhelming majority of Irish people really want to get vaccinated, and indeed here we are arguing about when they will. That was not a given either. A couple of months ago we were talking about how we would convince people of the safety of vaccinations. It is just important to note those two really positive things about the vaccine experience so far.

I have a real degree of empathy - sympathy is not the right word - with the Minister's position. He is dependent on manufacturers to produce vaccines and to get them to us in a particular way. We have no real control over such manufacturers when they do not do so yet we are dependent on them to get a public health response to our people and to meet the commitments we have made to people. I want to acknowledge that that is not an easy position. The Minister has people such as me coming in and reasonably demanding a vaccination schedule from him, but I acknowledge that it is a difficult position.

I have a question for the Minister about Drogheda. Drogheda is a town of 40,000 people and surrounding it live another 40,000. At the moment, insofar as we are aware, the HSE is insisting that the vaccination centre for Louth will go to either Navan or Dundalk, which is very difficult for a great many people. Will there be enough vaccinators to ensure that a centre is opened in Drogheda or, alternatively, will the vaccinators be rotated around large centres of population such as Drogheda, Dundalk, Ardee and so on? It is hugely important that the Minister answers that question. I appreciate that we have 8,629 vaccinators trained at the moment. How many more are needed to make sure that Drogheda can have its own centre?

The decisions on the locations of the larger vaccination centres were operational decisions of the HSE. To Deputy O'Dowd's point, by no means does this have to be the final and definitive list. If it is the case that a large vaccination centre is required in Drogheda, that will be provided. I wish to give the Deputy some comfort in the fact that people in or around Drogheda do not need to travel to Navan or Dundalk. As we scale this up, every GP practice and pharmacy in Drogheda will have the option to opt into the programme. Obviously, it is expected that a number of people will go to the larger vaccination centres, but people living in Drogheda will be able to pop down to their local GP or pharmacy to be vaccinated. I assure the Deputy that we can stay in regular contact, and if there is a need for an additional large centre in Drogheda itself, I will talk directly to the HSE about that.

The HSE is aware of offers of suitable premises in Drogheda and tells me it can open one if it gets the vaccinators. I appreciate that my time is up. I thank the Minister and I will correspond on this through his office. If the HSE has the vaccinators, we have the centre. I think the Minister is saying he has the interest and the intent to facilitate this.

The Minister will reply in writing in due course.

I too acknowledge the Minister, Deputy Donnelly, and the Minister of State, Deputy Butler, for their huge work to date. The roll-out in nursing homes in particular has been hugely successful, particularly given the story of Covid in nursing homes. That was based on communication and on a partnership. We need to make sure that the roll-out through GPs is based on the same principles: communication and partnership. The reason so many of us have been critical in the past few days is the lack of communication. GPs have been left without information. I acknowledge the work the Minister, the Minister of State and the HSE have put in with the relationship managers in the past week but I ask the Minister to focus on whether those relationship managers are working. This is the first time we have gone into the community and this is the way most people will get their vaccines: through their GP or their pharmacist. It has to work. We have to iron out the difficulties that have been picked up in the past three weeks. The criticism these past few weeks is to make sure this works.

I have a couple of questions. Why is there a difficulty in delivering consumables? Why are the syringes etc. not being delivered in alignment with the vaccine? In a number of cases there has been a few days' delay in delivery of vaccine consumables. Second, there are external supply issues absolutely beyond the HSE's control, but I presume we have visibility of supply on a Monday. Surely a portal could be established on a Monday to tell each GP what is available each week and to make preparations. One cannot set up a vaccine clinic at the hours' notice some GPs have been given. Based on internal supply, can we not give more notice to GPs of availability? Finally, will the Minister clarify the situation of those who are housebound? Are arrangements in place or are we still putting those arrangements together? I welcome the commitment today on family carers and bringing them up the list. Will the Minister confirm that as well?

Regarding general practice, we are all aware that a number of GPs have contacted many politicians and have taken to the airwaves to express their frustration. It was always a three-week programme. In week one 255 GP clinics were involved; week two added another 500; this week the number is 542. There is a number. I am told that in about 65 practices where for various reasons it has not been possible to buddy up they are engaged directly with the IMO and the HSE and they will get their deliveries next week. Of course we would love all 1,300 practices to have got exactly what they needed exactly when they needed it but, as I think the Deputy has acknowledged, this is complex. A lot of changes, the House will remember, were required at very short notice when NIAC advice changed. It should be remembered that the plan had been to use the AstraZeneca vaccine, which was a much more straightforward logistical operation. At very short notice the plan and the recommendation changed to mRNA, which is much more complex. However, these issues do need to be ironed out and the Deputy is absolutely right that consumables in every case should be arriving with the vaccines.

