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Dáil Éireann debate -
Friday, 2 Jul 2021

Vol. 1009 No. 7

Covid-19 Vaccine Roll-out: Statements

Dia dhaoibh ar maidin. Tá sé iontach a bheith ar ais sa Dáil, fiú más lá amháin atá i gceist. Good morning, Members. It is lovely to be back in the Dáil Chamber, as I believe the last time that we sat here was in December. We are beginning with statements on the Covid-19 vaccine roll-out.

May I raise a point of order, please?

Certainly Deputy, but as I understand it, on the instructions before me it is statements only this morning, to be concluded within 145 minutes. I call Deputy Cullinane.

I fully accept that according to what is in front of the Leas-Cheann Comhairle, this is a statements-only session. However, any time that we have had exchanges on the vaccine roll-out, it has been a questions-and-answers session and I have always used that facility because we have questions to ask and we need answers to those questions. It is not a productive use of anyone's time for Members to stand up and make long statements when people are asking us questions they want us to put to the Minister but we are not then going to get a response. I presume the Minister will say that he will forward such responses to us but it always has been much better to have an interaction, to go over and back and to get information in real-time. Statements are not the way to go. It was obviously the Government that decided this for whatever reason but it is not the way to proceed.

Yes, I completely agree with those comments. I do not understand why there is a difficulty with questions and answers in this session, which has been taking place for months now at the end of the week, at which we have interaction on the latest information on the vaccine programme. It is generally fairly productive and the Minister has not had a difficulty with that. Were the Minister agreeable this morning, we could continue like that where we use our time for a question-and-answer session. Would it be possible to arrange it in that manner? Is that acceptable, a Leas-Cheann Comhairle, because it is much more productive? Given the events of recent days and the need for us to get additional information for the public, there are endless questions to be asked about the vaccine programme. It would be fairly meaningless for us all to be just getting up and making statements. I ask the Minister to concede to that request.

What is before me is what is before me but I will afford the Minister the opportunity to reply here now.

I thank the Leas-Cheann Comhairle. To be honest, I was simply told that it was statements. It was not something that I had requested at all, as we do question-and-answer sessions all of the time. I cannot do it today because doing such a session requires a tremendous amount of preparation and there is a great amount of data that I need to have available for colleagues but I fully appreciate where they are coming from. Can I suggest that we proceed with statements today, as agreed, and I can work with colleagues to find the time to do a question-and-answer session? Alternatively, if colleagues have pressing questions we could set up an informal briefing for health spokespeople, as we did on the National Public Health Emergency Team, NPHET, advice. I am very happy to facilitate it, which is what we have done the whole time in the past, but I just cannot have such a session now because the preparatory work required to ensure that I have sufficient answers for colleagues takes a significant amount of time and that work was not done because today's session was for statements.

I ask Deputies to respond very briefly.

I thank the Leas-Cheann Comhairle. I accept that the Minister did not request this session format but essentially what he is saying is that he will not have the information we need at his disposal today, which is problematic. Briefings in private session, whenever they are organised, are not what we need. People are asking us reasonable questions on the supply chain, how many of the vaccines will be available for young people and when. The Minister made some announcements this morning, which we all welcome. It would have been a good opportunity to have an engagement to get that story out and to tease out some of the working in this regard. It is unfortunate but we have to proceed in this manner.

With all due respects to the Minister, he spoke on "Morning Ireland" earlier this morning and presumably he had preparation for that. He had a great deal of material at his disposal and he shared information on that programme. The Minister is fairly up-to-date on the situation and if there are issues we raise that he is not in a position to answer, we would be very happy to accept a note on them afterwards. The Minister should be reasonable about this and I do not know why there would be any attempt made to limit debate on this by not doing a question-and-answer session, especially given the week that is in it. We need to be in a position to ask questions and it is not sufficient to say to us that he will work to arrange a briefing. We waited six months for a briefing from NPHET and we got it finally this week. It is really not on to treat the House like this.

The points have been made on now. The Minister has 20 minutes to speak now.

The point made by Deputy Shortall is disappointing and I do not accept her final comment. I am not treating the House like anything. I have come into the House week after week to speak with all Deputies in good faith, to engage with questions and answers and I am offering to do so. The order of the House was not arranged by me but by the Business Committee and I have come here as requested to go through statements. I have offered multiple alternatives to that, as I recognise that Deputies have an important job to do, including to have a question-and-answer session at the next possibility, as well as informal briefings - to answer Deputy Cullinane's point - to try to get the answers for the Deputies as quickly as possible. I categorically do not accept that the House is being treated with anything other than respect by me by coming here as arranged by the Business Committee to make statements. I thank the Leas-Chathaoirleach.

The lines have been drawn, the questions have been asked, replies have been given and we will proceed now.

I thank the Leas-Cheann Comhairle. I will be sharing time with the Minister of State, Deputy Feighan.

It is fair to say at this point that our vaccine programme has been an enormous success. Uptake has been phenomenal and it is something we should all be immensely proud of as a society.

It has not been plain sailing, as colleagues will know, and I know many Members have had concerns in the past, just as I have had, at different stages through this programme.

Earlier on in our roll-out programme, we faced some real challenges in supply and some remain. Evolving evidence meant we had to regularly change our plan and update our implementation. Unlike other European countries, we did not have digital records at the level that we should have had. There were concerns about our capacity to deliver the biggest vaccination programme in the history of our State.

I remember when US President Joe Biden unveiled his ambitious vaccination plan. I wondered whether we, and indeed our European neighbours, would catch up with the United States. We did catch up. More of our adult population have now received a first dose vaccination than is the case in the United States. This did not just happen. It was not down to chance, or luck. If Members will allow me, I would like to pay tribute to the Department of Health, the HSE and its leadership team, the tremendous workers right across the country and indeed to the task force for the enormous contribution they have made in making this programme a success.

Approximately 20 people join me on the vaccination task force meeting on Mondays. Some are household names we all have come to know and others are not. It is through their hard graft and determination that we have the highest take-up rates of the vaccine in the European Union for the most vulnerable groups. We have many talented people working behind the scenes in our public sector and they are regularly working together alongside us into the early hours day after day. As a country, we will forever be indebted to their dedication and hard work - I want to re-emphasise this point to the entire healthcare family in every county in Ireland - as well as to the amazing partnership we have had with the likes of the Defence Forces, voluntary groups and volunteers right across the country.

I know the Oireachtas is hugely grateful to everyone who has been involved in that partnership. I also thank people for their enthusiasm, including Annie Lynch, who was the first person in the country to be vaccinated. I remember having a telephone conversation with Annie and her niece the morning Annie was to be vaccinated. Our first vaccination seems like an eternity ago now. I also thank everyone in our vaccination centres, including our wonderful volunteers. We all know that there have been a lot of challenges and that it has been a bumpy road rolling out the vaccine programme. However, as a society, a healthcare system and an Oireachtas, we have overcome those challenges on each and every occasion, and progress continues to be made.

The Delta variant presents us with another deeply unwelcome but, unfortunately, very real and immediate challenge. Vaccines are one of the most powerful preventative measures we can use against both the spread of the Delta variant and the damage it can do to people who contract it. Vaccination protects the people vaccinated but, just as importantly, it protects the people around us as well. This is not just about individual vaccinations; it is about a population vaccination programme.

While the recent cyberattack continues to impact the HSE's business activities and some healthcare delivery, it has not been allowed to impact the State's ability to deliver the vaccination programme, which is critical. Therefore, in spite of the attack, I can advise colleagues that almost 4.2 million vaccine doses have now been administered; more than two in every three adults in our country have now received at least one vaccine dose; and, at 45%, we are getting close to one adult in every two being fully vaccinated. Last week, the vaccine programme delivered the highest number of vaccines yet. It was a record week, with in excess of 350,000 vaccines delivered. This week will see in excess of 300,000 doses administered, probably between 310,000 and 330,000. The vaccine programme continues at pace. I can provide confirmation to colleagues on a measurement we have all been keen to ensure we endeavour to meet. It has been a cornerstone of our programme. The volume of vaccine that goes out is the volume that has arrived into the country. I refer to that really high percentage, well into the 90s, of vaccines getting into people's arms within seven days of arriving into the country. In spite of numerous challenges and changes, that pace has been maintained, which is really welcome.