On the visibility of supply on a Monday, believe it or not, in the past seven days, AstraZeneca has substantively changed its supply three times. Therefore, even on a Monday, there is not full clarity because of what is happening with AstraZeneca. The Deputy has aired the concerns of many GPs. We are taking them on board and we will endeavour to continue to do better.

The mood of the nation is understandably low. We have all been living under a dark cloud for a year now, we have all been bombarded with negativity everywhere we turn, and we have all had our fill of doom and gloom. What we need now is hope, and that hope comes in the form of a vaccine. The vaccine roll-out programme cannot happen quickly enough. We all feel that way. However, it is also important to acknowledge the progress that has been made. Many of us know front-line healthcare workers who are now fully vaccinated, and gradually, our older family members, friends and neighbours are also receiving their vaccinations. The best bit of all is the proof coming from our nursing homes and healthcare workers that the vaccine works.

Citywest has played central role in our response to the pandemic since day one. It has been a mass testing centre, a self-isolation centre, and a storage centre for the first vaccines. Soon, it will play a key role in the mass vaccination of our general population. I ask the Minister the consider opening a section of the Citywest vaccination centre now, ahead of schedule, so it can service the over-70s in west Dublin, south-west Dublin and south Dublin. This would mean those who have been isolating in their homes for almost a year would not have to travel to the far side of the capital city for their vaccine. It is a quick fix and an easy solution to an issue that is really upsetting older people in areas like Saggart, Rathcoole, Newcastle and Clondalkin, where they are being told to drive past Citywest and travel almost 30 km to the Helix for their vaccination.

Hope is something our most vulnerable and their carers need the most. While I welcome last week's revised vaccination allocation list, there are still many vulnerable people who have not yet been prioritised. Those on immunosuppressants and people with stable cystic fibrosis - a brand new term - have not been prioritised. There are many vulnerable people for whom the slightest illness can set them back severely in life. It does not bear thinking about the threat Covid-19 could pose to these people. If a person's condition is such that for the past year he or she has been afraid to leave their front door, that person must be considered for cohort 4.

We know progress has been made with the vaccination programme, albeit not at the pace the public had hoped for. We have heard of many logistical challenges that have arisen in the roll-out. I would like to begin by mentioning some of the logistical issues with the roll-out of the vaccination programme in my home county of Clare.

There was a bit of a debacle in Shannon Medical Centre last week, when vaccines were delivered on the Friday but, unfortunately, the equipment to administer them was not. According to a GP at the centre, it resulted in the unfortunate situation where those on the reserve list were not able to benefit from the leftover doses. It seems like such a basic thing to make sure the necessary equipment arrives with, or in advance of, the vaccines. It is surely an avoidable error. The vaccines are precious and simple errors like that cannot be afforded. Does the Minister know why this happened and what is being done to ensure it does not happen again? It must be said, if it was not for the resourcefulness of the staff at the Shannon Medical Centre, it could have been a huge disaster. I thank the staff at the clinic for the work they did that day, under pressure, to ensure the vaccines did not get wasted. They were amazing and showed great dedication and conviction.

I also mention the vaccination centres, as many people have been left wondering about access since the announcement. Those who live in rural areas, for example, are wondering how they might get to the centres if they do not have access to their own transport. I know we are still at the early stages, but it is important things are planned properly to avoid any last-minute chaos. Is there a plan for a dedicated bus service for areas not covered by the normal transport system? Is the organising and planning of that happening now?

My final but very crucial point concerns family carers. Carers are the forgotten healthcare workers of Ireland. They are treated differently from healthcare assistants who work in hospitals or nursing homes, yet they provide similar care, often in more challenging circumstances. They do not get to clock in and out; they are there 24-7. Family carers have not been recognised on the vaccination priority list, despite the fact there are some 500,000 family carers in Ireland, who are providing 19 million unpaid hours week in, week out, at a saving of €20 billion to the State. They have, of course, continued to care for family members throughout the pandemic, and it has been a tough year. They often have to wear full PPE at home while doing everything they can to keep their vulnerable family members safe. They are also often sourcing their own PPE, and at a costly price because the equipment is in high demand.

Many have said they feel like prisoners in their own homes, and despite repeated requests, they have not been prioritised for the vaccine. They are constantly worried and anxious, wondering what will happen if they get sick, and who will step in to take care of their loved ones. As my Sinn Féin colleague, Deputy Cullinane, and others have asked: who cares for the carers? It is quite clear the family carer's role in this pandemic is being undervalued. Many are at their wits' end, waiting for some relief which they thought would come from the vaccination programme. They have kept going and are doing everything to protect their high-risk family members from Covid-19 infection, only to be told they will have to wait at the back of the queue like everyone else. I urge the Minister to reconsider his position on this and give carers the priority on the list they deserve.

I was so disappointed by the Tánaiste's response to my colleague, Deputy Doherty, on Leaders' Questions earlier. This is not the time to be deflective and dismissive. I urge the Minister not to take the same stance.

I thank the Deputy for the various points she raised. On the question of consumables arriving with vaccines, they should arrive with them. There have been small number of cases where this has not happened, and it is not good enough. The HSE is looking at that and we must demand better. It is common sense the right consumables and syringes to get the sixth dose out of the vials need to arrive with the vaccines. I can assure the Deputy that a lot of work is going into finding individual solutions for those who are housebound. For example, a number of those aged over 85 are simply housebound. In some cases GPs will call to the houses, and in others the National Ambulance Service will be involved. The key principle here is nobody will be left behind. I will respond in writing to the Deputy's other points.

I welcome the opportunity to take part in the debate today. I would like to start by commenting, once more, on the failure of this Government the HSE to reach its vaccination target for the second week in a row. It is unacceptable this has happened, and to make matters worse, it has happened two weeks in a row. As the Minister knows, the people of this country have been in lockdown for the best part of a year. Their only hope of getting back to life as they once knew it is with the vaccine. It is soul-destroying for them to see on the daily news the continued failure of the Government and the HSE in respect of the vaccine roll-out. Will the Minister confirm to the House what plans are in place to get the vaccine programme back on track? Has he made the point to the HSE the approach currently being taken is simply not good enough? What actions will be taken to ensure the vaccine roll-out programme is brought up to speed?

It is not only Members of the Opposition who are deeply unhappy with this roll-out programme. Members of the Minister's own Government have also called it into question. The bottom line is we are falling behind in this. I constantly hear from GPs there is very little communication with the HSE. They are very frustrated. It is not good enough. The HSE must be more accountable. The Government has stated everyone will be vaccinated by the end of September. I find this very hard to believe given our the experience to date. GPs have told me they are not receiving vaccines when promised, and they are being forced to tell their elderly patients their vaccine appointments must be cancelled. This causes undue stress and worry for those in this age group, which is not fair.

In Northern Ireland, anyone over the age of 60 and those aged over 16 who are classed as vulnerable can now book their vaccine appointments.

The North is way ahead of us. The authorities there have vaccinated 96% of people aged over 80, 91% of those aged between 75 and 79, 86% of those aged between 70 and 74, 72% of those aged between 65 and 69, and 45% of those classed as vulnerable. They will have vaccinated their population way ahead of us and they will have their economy and society open before us. That will cause chaos, particularly in the Border counties.

I want to bring the Minister's attention to the situation of dentists and their staff. I have spoken to a number of dentists in Dundalk and they are all having the same issues with the HSE and the vaccine roll-out. Despite being told to register with the HSE's online portal, they have still not been called for the vaccine. In fact, they have not received any correspondence from the HSE. Dentists and their staff are front-line workers and are dealing with a large number of HSE patients. They are being treated unfairly in the roll-out programme. It is simply unacceptable that they are not receiving any correspondence from the HSE. I spoke yesterday to a dentist in Dundalk who informed me that no dentist in the area, apparently, has received a vaccine appointment through the HSE's online portal.

Will the Minister confirm what action he is taking to ensure the vaccination programme gets back on track and remains on track until everyone who wants a vaccine gets it? What date has the Government set to roll out the vaccine to everybody in the State? Finally, can the Minister address the issue I raised in respect of dentists and their staff not receiving a date for vaccination?

There is approximately one minute left for the Minister to respond.