The HSE is now accepting registrations for vaccination from those aged 35 to 39 and is scheduling appointments for that age group. I announced yesterday that registration for those aged 30 to 34 will commence next week. I can confirm to colleagues this morning that the portal will open to those aged between 30 and 34 on Friday. As has been the case with previous age groups, on the Friday the portal will open to 34-year-olds, on the Saturday to 33-year-olds, etc. That is how it will work. I confirm to the House this morning that we will see, in addition to this, a significant acceleration of the vaccine programme beginning this coming Monday. In short, the changes we are implementing from Monday will mean that the 18 to 34 years age group will have the option of being vaccinated one to two months early. That would have been really welcome regardless of the Delta variant and this surge but is particularly so in light of the modelling we saw from Professor Nolan's team as to what is likely to happen here through August and September. To be able to pull forward a huge number of people from September into August and some from August into July is incredibly valuable and will help us to protect one another and protect our population from the Delta surge that we know is coming.

I recently sought advice from NIAC specifically on the Johnson & Johnson, or Janssen, and AstraZeneca vaccines for the groups for which it was not available, that is, those aged 40 and below. This was in the context of the Delta wave. The question was whether, if we see the surge we are seeing in the UK arrive here, the advice can be updated to accommodate the higher risk of not taking a vaccine, since the risk of being infected goes up without a vaccine. While the data are still coming in and there is not consensus yet in the scientific community, there are serious pieces of research that suggest not only that the Delta variant is much more contagious but it is also potentially much more severe. There is some analysis that says the variant is about as severe as the Alpha variant in respect of the likelihood that it will put an individual in hospital. There is other analysis from the UK that says it could be two and a half times more likely to do so, or more. Obviously, therefore, accelerating the administering of vaccines and making the vaccines we have available to younger people in the face of that threat, I believed, was very important. Essentially, we could use every vaccine dose we had because, without this change, we would be left with supplies of Janssen and AstraZeneca, incredibly effective vaccines, and would not have been able to use them because everyone over 40 would have already been vaccinated. The changed advice from NIAC is therefore very much welcome.

The online portal for the mRNA vaccines we are all aware of will continue. As I said, this day next week it will open to the 30 to 34 age group. People in that age group will very quickly start getting appointments, and first dose vaccinations for them will start about a week after that. The current estimates - and this is important for people aged between 18 and 29 - for when their mRNA round of first dose vaccinations will begin are as follows. For the 25 to 29 age group, the estimate is early August, and for the 18 to 24 age group the estimate is from mid-August. For anyone in that group who is thinking, "I will be scheduled for an mRNA vaccine but I now have an option of a Janssen or AstraZeneca vaccine earlier - do I want to take that?", those dates are important to consider. Again, for those aged 18 to 24 it will be late August and for those aged 25 to 29 it will be early August.

In parallel with the portal for mRNA vaccines, from this coming Monday we will open up an opt-in model for those aged between 18 and 34. That, as I said, is so that if they want to avail of earlier vaccination, they may opt for either a Janssen or an AstraZeneca vaccine. People will be able to seek an appointment in one of over 700 pharmacies across the country for a Janssen vaccine, subject to supply. I will come back to this, but we do not have an infinite amount; it is subject to supply. That is from this coming Monday, 5 July.

The following week, the week of 12 July, those aged between 18 and 34 will also be able to register on the HSE portal for an appointment in a vaccine centre for an earlier vaccination. In the main, that will be AstraZeneca and there will be some Janssen supply available as well. The point is that they will then be vaccinated earlier than if they had waited for an mRNA vaccine. Supplies of Janssen and AstraZeneca will be somewhat limited during July, but we expect that supplies will be able to accommodate a significant number of this age group through July. To give colleagues a sense of this, the estimates we have as of this morning are that for this age group there should be between 205,000 and 210,000 Janssen doses available in July, and we have line of sight of about 100,000 AstraZeneca doses. That is after all the second doses are done, so those are new first doses. AstraZeneca is committed to providing significantly higher numbers than that. We do not have confirmation of that, so we are sticking with what we have confirmation of now. Essentially, the approximate numbers are between 205,000 and 210,000 Janssen vaccines and 100,000 AstraZeneca vaccines for July, and then significant amounts again into August.

As we unravel each lockdown measure, increasing the range of day-to-day freedoms we can enjoy, we must also have regard, obviously, to the progression of the disease, both internationally and domestically. The emergence and progression of the Delta variant is an issue which gives rise to other new decisions which now must be taken. It is unfortunate that these decisions have to be taken at a moment in time when many indoor activities, including hospitality, dance classes, other activity classes, were on the cusp of opening up. I know a huge amount of work was being done in hospitality, exercise, dance and all sorts of sectors getting ready.

Everyone was really looking forward to being able to open up on Monday. However, the Government and the Oireachtas were obligated to review all the evidence to hand before making a judgment to make sure that people are as protected as possible. I understand that these decisions have not been easy.

NPHET was tasked with carrying out an assessment of the evidence in order to determine whether to reopen. This is a responsibility it does not take lightly and which it has always conducted with the highest degree of professionalism. As they have always done, the Chief Medical Officer, CMO, and his public health colleagues carefully considered all aspects before making their recommendations, which the Government then took account of. I wish to put on the record of the House just how disappointed and uncomfortable I have been with some of the public commentary and the online vitriol that has been directed at senior figures in NPHET in recent days. These people have worked tirelessly for the past 18 months. I have enormous respect for them. They do have an important and difficult job that they have to do.

I will conclude by saying the potential danger of the Delta variant is substantial. Delta surges are being seen in the UK and other European countries. Scotland, for example, is recording its highest ever Covid case rates despite a large portion of its population having been vaccinated. I know colleagues will agree that the Delta variant is very serious despite the progress in vaccination. The message I want to get out, and I ask Members to help with this, is that we must do two main things - we have to get as many people vaccinated as quickly as possible, as quickly as possible, and we have to help people to stick to the public health measures. Things have been going well and naturally people have become a bit more relaxed. That is totally understandable but we must really lean into the public health measures again, and as we have done before, together, as a society, we will get people protected and we will get through this.

The Covid-19 vaccination programme is the largest immunisation programme in the history of the State. More than 4.1 million doses of vaccine have now been administered since the programme began in December. Approximately 65.2% of the eligible population have received a single dose while 44.5% have been fully vaccinated. The programme continues to gather pace and the trajectory it is on has been unhindered by the recent HSE cyberattack. This robustness has been matched by an agility which has enabled the programme to respond to updated clinical advice and changing delivery schedules.

The success of the programme has necessitated an unprecedented national effort from across the healthcare system. There are now 40 vaccination centres operating across the State, including at least one in each county. A further centre will commence operating at the Munster Technical University campus in Cork this week. Approximately 1.7 million people have now received a vaccination at one of the HSE-operated vaccination centres following registering on the online portal.

The roll-out has now begun to reach those in their 30s with those aged between 35 and 39 years invited to register for vaccination. The portal remains open for those aged between 40 and 49, with 644,000 people having registered to date. The HSE expects registration to open for those aged between 30 and 34 years towards the end of next week. I encourage anyone in these age groups who has not yet registered for vaccination to do so and avail of the protection it offers. GPs have played a pivotal role in the programme thus far and their involvement continues. Approximately 1.64 million vaccines have been delivered by GPs since the roll-out began.

Protecting the most vulnerable has always been a core tenet of the roll-out and this continues with socially vulnerable groups now being prioritised for vaccination. The Minister for Health approved three vulnerable groups to be prioritised for vaccination, namely, the homeless and members of the Roma and Traveller communities. Individuals in the custody of the State, including those in the Irish Prison Service and residing in direct provision, were subsequently also designated as high priority. Rolling out vaccines to the estimated 4,800 people residing in the 73 direct provision centres commenced this week. The vaccinations will be delivered through bespoke vaccination clinics, GPs, vaccination centres and pharmacies. I was in one of those clinics yesterday near Broombridge and want to thank all the workers and everyone who has participated in this very successful project.

GPs continue to offer vaccination to members of the Traveller and Roma communities, either directly or via referral to their local vaccination centres. To date, approximately 3,300 vaccinations have been delivered to members of both communities and an additional 400 vaccination appointments were scheduled for last week. The HSE is working closely with the community healthcare organisations to ensure that the vaccine roll-out continues efficiently to both the Traveller and Roma communities.