It would take more than a minute or a minute and a half to respond adequately to the Deputy's questions. No one is saying that everything is going perfectly with the roll-out. It is not going perfectly and there have been issues, as discussed here today, in terms of some consumables not arriving and some vaccination dates for GPs having been changed. Nobody is suggesting that it is going perfectly. However, the language the Deputy used is complete and absolute nonsense. It is that kind of loose talk and nonsense that erodes confidence in what is the most important thing that is happening in our country right now. To suggest that there are continued failures is nonsense. To suggest that targets are constantly being missed is also nonsense. In fact, had the Deputy been here earlier on, he would have heard a very reasoned debate between Government and Opposition on exactly that point.

The HSE's target is to vaccinate people as soon as the vaccines come into the country. To that end, at the start of this week, approximately 520,000 vaccine doses had arrived into the country. By the end of this week, approximately half a million vaccine doses will have been administered. That is the target, and the HSE and the thousands of men and women around this country, including doctors, nurses, school vaccination teams, community vaccination teams, the Defence Forces, the National Ambulance Service and many more, are working night and day to make sure this programme is a success. If the Deputy wants to check, he can look at the European league tables and what he will find is that Ireland is consistently among the top few countries in terms of the percentage of the population that has been vaccinated.

I will finish on this point. On top of that, we have correctly prioritised those who are most vulnerable.

I begin by reminding the Minister that we are also top of the European league table for the number of days for which businesses and society have been closed under Covid restrictions. We are up to approximately 172 days now, compared with Denmark on 15 days.

Yesterday it was announced that we have missed yet another vaccine target, when last week's goal of administering 100,000 vaccines was not achieved. This morning in the House, the Tánaiste admitted that there are problems. The issues are reportedly due to the change in AstraZeneca's delivery schedule for last week. It is very concerning that targets are being routinely missed and it is too easily accepted that they can be missed. The French and Germans have decided to allow over-65s to be given the AstraZeneca vaccine, as we predicted more than three weeks ago that they would. Is this the real reason that we have received fewer vaccines?

The vaccination programme is one of the most important mass healthcare events ever to take place in this country. Our fastest way back to normality is through vaccination, but we do not appear to be treating the vaccination programme with the urgency it deserves. Why are we not sourcing vaccines from anywhere we can? It is very patronising of the Government to suggest that calling on it to source an increased vaccine supply would mean bringing in vaccines that have not yet been passed by the European Medicines Agency. By refusing to go out and source our own vaccines, the Government is, in effect, saying to the Irish people that more Covid deaths are an acceptable price to pay so long as we do not upset the EU. Germany and Denmark have done it. Some 29% of people in Northern Ireland have been vaccinated, compared with just 6% here. Denmark is a country similar in population to Ireland and it has vaccinated virtually everybody. The Minister must tell us what is causing this imbalance and what the Government intends to do to address it and speed the process up.

The position of family carers on the vaccine priority list needs to be reviewed. Currently, family carers are being told that they will receive no prioritisation and will be vaccinated whenever it is their turn, based on age and underlying conditions, with no recognition of the work they do. This is totally unacceptable. Family carers work in close contact with our most vulnerable people. It is beyond belief that the vaccine roll-out strategy does not recognise the importance of protecting them in their vitally important work. For the purposes of vaccination strategies, family carers should be classed as front-line healthcare workers, not treated as an afterthought. The 500,000 carers in this county, 8,000 of whom are in Wexford, do not accept the Government's position that this is solely a decision for the National Immunisation Advisory Committee. As they see it, the Government does not appreciate the millions of euro they save the State in residential care costs and they, rightly, believe that this should be a deciding factor.

Another issue being brought to my attention daily over the past month is the situation with people aged 80 to 84 and the over-85s, who are supposed to be top of the list in terms of prioritisation. Many colleagues have mentioned this today. A total of 200 doctors have not received the vaccine, which is not by any means a small number. Will the Minister clarify exactly what is happening? It is completely unclear to both doctors and their patients.

The Minister will give a written reply to the Deputy. We are running short of time and there is a sos coming up. There are four members sharing the next slot, which is a Government slot: Deputies Murnane O'Connor, Dillon, Pádraig O'Sullivan and MacSharry. The Deputies have approximately two and a half minutes each.