Individuals in custody in the Irish Prison Service are also being prioritised for vaccination. The roll-out in this commenced in March with those aged 70 years and older. It has now reached younger individuals in the custody of the State and it is anticipated that, over a four-week period, 75% of prisoners will have received a first dose. In order to accommodate the estimated 4,000 population residing in prison facilities, the National Ambulance Service has been attending some prisons to assist with vaccination.

As Minister of State with responsibility for the national drug strategy, I am pleased to inform the Dáil that those with addiction issues have now been designated as high priority for vaccination. The HSE is in the process of developing an operational plan to roll-out the vaccination to this group and once finalised it will be issued to the Department.

The national vaccination programme is well advanced and continues to gather pace. Thanks to the extraordinary efforts of staff across the healthcare system and the significant sacrifices of the Irish people, there has been a marked improvement in the situation. The continued success of the vaccination programme has led to a marked reduction in levels of hospitalisation. The vaccination programme has always sought to prioritise those most at risk, whether on the basis of their age, existing conditions or surroundings. I am pleased that the programme is reaching some of the most marginalised and oft forgotten in our society, including those seeking refuge and most in need of assistance, members of the Travelling community and those in the grip of addiction. The vaccination programme will leave no one behind and all will be offered the protection that vaccination affords. I was in a clinic in the city centre some weeks ago which had vaccinated 700 medically vulnerable people who are homeless. This great news for the people involved.

The Minister said, and rightly, that we all have a responsibility to get the message out about the threat posed by the Delta variant. We do. I take my responsibilities very seriously in that regard because it is a threat. Right through the pandemic, my overriding objective has been to keep people safe. That has to be what we all do. Decisions that have to be made are never easy and a curtailment of people's individual freedoms is really difficult. We had hoped that we were out the gap to some degree but now the Delta variant has given rise to complications. We have to look at how we manage that variant as best we can. However, while we in opposition have a responsibility to ensure that that public health message is given, the Government has a responsibility to present the plan.

On Tuesday, we all anticipated and expected a plan from the Taoiseach about the safe reopening of indoor dining. I accept that recommendations were given to the Government on Monday or Tuesday by NPHET and that recommendations came from NIAC on Monday evening in respect of changes in the vaccine roll-out, but we also have to be honest. Those of us in opposition have been on the media in recent weeks. One of the main areas of discussion has been the possibility that the medical experts could recommend pausing the reopening of indoor dining, at least for two weeks. What was the Government doing during that two-week period? Industry tell us that it had no serious engagement during that time. What NPHET actually presented to the Government was modelling with different scenarios - it has to look at every eventuality - and that modelling has all sorts of assumptions underpinning it.

That is the purpose of contingency planning. The Government should have been doing that and then presented a plan on Tuesday based on having worked out all of the contingencies, engaging with the sector and building in the public health advice that was given at a particular time. Let us be honest: what the Taoiseach said on Tuesday is that we do not have a plan but that we will come back in a couple of weeks, on 19 July, and will hopefully have one by then.

That said, I welcome the engagement that is now taking place with the sector. I want a safe reopening of indoor dining and hospitality for everybody. I do not want to see anybody left behind. As the Minister is aware, social cohesion is important. To take steps which, for example, would leave young people behind would be impractical and problematic. The Government's focus must be to put in place a plan that allows for the safe reopening of indoor hospitality and indoor activities for everybody. The clear ingredients for that include an accelerated roll-out of the vaccine. I welcome the changes that have been made for those in the 18 to 34 age bracket and that vaccines will be made available for them through pharmacists from Monday next. That is going to be important.

We must make sure that the over-60s are vaccinated as quickly as possible. I got my second dose of the Moderna vaccine yesterday, but I know family and friends who are over 60 and who are still waiting for their second dose. Is that fair? I do not believe so. When the vaccine roll-out was first presented to us, we were told that we had to vaccinate the most vulnerable quickest. That did not happen because of the way various vaccines were administered to different age cohorts. I know that was based on recommendations from NIAC but I simply make the point that there is not just an irony, there is an unfairness in me and, possibly, the Minister and others getting our second doses and being fully vaccinated, yet there are some in the over-60s category who are not.

I anticipated that this would be a question-and-answer session but it is only statements. I will, however, ask some questions and the Minister might be able to come back with the answers. NPHET outlined four scenarios - one pessimistic, two in the centre and one optimistic. When will the changes the Minister announced and signed off on today be factored into that modelling? When will we see revised assumptions and estimations in respect of case numbers, hospitalisations and ICUs? That is important for public confidence. That is the first question.

Are we going to see a plan for everybody brought forward by the Taoiseach on 19 July? Is it possible that there will be more delays? It is important that people have a sense that we will get a plan the next time. As part of that, we must also see revised timeframes and a revised scheduling for the vaccine roll-out. Some of the data the Minister provided is welcome, but more information is necessary.

I had a question on how many Janssen and AstraZeneca vaccines will be available for the 18 to 34 age cohort in the next while. If I read what the Minister said correctly, it is that there will be approximately 305,000 in total - 205,000 doses of Janssen and 100,000 doses of AstraZeneca.

For July. Obviously, that is an important start, but what we need to know then is where we stand in the following months. Getting that age cohort vaccinated is going to be key to ensuring that we can have a safe reopening everywhere, which we all want to see. It is important to outline not only information on those vaccines but also on the supply chains for the coming months. When the Government comes back with its plan for reopening – let us hope it is a plan for everybody – it would make sense that it be underpinned by an accelerated vaccine roll-out that will not be the victim of the type of supply difficulties and challenges we saw in the past, that will be sustainable and that will happen. There is a major concern regarding what occurred in recent weeks.

May I advocate that we look at antigen testing as an option as well? Nobody has ever said that antigen testing can be a replacement for PCR testing. I understand the points that have been made time and again by the CMO, but he has never said he is against antigen testing. What he said is that it is not a replacement for PCR, but antigen testing does have a role to play. Months ago, the European Commission set out very clear terms and ways in which antigen testing could be used. We were looking for antigen testing to be rolled out on flights as a pilot scheme in order that we could learn from it. This is something that must be examined.

When looking at the fastest return to indoor hospitality, we must examine indoor ventilation and air filtration. That must be part of the solution as well. I hope that when the Minister and his Government colleagues sit down to engage with the industry, the discussions will focus on the acceleration of the vaccine roll-out, potentially antigen testing, PCR testing, indoor ventilation and air filtration.

Before I hand over to my colleague, I will use my final minute and 40 seconds to raise with the Minister the harrowing "RTÉ Investigates" programme that aired last night. Many of us in this Chamber were members of the Covid committee that met some months ago. We compiled a report on this matter and we heard from advocate organisations, care champions, the Irish Association of Social Workers and others who were raising these issues for many months. They raised very real concerns about neglect in some nursing homes and care homes because of the major challenges Covid presented in those locations at a particular time. I echo the call made by the committee: something the Government must consider is a full public inquiry that puts the families of the bereaved first and also survivors in nursing homes as well, and people who worked through all of that. It was all rehearsed – there were major staff shortages of between 50% and 80% in some care homes and some residents did not get the care they needed, sometimes for days. How could people have got the proper care when one considers that was what was happening? Phones were not answered. People were not able to see their loved ones die. They were not able to get information on what was happening. We all accept that it was harrowing. I am not apportioning blame, what I am saying is that we need a full inquiry into the matter. I hope that is something the Minister will support.

I thank an Teachta Cullinane for sharing his time with me this morning. I pay tribute to those workers who have been on the front line right throughout this pandemic. While we were all busy having a series of L’Oréal moments in the convention centre, people were putting themselves in harm's way. They were going into Covid wards. They were working in retail. They were making sure that we were fed and kept safe. There are people who have worked right throughout this pandemic, including the staff here in the Houses, who deserve to be recognised and deserve our respect.

We should not lose sight of the fact that many of the measures that were recommended had to be implemented on the back of the fact that we had to protect the health service. We had to protect the health service because we went into this pandemic with a health service that was effectively on its knees because it was understaffed and under-resourced. We know how that happened; it did not happen recently, it was decades long in the making. That is the reason many of the measures had to be taken. The legacy of this pandemic must be a wake-up call for the people who sit on the Government benches. We cannot allow the health service to be exposed in that way ever again.

I want to touch on two areas in the few minutes available to me, namely, aviation and hospitality. Both of those sectors are anxiously looking at antigen testing.

I refer to the minutes of the 4 June meeting of the HSE antigen testing working group, which state:

A recent modelling exercise by HIQA the Health Information and Quality Authority of Ireland, has suggested that with respect to workers in ... processing plants, [which are high-risk work environments,] ADT-based testing of supervised self-collected nasal samples once or twice a week with RT-PCR confirmation of positive results may offer benefit in terms of a potentially increased detection of cases, reduction in infectious person-days circulating, and a reduced overall cost relative to the current practice of monthly RT-PCR testing.

It seems, therefore, that the use of antigen testing was modelled in meat factories. Like an Teachta Cullinane, I thought we would have questions. My question is, why was it not modelled for aviation or for hospitality when there was time to do that and when case numbers were low? This time last year case numbers were in the single digits. That was not done and now we are in a situation where we are playing catch-up, which is regrettable. As the Minister will know, there are 140,000 jobs hanging in the balance in the aviation sector. Public health and safety must come first and we absolutely realise and respect that. The vaccine passports are due to go live on 19 July and while we all hope that works, there are questions. As people in the airline industry are used to dealing with inoculations and with them being a requirement for travel, they are ready to go. They are asking whether the Minister is ready to go and whether this will go live on 19 July. The hope is it will but as yet, we have not seen any evidence. We do not know if it has been trialled and we do not know the result of that. Has it been trialled as yet? Are we up to speed? Can the Minister confirm it will go live on 19 July?

Turning to hospitality, as the Minister is aware, it is a low-paid and largely non-unionised sector. I will point to the correlation there, which is that if a person wants to improve his or her pay, he or she should join a trade union, get active in that trade union and demand decent terms and conditions. Notwithstanding that the conditions are poor and the pay not great, despite what some in government would claim, people in the hospitality sector are really anxious to get to work. They want to get off the pandemic unemployment payment, PUP, and back into work. I know there has been engagement with representatives from industry and I am asking that the workers' voice also be heard at that table. It is really important. These 180,000 workers want a safe place in which to go back to work.

In the few seconds remaining to me, I have a few questions. As I said, I had hoped to have a back and forth but there are some issues arising with dance classes. If they are in a private facility, it appears they can go ahead but where a person is renting a facility from the council it appears he or she is being told they cannot go ahead. The Minister is nodding, which is good. There is some confusion there.

On the sacraments of communion and confirmation, I am not a religious person but for some people it is really important and is not about the party afterwards. Has the Minister looked at the possibility of having some ceremonies outdoors and will he be discussing that with church leaders?

I want to put on record that we could have had questions and answers this morning. Many of the questions that have been asked by the preceding Deputies and others that are going to be asked are ones he would be able to answer easily enough. We all accept there is stuff he cannot answer and would have to come back to us on.

We welcome the Minister's contribution on "Morning Ireland" earlier and his statement on the Janssen and AstraZeneca vaccines for 18- to 34-year-olds. It is something our leader, Deputy Kelly, and the Labour Party have been calling for all week. We are very happy that has been brought forward. It messed up my planned script for this morning, I must say but that is not a big issue. On the opt-in element for people aged between 18 and 34, will he be able to confirm at some point how that will match up with the mRNA vaccination system? We must ensure we do not reach a stage where there will be a cohort of 18- to 34-year-olds that has not opted in but is not captured by the parallel system and ends up falling through a gap. I am not going to say this is rushed; I will be positive and call this a reactive process. I just want to ensure young people are not going to fall through a gap, which is very important. Is the Minister sufficiently confident in our supplies that, with this parallel process, we will by 13 September have enough young people vaccinated in advance of third-level education terms restarting?

There are now reports that some states, such as Romania, have excess supply and Denmark is purchasing some of that. Is Ireland actively in the market with other states to purchase surplus supplies? That would be really interesting to know.

I was due to be vaccinated on Wednesday. I got a text asking me to fill out a form online. It had two questions, namely, did I have Covid and did I have a coagulation condition. I was scrupulous and in my two short responses I said "No" but then I got a text saying my vaccination appointment had been cancelled. I rang up the next day thinking I had messed up and got great customer service on the 1800 number. It turned out this text has been piloted with a number of people in my cohort and there have been major problems with it. I have since had people of my own age contacting my office who did the same thing. They filled out answers to the two short questions. These are questions that were asked in seconds in the vaccination centres. There is no real need for this and that has been recognised. That said, there are now a number of people to whom the process is now shut, myself included, and we are waiting for a repeat vaccination. I would be interested to know just how widespread that its. It is probably small enough but it is affecting a few people.

The AstraZeneca vaccine for people over 60 years has already been raised and I note people over 50 years are caught up in this as well. They are becoming the left-behind people of this vaccination programme. It is a positive process and admittedly, is something we have never done at this scale before. However, the one consistent negative representation I am receiving in my office about the process relates to this group. Those people really need to see the Minister and the Government lead with something which is going to improve that for them and which is going to try to shorten it. As Deputy Cullinane said, he will be fully vaccinated, as will many people in their early 40s and late 30s, before people in their late 60s and that is not right.

On antigen testing I heard the Minister on the radio this morning saying he had now set up an implementation group. This is a huge issue. There are people out there now using antigen testing. Tests are readily available and people know how to use them. They are effective. We know they do not meet the gold standard like PCR. We have been hearing that for a year and people know it as well. I believe the Minister is a supporter of how antigen testing can be used within the overall system of testing. As someone representing a constituency that has many aviation workers, it is difficult to see aviation continuing to be treated separately from every other industry, especially when there were examples of how we could have piloted antigen testing on a route-by-route basis, which we saw at the transport committee of which I am a member. The system was there and it was acknowledged by the aviation industry and people in the HSE that it could be done. It was never done. As for the role of NPHET with respect to antigen testing, the team's appearance at the transport committee a couple of weeks ago was quite incredible. NPHET brought absolutely all its big hitters. It was quite an aggressive meeting and it did not need to be like that. At the root of that was this feeling around antigen testing and how it is not being used in aviation. We are in July now and we have two and a half weeks now until 19 July. The aviation industry needs some certainty on the EU Covid certificate. They need certainty as well in relation to children being vaccinated in relation to travel. In terms of children being vaccinated in general, we need more information on that.

I will finish on the matter of indoor and outdoor dining because I am running out of time. I am sure everyone has picked this up, including the Minister, but not since "golfgate" last year have I experienced such anger in my office as I did when the announcement was made by the Government earlier this week. People want to be in this together and for the most part feel they have been. However, when the Government is implementing a policy that is going to drive a wedge between younger and older people, the whole edifice could fall down. I hope the Minister has pulled some of that back now with the Janssen and the AstraZeneca vaccines for 18- to 34-year-olds but he should not take that for granted. There is a whole heap of work that must be done to ensure our young people are treated with the respect they deserve after everything they have been through as a cohort over the last year and a half.

I welcome the Minister's statements, the Government's work and the HSE's work to provide vaccines and to reach out to people to ensure that the most vulnerable in society are dealt with fairly. I welcome the comments made today. I get a sense that all of us are working together to achieve the best for everybody.

I raise the issue of people aged between 60 and 69. It is clear, as the Minister knows, from Dr. Holohan's letter, that about 75% of this group had received just one dose. Much work is left to be done. There is clear evidence now that while getting two AstraZeneca doses is very effective, it is not as effective as two doses of Pfizer. There is evidence from the Com-CoV study, which is led by the University of Oxford, that one dose of the AstraZeneca vaccine, followed by a dose of the Pfizer vaccine, gives the best immunity to people in this age cohort. There is evidence that people are concerned about that. Some commentators on the media are clear on this. If the Minister has the medical advice to do so, could there be substitution of the Pfizer vaccine for the second AstraZeneca vaccine dose for that age group, which is most at risk?

The other question that arises in the United Kingdom is that the National Health Service is looking at a booster vaccine for the vulnerable population in the autumn. I appreciate that this is not a question the Minister can answer here. I ask him to correspond with me on that issue. Does the Government intend to provide booster vaccines this autumn, especially for vulnerable age groups and vulnerable people? We are learning as we go. The best evidence is what we have always acted on. I support all of the actions the Government has taken on this matter heretofore.