I thank the Acting Chairman. I have three minutes. I thank the Minister, Deputy Stephen Donnelly, and the Minister of State, Deputy Butler, for answering our questions. Last week, we were told that there were operational issues in the vaccine roll-out to over-85s to do with ordering and the delivery schedule. That problem was identified but I am concerned that such operational issues will continue and that every cohort will see some GP surgeries, in the same town, getting their vaccines while others do not. That has happened in Carlow, Tullow and other rural towns throughout the country. My understanding, according to what we heard today, is that 200 GP surgeries have no vaccine. Will the Minister clarify that? My mother, who is 85, was contacted on Monday and is receiving her vaccine today. I contacted the Minister of State, Deputy Butler, and the HSE at the weekend because, last week, there were surgeries whose elderly patients were told they would be getting their vaccine but there was no vaccine to give them. There is a problem with communication. We are delighted that the vaccine is here and it is the story we all want to hear. However, we must be very careful in our communications and the information we give. That is the most pressing issue.

Will the Minister indicate whether a new GP order support team is being put in place? I welcome that the HSE has identified several mass vaccination centres. I have raised the issue of transport with the HSE and was told that the Community Call initiative will be in place to manage transport and communications. However, I had a call this morning from a person who has no means of transport to the GP surgery to receive the vaccine. There was no one there to help that person. We have great services in this country, with GPs and other front-line staff doing excellent work. We must ensure there is really good communication between the Community Call initiative, the HSE, doctors and nurses. I ask the Minister to put in place some kind of communication map that will ensure people have somebody to contact if they cannot access the vaccine because they do not have transport, whether to a vaccination centre or their GP's office. There must be effective communication with people in that situation.

Is the Minister hearing about many people refusing the vaccine?

We are really tight on time so I ask the Deputy to conclude.

I ask that carers be moved up the list. It is so important that family carers get the vaccine.

I welcomed the clarity last month on the location of the vaccination centres, including the one in Breaffy, Castlebar. Mayo is one of the largest geographical constituencies in the country. One centre is insufficient based on journey times and the lack of public transport. Considering the high incidence rate of the virus in some parts of the constituency, especially around north Mayo, there is deep scarring in local communities. This has particularly been the case since Christmas. I have raised this issue with the HSE and it has pointed out that the situation is reviewed as necessary. However, I would really appreciate clarity at this point. It is more important for the communities of both Bellmullet and Bangor. I appreciate and understand that vaccination centres are but one part of the infrastructure but they are a critical part, along with general practitioners and pharmacists.

I welcomed the publication last week of the updated vaccine allocation strategy, which brings some relief to people with underlying health conditions. However, there is room for refinement so I urge the Minister to review the strategy as further vaccine supplies become available, especially for home carers.

An aspect of vaccine roll-out that is causing great concern relates to the lack of information on what is happening locally and the potential for misinformation. It would be worthwhile publicising more information to create a transparent overview of where vaccines are being distributed and, if they are not being distributed, when they can be expected to arrive and be administered. We need a county-by-county breakdown in this area. I fear that, in the months ahead, neighbours will be peaking over garden fences to report people who get a vaccine ahead of them. As we wait for supplies to become available, there is a need for a major public information campaign on the vaccine allocation process, the science behind it and even a rough timeline as to when people can expect to be vaccinated. There is a mammoth logistical task, with some vaccines being more difficult to transport than others, but there is an onus to inform people. Public representatives are critical in this regard and in helping people to better understand the complexity of the vaccine roll-out and how it is progressing. I appreciate that the data hub provides a large amount of information but I do not see that information being distributed or circulated on social media. I would appreciate it if the Government ensured it did not drop the ball in its communications on the vaccine roll-out. I hope the position will change over the coming weeks as people need something to be hopeful about.

I am going to be brief and allow the Minister one and a half minutes in which to respond to my question. Initially, it needs to be acknowledged that we are administering the vaccines as soon as they come in. That is lost here as Members play politics with the matter. Most of the vaccines that have arrived in the country have been distributed and are finding their way to patients. That needs to be acknowledged. I welcome the NIAC review that was undertaken in the past few weeks. It has given great comfort, including to cystic fibrosis patients, those with underlying health concerns and people on dialysis. It was welcome. I ask that it be reviewed constantly over the coming weeks.

My first question is on the Covid app. It is a great piece of technology. I use it myself but it is underutilised. Only 100,000, or a maximum of 170,000, check it every day. I would welcome a review and the readvertising or revamp of the app. We need to use the technology in the best way we can.

To follow on from Deputy Murnane O'Connor's question on vaccine refusal, I have a query. Are refusals being logged by general practitioners, the HSE or the Department? Is the information being kept? On housebound patients, could the Minister expand on the facilities for those who cannot find their way to a general practitioner or vaccination centre?