I refer to "Prime Time" on television last night. I ask the Minister about the appalling number of deaths in Dealgan House Nursing Home and the need for a public inquiry into those deaths. I have been made aware, as the Minister has, of the appalling situation that arose in Kilbrew nursing home and the deaths there. Last night, three more nursing homes were added to that list, the Ballynoe nursing home, Cahercalla nursing home and Tara Winthrop Private Clinic. The families affected suffered grievously as a result of care not being provided and they are concerned. The Irish Examiner today refers to one patient, who died later, saying that he was not in a nursing home but on death row, because there were so many dead bodies being wheeled past the door of his room. There is clear evidence that in one of these homes, no nurse was on duty for a 12-hour shift in one part of the home. That is entirely unacceptable. There is mounting and conclusive evidence of the need for an inquiry.

I refer to the Tara Winthrop nursing home. I wrote to the HSE last year to list the 20 nursing homes in Ireland where most people had died from Covid. One of those nursing homes was Tara Winthrop Private Clinic. I have some information on minutes of meetings between public health officials, the area crisis management teams and records of meetings between nursing home proprietors. I was refused the information I was looking for about Tara Winthrop Private Clinic in Swords on the grounds that it would prejudice the effectiveness of investigations, inquiries or audits into that home. That information was given last March. I ask the Minister to publish the information about those investigations, inquiries and audits into Tara Winthrop Private Clinic. There is clear, abiding and serious concern about it. I do not doubt the Minister's integrity or that of the Department. I do not doubt that there are fantastic, well-run, brilliant nursing homes in the country, but a core number continue to raise serious concern.

I have evidence about Dealgan House Nursing Home in Dundalk. Two witnesses told me that they are prepared to give serious evidence to an appropriate and proper inquiry. The families were in touch with me again today and will publish a letter for the Minister shortly. The Minister needs to grab this in both hands, have those inquiries, and meet the needs of the families, especially those who spoke last night and those I listed. Dealgan House Nursing Home cries out. It is the only nursing home in which the State intervened to take over management.

It is nice to be back in this Chamber. I hope it will be possible to return to Leinster House in September. I speak about the vaccination programme this morning in a totally different context from when I have spoken previously. I acknowledge the 5,000 people who have sadly passed away during the pandemic and I express my condolences to their families, friends and loved ones.

Anyone who watched last night’s "Prime Time" programme on nursing homes will have been struck by the sense of sadness and anger at conditions in some of the nursing homes. I welcome the Minister of State, Deputy Butler's, comments about investigating the issue. As a member of the Special Committee on Covid-19 Response, I also support a public inquiry into the issues raised. There will be others.

News of a fourth wave of the pandemic, driven by the Delta variant, has come as a disappointment, both here in this Chamber and across the country. We all hoped that this pandemic was in our rear-view mirror but we must prepare once again as a society as we face into a fourth wave for the impact it will have on our society, economy and health service. It is devastating news for the hospitality sector. I urge all Ministers to work together to find an innovative solution in the period ahead, including antigen testing, which I have spoken about before. I hope there will be no need to roll back the easing of restrictions that has been achieved to date. Thankfully, Ireland is well placed to face a fourth wave. More than 4.1 million doses have been administered. About 67% of adults have now had their first jab with almost 45% fully vaccinated. We are told by EU and Irish medical experts that all four vaccines licensed in the EU are extremely effective against the Delta variant. This is extremely reassuring.

Uptake of the vaccine has been extraordinary. It is at 99% for people over 80, 98% for people in their 70s, and 92% for people aged 60 to 69. This is well ahead of EU averages which are as low as 76% in many states. I am hopeful that our extremely high uptake in older people and people with underlying health conditions will pay dividends as the fourth wave begins to be established. The vaccines also appear to limit the transmission of the Delta variant. Therefore, it is critical that we accelerate the vaccination programme with all possible speed. I welcome the Minister's comments that the portal will open from next Friday for people aged 30 to 34.

News that experts on the national immunisation advisory committee, NIAC, have approved the use of AstraZeneca and the one-shot Janssen vaccine for everyone over 18 if they wish to be vaccinated early is also welcome. I note the Minister's comments this morning about the opt-in for that cohort. The reduction in the interval between AstraZeneca vaccine doses to four weeks is welcome. I know many people in the 60 to 69 cohort are still awaiting their second jab and are hoping for an appointment in the next two weeks. I ask NIAC to explore having an opt-in for the over 60 cohort if there are excess vaccines because a number expressed concern about the option facing them about what vaccine they were getting.

I urge the Minister to ask NIAC to decide on vaccinations for children aged 12 to 15, especially those who would otherwise fall into group 4 or group 7, with a serious underlying condition that puts them at risk. I have raised this matter before and I understand that many hospital consultants have lists prepared and are awaiting the decision and that the HSE is drawing up plans. I note the European Medicines Agency, EMA, approved the measure some time ago. The Minister might come back to me about whether NIAC cited any reason for what seems to be an undue delay. We need to offer these children a vaccination as soon as possible and certainly before the return to school in September.

The Minister might also confirm if he expects most teachers and special needs assistants, SNAs, to be fully vaccinated before the return to school.

I join with the Minister in expressing my gratitude and that of the House to all those working on, and administering, the vaccination programme across the now 40 national centres, pharmacies and other healthcare centres. Feedback has been very positive, but I ask the Minister to ensure there are proper facilities for people with disabilities. I will forward details to the Minister of feedback I have received in this regard. It is wonderful to see 692,000 vaccinations arrive this week, with another 1 million due over the course of July and more again in August. I wish everyone involved in the programme every success as they ramp up administration to protect Ireland from the worst effects of a potential fourth wave.

The Minister's comments on this morning's "Morning Ireland", and in his opening speech this morning, are welcome. It seems that a lot of work and preparation has gone into what is facing us in the next couple of months. Hopefully, with the co-operation of all in this House, we can put out positive messages, get engagement and keep the co-operation of the public as we face into the next couple of months.

I will comment on several issues relating to the Covid-19 vaccine roll-out. In Clare, over the course of the last few months, I have been inundated with emails from constituents who were not given appointments in due course as per the stated timeline of cohorts, despite the fact they had underlying conditions and, as such, were told they would be prioritised. I am talking about our extremely vulnerable people who believed they would be prioritised.

I will raise one specific example. I have been in regular contact with a constituent whose wife is housebound and suffers from multiple sclerosis, MS, and, therefore, has extremely limited mobility. This individual has a care team that have all been vaccinated but there was no contact, unfortunately, from her GP about her vaccination date even though she reached out on multiple occasions. Eventually, the independent care team rather than HSE workers orchestrated her receiving the vaccine. Her husband, unfortunately, had to drive her to a test centre more than an hour away, where a nurse agreed to come out to the vehicle and vaccinate her in situ. In response to a representation from my office to the HSE, I was told that generally people in cohort 4 were being vaccinated in hospital settings, which is an erroneous remark as housebound people are entitled to access vaccination through GPs and-or their consultants.

This is all the more striking when we consider the circumstances of another individual in the same locality, with the same risk and in the same cohort, but for whom the National Ambulance Service managed to arrange vaccination at home six weeks earlier. This discrepancy in the time elapsed is a serious concern and I wanted to raise it with the Minister today. Time and again this constituent reached out to the HSE helpline, specially formed to deal with queries from the public, but there did not seem to be any sort of effective communication between staff answering the freephone line, who are tasked with redirecting and resolving queries, staff in HSE headquarters or staff working remotely for GP offices across the country. The lines of communication were extremely, and frustratingly, convoluted.

We welcomed the announcement that vaccinations would be administered through pharmacies. That seemed a proactive response to address a lack of access to centralised vaccination centres but, to date, in Clare, only one pharmacy has been given the capacity to administer vaccines and, ironically, it is in Ennis where there is a vaccination centre. Clare is a huge county and I ask that this matter, in particular, be addressed. Access is so important. We do not want to make it difficult for people to access their vaccination. It was initially conceived of, and presented as, something that would benefit people in more isolated areas but that does not seem to be the case. Many pharmacists in Clare were excited at the prospect of being able to offer this opportunity and essential service to their local populations in more rural parts. Again, I ask that this matter is addressed.