I thank the Deputy for his questions and suggestions. I agree on the app. It was a great success. Particularly now that we have moved into the vaccination phase, we could probably do with a review to determine whether there is a bigger role for it. The Deputy will be aware that the vaccination numbers are on the app but I would be very happy to ask my team to conduct a review and determine whether there is more that can be done.

On vaccine refusal, my understanding is that it is not logged. By a process of elimination, the rate would be reasonably easy to work out given that we know the various cohorts, be they in nursing homes, long-term residential care or healthcare settings, or among certain age groups. My understanding, although I may be incorrect because the system may have been updated, is that the number is not logged. That was the case the last time I checked.

On individuals who are housebound, I assure the Deputy that the principle we are pursuing is that nobody should be left behind. Therefore, individual solutions are put being put in place where there are housebound people who cannot get to a GP or one of the vaccination centres.

I have been raising the issue of vaccine supply publicly since 2 January and, indeed, privately before that with the Taoiseach. I am glad to see the rest of the Oireachtas is now raising it. I am well used to Governments not listening to me but at this stage we are hearing about the matter from every quarter, party colleagues and every Deputy across the House. I hope we can begin to listen. Our supply procurement has been an abject failure. Where we stand by comparison with the next worst in the league is of no interest to me. I am interested only in putting an end to the current misery faced by our people, including those in the Minister's constituency and mine. The question of how well we are doing compared to some of the other countries that were asleep at the wheel is of no interest to me.

We know the EU has made a balls, quite frankly, of procuring vaccines for its nations. It went in and played hardball on price thinking it was dealing with office supplies and now we are what the Taoiseach has described as suffering the consequences of bumps in the delivery schedule. It is not lost on me that there are no bumps in the delivery schedule in Tyrone, Fermanagh, throughout the rest of the UK and Israel, but there are bumps in the road for us. I have suggested many times that we procure from others and do a side deal but we are obsessed with being goody two-shoes Europeans. Austria has done a deal with Israel to secure some of its vaccines. I have suggested this directly to the Minister and Taoiseach but they said we cannot do it as it might spook the horses. They implied that we must not offend anybody. Even at this late stage, we should ask the UK whether it can give us a number of million vaccines today on the grounds that we will replenish its stocks when ours increase in several months.

What is the position on extending beyond three weeks the period between the first and second? I am not a physician but it seems to be working for the people of Scotland, Northern Ireland and the rest of the UK. Does it not stand to reason? Is it not reasonable to pose the question as to whether it could also work for us?

On logistics and the management of this whole strategy, it galls me to see hard-working people such as three Ministers having to come in here to defend mediocrity dressed up as efficiency. How they manage to do it I will never know. We have the high-level task force on vaccination, NIAC, NPHET, the individual members of NPHET, who have their own media careers, the HSE, the Department of Health and the Government. We have used the wrong structure from the beginning here. We should have embraced the structure that has a proven track record, namely that of the national emergency co-ordination group, and we should not have been dealing with five or six silos. The co-ordination group had experience in a caretaker role under a previous Government and adopted a different approach. We just rowed in and we are suffering the consequences now.

I demand of the Chair that we receive answers to our questions in writing. I never got answers when I asked questions here. I have asked the Minister five times here about the roll-out of the vaccine for the flu. Only 1.4 million of the 2 million available could be accounted for. I want an answer in writing.

The UK has 20 million vaccinated, including 600,000 vaccinated in Northern Ireland. What are we doing wrong here? Could the Minister please answer the question as to why gardaí, who are on the front line, and our carers are not vaccinated? Surely to God gardaí should be vaccinated considering that we expect them to deal with every situation.

The Garda Representative Association has been on to me and, I am sure, every politician in this House asking why they are not a priority, and the family carers also. I want written answers, please.

On 23 October 2018, something peculiar occurred. The European Commission minutes show a meeting on the organisation and delivery of vaccination services to 28 countries. There was an update on that in March 2019, a year before there was any virus in Ireland or a pandemic. What was going on? Is this the great plan? I want the Minister to answer that. There was also a feasibility study by the European Commission on the development of a common EU vaccine card-travel passport. Is the genie out of the bottle here? This happened in 2018 and 2019 and we have no accountability. The Government wants to be the good boys in Europe. I have asked the Minister to go out and source vaccines, as Deputy MacSharry has, but no. It is an absolute shambles. The clinic in Cahir was to give clinics to 37 elderly people two weeks last Wednesday. They will get them this Saturday, we hope. It has been an absolute shambles.