Another issue raised with my office is the seeming postcode lottery determining where constituents are allocated a vaccination appointment. People living in the same locality, for example, have been sent to different vaccination centres, which has caused huge frustration and confusion. This may be a less pressing issue than the ones I have outlined. However, I mention the frustration and difficulties this has caused people in trying to arrange transport in order to make an appointment that is more than an hour's journey away. These are seen as minor administrative errors that should, and could, have been foreseen and avoided.

I will raise a further issue, which is the access to vaccination appointments for homeless people. I understand rough sleepers are finding it impossible to access vaccinations as they may not necessarily be linked in with homeless charities. If they are not linked in with charities through accommodation services, will they be able to receive vaccines another way? Some of these people are the most marginalised in our society, already dealing with the everyday stress of not having accommodation and, therefore, Government should ensure they are reached and enabled to get their vaccines.

I will mention the mass confusion regarding the initial extended interval between first and second doses of AstraZeneca for the cohort aged 60 to 69, much to their dismay, as they see younger, stronger people only waiting four weeks between their first and second vaccine. The projected figures for incoming AstraZeneca vaccines mean that interval has now, finally, been reduced to four weeks, but not without serious and legitimate anxiety from a section of our population that has already struggled enough and does not deserve unnecessary ambiguity and lack of clarity. I wish I could say that a line has been drawn in the sand and these issues have been resolved, but I foresee we are not out of the woods yet, unfortunately.

I will mention last night's "Prime Time" programme, which exposed very disturbing and shocking abuse and neglect of older people in some nursing homes. This is an issue that has been very well flagged for a long time. Last year, the Covid committee raised serious concerns, as did the expert group Sage Advocacy and care champions. They have all raised issues relating to the maltreatment of older people. An inquiry is needed, but we know the key things that need to be done urgently and we need action on those. The introduction of statutory staff-resident ratios in nursing homes needs to happen very quickly. It is shocking that they do not exist. Obviously, the Health Information and Quality Authority, HIQA, needs to be given greater powers as a regulator. Those two things should happen, urgently. I ask the Minister to take action on that. The fundamental problem is the privatisation of nursing home care for older people and care for older people generally. It is a major issue that nursing homes are seen as good investment opportunities rather than essential elements of the care service for older people. We need urgent action on that.

On vaccinations, I join with others in thanking and commending HSE staff, GPs, people who volunteered as vaccinators, pharmacists and all the people who really stepped up to roll out the vaccines as quickly as possible. The system has been absolutely fantastic. As somebody who has both experienced it first-hand and also spoken to many people, there is nothing but praise for how the system is working. It has been very successful. More demands will be made on all those people in the coming weeks, but I am very confident they have the capacity to deal with that. There is great willingness and the public has responded extremely well.

I will make a couple of points. Many of the pharmacists have been blindsided. I am getting reports this morning of a big rush to contact pharmacists to find out when people can get access to vaccines. Pharmacists have not been told what their deliveries are likely to be. Many of them have run out of vaccines at this stage and do not know when they will get new deliveries. It is very important that the message of what pharmacists can expect gets out to them as quickly as possible. They are very keen and willing to participate fully, but they need to know what the supplies are going to be.

I will make another point about public health messaging, which has been quite weak in recent weeks. There is now a need to put a new focus on it. We all have a responsibility on the whole question of the importance of vaccinations. All of us in this House have been putting out that message loud and clear. That needs to be repeated. However, we also need to make it clear to people what the waiting period is after completing vaccination in respect of the different vaccines.

Everybody is keen to get back to some kind of normality and to get out and about and so on, but it is important to stress that waiting period. It is not clear in relation to the Janssen vaccine what that waiting period is. We need to be much clearer in the message to people that they are not fully protected until they have completed that waiting period. There is also a need for clarification in regard to the level of protection having had Covid gives to people, particularly in the context of the Delta variant. As of now, we have not heard much about that. The information messaging to people who have had Covid in regard to the period of protection that affords them is not clear. We have a lot of people in that situation and they need clarity in that regard.

The general public health measures, in particular in regard to ventilation, need to be refreshed and repeated. This is an issue that has been neglected by official sources. The tendency is to talk about the medical aspects of this and while they are essential there are also many practical and non-medical or non-pharmaceutical aspects to responding to this and ensuring public safety. Ventilation is a key aspect. The expert group made recommendations but those recommendations do not appear to have been taken on board and incorporated into the public health messaging. I ask the Minister to check the HSE website in regard to ventilation because the information provided there is not accurate. It states that there is no evidence to support that Covid is airborne. That does not stand up any longer. That is an incredible statement that is on the HSE website. It must be changed. There must be clear guidance given to industry as well in regard to the important role of ventilation. That can be as simple as making CO2 monitors obligatory in business premises. This has been taken on board by education, which is great. There has to be clear guidance and standards set out in relation to ventilation. I do not know why we are not doing that. I ask the Minister to take up that matter.

On booster doses, what contingency planning has been made and have pre-orders in that regard been made? On older people, Age Action Ireland has set out a number of requests in regard to the queries and concerns of older people, particularly the over-60s. Concern has been expressed about the fact that they did not get access to what they would see as the best possible vaccines. There needs to be clarification on that. I ask that the Minister interact with Age Action Ireland in particular and that information be provided.

I want to raise the issue of Erasmus students who have contacted me worried about the fact that under the current roll-out programme they will not be vaccinated prior to leaving to attend universities across the EU. I submitted a parliamentary question on this matter to the Minister's office, but the reply takes no account of the vaccine needs and concerns of these young people who will be leaving this State for up to ten months, and their parents. It is a record year with over 7,000 students heading across the EU and an exciting time for them after the two years' disruption to their studies. To protect them and our neighbours in the host countries they should be able to get vaccinated before they leave and not be left at the mercy of the bureaucracy of a health system in another part of Europe. In some countries in Europe, non-residents are at the end of the queue. No young adult wants to have that worry and no parent wants to be worrying about his or her adult child or children getting sick or at risk of Covid when abroad. I ask the Minister to give consideration to these students being able to get vaccinated before they go. We have an international responsibility to ensure that the students we send abroad are not at risk and will not cause risk or burden to health systems in other countries. I am also anxious that we would live up to our international responsibility to get more vaccines to our brothers and sisters in poorer countries around the world.

As in the case of climate change, Covid affects all of us. We are all interdependent. If this pandemic has not taught us that, I do not know how our intelligence fairs. Our fates are intertwined. Leaving the selfishness out of it, the Delta variant has shown us that we are not at the end of the road in terms of Covid. The mood has much changed in the last week. Last week, the CMO was optimistic, but we appear to be back to square one. The sharing of vaccines is essential to poorer parts of the world where the virus is outrunning vaccines. We still have a chance in our race. Their new variants become our new variants. For selfish reasons alone, we should care about that very much.

Ireland has a seat at the UN Security Council. We need to do what we can to make the world secure. I hope there will be a rethink in relation to the intellectual property rights and the lifting of the waiver to expand vaccine production across the world. If this pandemic was not something that affects economies all over the world, I dread to think how we might have reacted to it.

On "Prime Time" last night, I add my voice to the calls for a public inquiry. It is almost one year since I called for such an inquiry. I am a Teachta Dála for Kildare, which has suffered disproportionately in terms of deaths. I pay tribute to Professor Cusack, the Kildare coroner, who was to the fore in highlighting how we fared in Kildare.

Related to the virus and vaccine roll-out is the issue of partners of pregnant women having access to visits. It is almost a year since I first raised this issue with the Minister as well. I was one of the first Deputies to raise it in this House. Listening to the airwaves, it appears we are back again to this being an issue. Fathers are now more likely to be able to wet their baby's head indoors in a pub than to see it on a scan. That is bonkers. We are supposed to have had huge learning over the past 18 months about what really matters in life, but I do not think we have. The maternity hospitals need to be on board. Access should not be dependent on where a person lives. As I said, it is almost one year since I first raised this issue with the Minister. Women are facing invasive internal examinations not because they are necessary but to establish their status in labour in order that their partners might be allowed to join them. It is obvious that the people making the decisions here have never given birth. I hope the Minister will look at this area again.

I am sharing time with Deputy Barry.

Is that agreed? Agreed.

I too would like to raise serious questions in regard to the "Prime Time" programme last night. There must be a public inquiry in regard to what happened in nursing homes last year in the interests of the loved ones and relatives and in the public interest. It is inevitable that that will happen.

Vaccine roll-out is a logistical challenge.