I will be making statements. I would appreciate it if the Minister would come back to me with the answers. The vaccine roll-out did not get off to a good start. We all know that and I hope things are ironing themselves out. I raised with the Minister several times the issue of home helps being offered a vaccine throughout west Cork. This took some pleading but it seems that many got the vaccine last week, which they greatly appreciate.

I will never play political football with the vaccine roll-out. I will come in here and press for vaccines for those who ask me to do so. I would like all politicians to do the same. I saw some comments about me and the vaccine leading to letters to editors of papers misrepresenting my views. I did not waste my time with an answer as it was all politically orchestrated, in particular by the Fine Gael Party. Politics should not be played on this issue. If people want the vaccine, by all means they should get it.

Some concerns have been expressed to me by the elderly on the islands of west Cork - Cape Clear, Sherkin, Long, Whiddy, Dursey, Heir and Bere Island. Some of our elderly are being requested to go to the nearest health centre on the mainland. Many may be genuinely infirm and unable to go to the ferry. Most of these could be vaccinated in one day if the helicopter service could be used. Is this possible?

When will workers and patients in CoAction in west Cork be in line for vaccination? As Deputy Mattie McGrath said, our gardaí are pressing that they are front-line workers in their own right and they deserve to be vaccinated if they want it.

While Covid-19 is of the utmost importance, we have to look at life after Covid and the other health crisis we will face. My concern is about Bantry General Hospital and improved services to meet demand. I have raised in the Dáil a number of times the promised endoscopy and rehabilitation units in Bantry hospital. I was informed by the Minister, Deputy Harris, on 25 February 2020 that a decision had been reached to appoint a design team to progress both projects this year. Bantry General Hospital serves up to 80,000 people in west Cork from the Beara Peninsula to Bandon. Will the Minister get back to me and tell me when the project team was appointed and what progress has been made on both projects?

Childcare providers are still in limbo and feeling vulnerable. Insurance is a huge issue for them, bouncing from Allianz at €7,800 to a broker for €5,170. That is just two quotes. These workers want to be escalated to level 6 and reclassified as essential workers because they are minding the children of front-line staff. In Ireland, there were 4,500 childcare facilities; there are now 1,923. They are at only 20% capacity, which is not sustainable. There needs to be proper consultation between the Government and early years providers on the early childhood care and education scheme. Will they be getting paid on 8 March? Is this only for children until September? What happens kids after school?

Retired nursing staff have been requested nationally to register with agencies for Covid-19 vaccination roll-out. CPL and Nurse On Call are two agencies used by the HSE. How many retired nurses have been called up to do the vaccinations? Why am I hearing that nurses are being brought out of hospitals where they are badly needed to do vaccination centres when we have nurses who have put themselves out there and have not been called? I thank the Minister.

There is one minute and ten seconds left in that slot but presumably-----

Is that for an answer?

Does the Minister want to reply to any of that?

On Deputy Mattie McGrath's statements regarding the flu vaccine----

The answer was for me.

We cannot have a debate. The time is 40 seconds now. We cannot have a debate. There is no space for that. We are up against the clock. Will the Minister reply in writing to the queries raised?

I have 30 seconds.

Can the Minister reply very quickly? There are 25 seconds left.

I will do my best. I was making the point that Deputy Mattie McGrath has continued to make false statements and he is seeking written answers to false statements around flu jabs which obviously we cannot give him.

I want an answer.


I thank the Minister. That is all the time there is. We are up against the clock and we can do nothing about that. We cannot have a debate here. We have two more speakers. From the Independent Group we have Deputies Joan Collins and Catherine Connolly. They have six and a half minutes starting now.

You are nothing but a coward.

Dr. Peter Sloane, who is a GP, was on the radio this morning saying he is dying on his knees because his patients have not received the vaccine as yet. He said there has been huge communication issues and inconsistency in delivery schedules. We are only dealing with 70,000 over-85s, so we should be much slicker in delivering the vaccines and getting them into the arms of people who need them. GPs have the expertise to do that. We will see over the next couple of weeks over-70s, over-80s and the second vaccine for the over-85s. The HSE has to get its finger out and make sure this works effectively.

The transparency of the vaccine programme has been raised here a few times. Can we not see every week included in the data the date we received the vaccines, how many of each vaccine we received and, on the other side of the table, how many cohorts are in each grouping? For example, we could be told how many over-65s have underlying illnesses and or are at high risk with underlying illnesses. How many of each those groups is getting vaccinated and when? That should be put up every week so people can see things moving on, particularly when we reach 250,000 per week, as we have been told we will.