This country has been quite good in administering the roll-out. It is going very well. My experience at Citywest was excellent. The Minister's statement about the roll-out of the vaccine for the cohort aged between 18 and 35 is very welcome. Many in this cohort work in the hospitality industry and could be vulnerable at this moment or in the future to any counteroffensive from the virus, such as the Delta variant. There was sombre news during the week when NPHET gave its advice. It probably shocked most people in the country to hear that we could be facing the deaths of up to 2,000 people over the next three to four months. Anybody would have been shocked by that news. We have an advantage, which is that we can see what is happening in Britain. In some ways, Britain is four to six weeks ahead of Ireland. Its vaccine roll-out programme is probably four to six weeks ahead. One can see the trajectory of the virus. It is not plateauing by any means, it is actually going up and at a rapid pace. The good news is that the vaccine roll-out is being run really well in Britain but the Delta variant is taking hold. That is very important.

I have another criticism, which relates to the handling of the cohort aged between 60 and 69. It was a mistake to leave a gap of, in some cases, three months between vaccinations for this cohort. I am fully vaccinated but somebody who is 20 years older than me still is not. That was a big mistake. I know this is being addressed but the ambiguity around the mixing of vaccines as it relates to this age group still has not been cleared up. It is very important that happens quickly.

I have another question, the answer to which the Minister can send me in a note. It relates to a cohort of Irish citizens who are living in Abu Dhabi. They may contact the Minister with regard to their situation. There are 2,000 Irish citizens living in Abu Dhabi, most of whom working in the education sector. They have got a vaccine made by Sinopharm. They are fully vaccinated but, if they want to come back to Ireland, they have to go into mandatory hotel quarantine. They are unhappy about that because at the time, a number of months ago, this was the only vaccine available to them. At this moment, if they wanted to come back to Ireland, they would have to go into mandatory hotel quarantine, which they believe is very unfair. I hope the Minister could address that at some point in the future.

Last night's "RTÉ Investigates" provided shocking insights into the treatment of elderly citizens in some of our nursing homes during the pandemic. I again support, loudly and clearly, the call for a national inquiry into nursing home care and nursing home deaths in the time of Covid. The case for that is now unanswerable. I will address the issue of the vaccination of people aged over 18. They are to get the one-shot Janssen vaccine in pharmacies. This process will start on Monday. I will start by appealing to young people to avail of this and to get vaccinated. The point has been raised over the course of this week that young people should be paid money to get vaccinated. I do not quite know where this idea came from. It smacks of the scenes in the United States wherein people were given beer and pizza if they got vaccinated. I do not believe that young people need that. They can see the sense in getting vaccinated. It makes sense for themselves, for their families and for society. Young people have made big sacrifices. They have not only been hit the hardest medically, they have also been hit the hardest economically. They have made great sacrifices and have shown great patience. Young people will do the right thing with the vaccination. To leave the beer and pizzas to one side, there is a powerful case to be made for a Covid dividend for our young people, a package or suite of measures as we come towards a point in this pandemic, during which our young people have made a great many sacrifices. Such a suite of measures could and should include things like an increase in the national minimum wage to €15 an hour. That is a far better to dealing with this question than the beer-and-pizza approach floated earlier in the week.

Táimid ag bogadh ar ais go dtí an Rialtas. There are three speakers listed here but I am not sure about that. There are 11 minutes of speaking time remaining. An Teachta Pádraig O'Sullivan is here. I am not sure if he is taking all 11 minutes but he is entitled to do so.

I have never been offered 11 minutes of speaking time for anything here. I will use as much as I can.

Unless the Deputy's colleagues arrive.

Yes. I am aware that this is not a question-and-answer session but I would appreciate it if the Minister or the Minister of State could respond to some of these issues when replying. Like every other Deputy present, I welcome this morning's announcement regarding vaccine portals being opened up for those aged 18 to 34. This is something for which I have called repeatedly. It gives young people an opportunity to register in advance of returning to college in September. It will also be of benefit to those undertaking summer work and who find themselves stuck in different scenarios with regard to the proposed certification for indoor dining and so on. I will put on record that I personally have issues with the idea of certificates being required to dine indoors, to attend one's local pub or whatever the case may be further into the summer but I feel that today's announcement regarding the potential for those aged 18 years and older to get vaccinated renders the issue of certification moot. I do not think that system is practical or implementable in light of what has been announced this morning, which is very welcome.

I will also speak to vaccine hesitancy and the need to vaccinate as many people as possible as quickly as possible. I concur with Deputy Barry who mentioned the idea of rewarding young people for getting vaccinated. We do not need to go down that road. Our rate of vaccine take-up is among the highest in the EU. The idea that was mooted this week is a non-runner. I do not believe there is a need for such inducements. As I said, our rate of vaccine take-up is among the highest in the EU. Will we, at some stage, have figures or a breakdown regarding those who have refused the vaccine? The reason I ask for this once more is so that we can try to tackle resistance to taking up the vaccine.

What plans are being made for vaccine top-ups in the autumn, the winter or into the future? It seems to be widely recognised that this will be necessary and I would like to know what preparations we have made. In addition, I would be interested to hear how the State is preparing to combat future pandemics. When will such an assessment be ready or published? Many of us here have been contacted over the past few weeks by people who are awaiting their second dose of the AstraZeneca vaccine. They have been waiting nine or ten weeks, or longer. Will the Minister clarify NIAC's advice regarding reducing the interval between doses to four weeks? Will this lead to a further reduction in waiting times for those still awaiting their second dose?

I will also raise the issue of last night's "Prime Time Investigates" programme. Ballynoe Nursing Home is located on the north side of my constituency. Over a number of months, I have been seeking answers to questions raised by grieving families. I join the call for a public investigation into this issue. This is again something the Special Committee on Covid-19 Response, on which I served, asked for last year. In light of what was reported last night, further delays are not acceptable. Some form of inquiry needs to be undertaken. Will the Minister confirm if any preliminary report or investigation has been conducted by himself, the HSE or any other relevant State actor?

I will also mention antigen testing. This is something I have pursued for the best part of 12 months. Judging from news reports this week, the Government is finally looking to undertake measures in this regard. We waited for the Ferguson report for a long time. Now that it has finally arrived, it needs to be implemented quickly.

I understand there are mentions of pilot programmes in relation to return to colleges but antigen testing is happening in private and public settings all over the country. I do not understand why we have not rolled it out to a greater level, as other EU states have. I have heard nobody in here argue that rapid antigen testing will replace PCR. It is time, in relation to the return of travel and of industries like hospitality, indoor dining and so on, to grab the bull by the horns and implement a proper, cohesive rapid antigen testing regime.

Most people are saying it is great to be back here. The only advantage I have in the convention centre is nobody notices when I walk about. I am not good at staying in one place.

We are dealing with an incredibly serious issue. I would be happier if it was questions and answers. I accept the situation we are in and recognise the tragedy the Covid pandemic has been for many families. We have heard the shocking figure of 5,000 this week. My heart goes out to all those families. We believed we were in a slightly better place but the conversation changed in recent weeks to the Delta variant.

There should have been preparation for the fact this week would not be what we anticipated in relation to opening up but we are where we are. I welcome the change to the NIAC guidelines. We need as much clarity as possible on the revised timelines for the vaccine roll-out. I think it was Tony Holohan who said it was a race of the Delta variant versus the vaccination roll-out. We need that to happen as soon as possible.

Many Deputies have spoken about the difficulties in relation to those in the 60- to 69-year-old cohort who have not got their second vaccination. We have all been contacted by people in this cohort who are worried and probably annoyed that younger people ended up being vaccinated earlier. We welcome the clarity that those people should be dealt with in the next fortnight. I think 12 July is the date given. We need to ensure this happens. We welcome the changed guidelines for 18- to 34-year-olds. We need to ensure the systems are up and running as soon as possible. We cannot have a two-tier society comprising those who have been offered vaccinations and those who have not. We need to streamline this as much as possible.

We are all living with a variant and see the difficulties that will arise until we deal with a global vaccination programme. COVAX will only look at 20% of people in the developing world so that will not work. We have to look at the TRIPS waiver and whatever else is necessary. None of us is safe until all of us are safe.