On international vaccination, I put a question in to the Minister last week in relation to the World Trade Organization, asking the Government to support the Indian call for the vaccinations to be produced in their own country. I got a disparaging answer: "Specifically, the TRIPS agreement allows compulsory licensing which is when a government permits someone else to produce the patented product or process without the consent of the patent owner." I refute that. We are already seeing how difficult it is to get vaccines and supply is not what it should be in Europe, where they have ordered them. Nearly 80% of the vaccines have been ordered by the wealthiest countries but we have to make sure other countries get the vaccine. Otherwise, even if we have 80% of our people vaccinated and these countries are not vaccinated, it can easily come back into our country. I demand that the Minister support the call for the India-South Africa proposal. It is crucial they get that. AstraZeneca was supposed to help out here. It is supposed to be the non-profit vaccine that would transform the world but it is not happening. The COVAX idea of us giving money to the WHO to get more vaccines when there is a shortage will not work. There is a huge contradiction there.

I have one further question, which the Minister will not be able to answer here. How can a decision be made that there is a higher risk category among cystic fibrosis sufferers? Every cystic fibrosis sufferer is high risk and should get the vaccination and get the call first.

I have three minutes. I could say a lot but I will not. The vaccination is one part of a process and the Government is utterly failing in relation to the overall process to obtain trust. I do not think the Government's messaging and mixed messaging is helping to increase trust in the system, specifically with the time available in relation to the vaccine.

My colleague mentioned Dr. Sloane, who was on "Today with Claire Byrne" earlier.

Let me take the front page of The Irish Times in which Dr. Mary Favier, a GP and member of the National Public Health Emergency Team, NPHET, talked about a problem with deliveries, and Dr. Denis McAuley, chair of the GP council of the Irish Medical Organisation, talked about delivery in a very mild, moderate manner. Then we have Dr. Sloane at the end of his tether on behalf of his patients. What he describes is simply unbelievable. I do not know if the Minister or the Minister of State is going to answer me, but perhaps he or she could take one minute and then allow me one minute to come back in regarding that debacle.

I thank the Deputy. She has used very strong language. Her criticism is essentially a criticism of the thousands of women and men who are working seven days a week to deliver what has been one of the fastest roll-outs in the EU, prioritising our most vulnerable, changing at very short notice from AstraZeneca to the much more complex mRNA vaccine and changing at short notice to the reprioritisation of people with underlying conditions. It is deeply unfair criticism, not of me - the Deputy can criticise me all she wants - but of the people who have worked night and day.

The facts speak for themselves. At the start this week, we had received approximately 520,000 vaccine doses. By the end of this week, we hope to have administered approximately half a million doses. It is deeply unfair and unbalanced to come in here and suggest that is a shambles. I accept that there are-----


I will finish on this.

This is my minute. It is my time. The Minister has abused that time. I did not criticise anyone. I commented that Dr. Sloane was at the end of his tether on behalf of his patients. It is totally disingenuous of the Minister to twist those words.

I am not asking the Minister any more questions. I am using my 30 seconds to say that what he has said is utterly disgraceful. We want to work with the Minister. It is impossible when he is being disingenuous. I had three minutes and I wanted to use them to elicit clarity. Perhaps, if the Minister of State had answered, we might be further along the way. I now have 13 seconds left. It is simply unacceptable to deal with elected Members in this manner, to personalise matters and not answer a practical question regarding the operational difficulties that one doctor, in particular, who is only representative of others, has on the ground. The criticism is with the Minister.

Will the Minister reply in writing, and address the criticism?

The Deputy said it was a shambles.

It would be a good idea because we are up against the clock.

I would be more than happy to debate it at length and respectfully. I really would. I know we are out of time.

I will be more than happy to engage with the Deputy at length on this at a later date. I was simply responding to the Deputy's charge that the programme was a shambles. I was trying to answer the questions raised.

If the House would allow it, I would be more than happy to spend more time with the Deputy.

On a point of order, it is totally unfair for the Minister to abuse his time in this manner.

The Deputy knows we cannot have a point of order in the middle of this. I thank everyone for their co-operation, in general. We have managed to come to the end of our time. We will have a sos for 20 minutes.

Sitting suspended at 3.44 p.m. and resumed at 4.05 p.m.