I add my voice to what Deputies have said about "Prime Time Investigates" and families that have gone through so much. We have had multiple reports into weaknesses in how we look after our old people and the whole system. We know the issues in relation to the Covid period. I think everyone is in agreement that there needs to be an inquiry into that period, particularly regarding nursing homes and what the State did or did not do. The Minister will not be shocked, having met the Dealgan House families. He knows the tragedy, the huge loss of life and the impact on a huge number of families who are still looking for answers.

At this point, I can only see the answer being a full public inquiry. There is a huge number of players and everybody has a right to their narrative. We need this to be interrogated completely, involving nursing home management in Dealgan, HIQA, the MEP who was involved in some of the interactions, the HSE, CHO 8, the Minister for Health at the time, the CMO, the CEO and the head of community operations of the HSE and the RCSI Hospital Group. Everyone has a part to play. We need a full inquiry. I would like the Minister to return to the families. He has told them they need to be given some mechanism to provide answers and an inquiry is the only way to do it.

I have called consistently for a plan from Government on reopening. It was never produced, even though I was told on the airwaves by many Government Members that there was a plan. According to the Government's reaction this week to NPHET's modelling figures, it does not have a plan. It offered another reactive approach which has been an absolute car crash instead of ensuring preventative measures by having a plan in place. We have been hearing for months about the Indian variant, called the Delta variant. Now the Government is considering allowing only fully vaccinated people to eat indoors, whenever that will be. In other words, the Government is considering introducing a medical apartheid, keeping many families from being able to go for a meal together. Then it tells the restaurant sector to come up with the idea on how to do this.

If Government cared to look at how countries which are opened are doing this, it is called antigen testing. They have been doing it since last year and it allows people to eat indoors, stay in hotels and in the workplace and keeps nursing homes and meat factories clear of Covid. It has also allowed HGV workers to continue their work distributing food imports and exports for months when the French requested it. Still NPHET says no to antigen testing. Young, unvaccinated people can work in our pubs and restaurants for hours on end but if they eat indoors, NPHET says they are at risk. This is the 2021 version of the €9 meal. Having destroyed and closed businesses for most of the last 15 months, does the Government really expect the publicans or restaurateurs to check people's vaccination status? Is there any scrutiny of these hare-brained ideas going on inside Cabinet? Of the 44 countries in Europe, we are the only one with a ban on indoor dining, even though the Minister says we have the greatest take-up of vaccine in the EU in the vulnerable age cohorts. We have administrated to date over 4 million vaccines and we are still in a disastrous place.

Despite NPHET's ongoing doom and gloom reports, deaths in Ireland for 2020 were within the usual rates in a given year. Yet NPHET says we could have a surge of 2,000 deaths if we open the pubs. As a matter of extreme urgency, the Government must carry out an international peer review of NPHET's modelling. This has nothing to do with trust. It is because we are outliers in the EU. My constituents in Wexford, young and old, want to know what is different about Ireland, even if the Government does not.

This week's stock response from Government was that it would consider the issues over the coming weeks and come up with a plan. The people thought that is what Government was doing when it announced dates to open. Government should be putting resources into the mechanisms to ensure it happens on the date announced, no matter what the strain and what numbers. We have to live with Covid. We need measures such as a fit for purpose test, trace and isolate system, antigen testing in every village and town pharmacy so people can test for Covid affordably and increased ICU beds. Instead, we just have a shambolic approach. We have no leadership and no plan other than lockdown and delay, delay, delay.

It appears that the decision to cancel communion and confirmation services was not based on NPHET's advice but that is what the Tánaiste said when he announced it. The children who would be attending those services have been in schools with Covid cases and those schools were not closed. Their grandparents have been vaccinated. The churches made preparations to have 50 people at most at the services. However, like young working adults, the people involved cannot have a party because, it appears, they cannot be trusted. The disrespect shown by the Tánaiste and the Government to religious services and the people involved in organising communion and confirmation ceremonies for the past number of months is unforgivable.

I heard the Tánaiste suggest some days ago that we should give away our unused vaccines. A couple of days later, however, he announced continued restrictions because our vaccine roll-out has not been fast enough. It appears from information I have been given, on very reliable authority, that the no-shows at vaccination centres are people who have already been vaccinated by their GP but failed to get a response from the HSE's helpline when they tried to cancel their appointments. The question they want answered is why their vaccination was not recorded on a system that correlates data on vaccination centres and GP patients, and what system is in place to record vaccinations if certification of same is needed.

I have had people contact me who are in the 60 to 69 years of age category and have passed the eight-week period without receiving a text calling them to attend for their second jab. Others have told me they were contacted and asked why they did not turn up for their second jab, even though they did not receive a text calling them for it. When they explained this to the HSE operative, they were told this is happening a lot. What was initially a vaccine roll-out based on prioritising vulnerable and older cohorts then became just an age-based roll-out, going from the oldest in the population to the youngest, who are being left until last because they are not at any great risk. Now it appears that a choice is to be made between giving a second jab to the older cohort or a first jab to the younger population. When NPHET asked NIAC about this and got an answer, NPHET did not even factor that answer into its modelling.

There are serious questions to be answered on this issue. The answer is not to attack the people asking those questions as conspiracy theorists. Nor is it to create an environment in which vaccinated people are pitted against those who are not vaccinated. It is very important to understand that not all of those who will not take the vaccine are anti-vaxxers. There are genuine medical reasons for not taking a vaccine. I have a constituent who suffers from an allergy that causes anaphylactic shock, for which he has been hospitalised in the past. The health authorities will not give him the vaccine and, as such, I take it he will not be able to eat indoors in restaurants or pubs. I have also spoken to a number of people who are home from the United Arab Emirates visiting their families. They have been vaccinated but the vaccine they received, Sinopharm, is not recognised by the Government or NPHET. Those people will not be able to eat indoors in restaurants or pubs.

Being vaccinated is voluntary, as has been stated at all times. There are people who will not, as opposed to cannot, take the vaccine. Why point them out and ostracise them? It is a very dangerous precedent to set. In the course of its vaccine roll-out, the Government has yet to meet any vaccination target. Who has been held to account for this? Has anyone lost his or her job because of it? In fact, the only people who have lost their jobs are the hundreds of thousands of workers in the hospitality industry who have seen their jobs and livelihoods destroyed by a disorganised, NPHET-controlled Government. The power of decision-making must rest with the individual because the Government, it seems, has completely lost the plot.

The issue raised on last night's "Prime Time" programme will come as no surprise to the Minister as I emailed him about it months ago. While the HSE had a recruitment embargo in place coming into the Covid period, it thought nothing of instituting a recruitment drive to poach staff from nursing homes and leave them bereft. Facing staff shortages in the teeth of a storm, nursing homes were told by the HSE that they would not be receiving assistance to address this problem, which was caused by the HSE itself. I very much hope that issue will be considered pertinent and relevant to the inquiry we will have to see into what happened in nursing homes, both public and private.

I am sharing time with Deputies Flaherty and McGuinness. I expect the Acting Chairman will allow us the same additional minute and a half he allowed the previous speaker.

That is not negotiable at the moment, Deputy, so we will proceed on the basis of the time allocated.

I am delighted to speak in this debate in the time allowed to me. I welcome the announcement by the Minister, Deputy Stephen Donnelly, yesterday regarding the appointment of Professor Mary Horgan to lead an antigen testing working group. As Chairman of the Oireachtas Committee on Transport and Communications, I wrote to the Minister yesterday afternoon requesting that the aviation sector form part of the terms of reference of the working group. It is hugely important that it does. The committee has held extensive public debates on antigen testing. In fact, we have led the way in terms of a constructive discussion on the role antigen testing has to play. Witnesses who have appeared before the committee include Professor Mark Ferguson and Professor Michael Mina, as well as the CMO, Dr. Tony Holohan, and his team. I would like the Minister to give a commitment here today that antigen testing for aviation will form part of the work programme of the new group.

It is also important that the working group led by Professor Horgan should move on from questioning antigen testing to seeing how we can best use it. All I have seen, within the system as opposed to within the Government, is questioning. The bottom line is that antigen testing is not foolproof but it has a role to play. PCR testing is the gold standard but there are areas where it may not be able to do what antigen testing can do. One of those instances is aviation, where there is a requirement for PCR testing three days prior to departure but no guarantee that by the time a passenger gets on the aeroplane, he or she does not have Covid. Antigen testing will pick up that cohort of people who are at their most infectious. It will not identify everyone who has Covid but it will pick up the cohort in which people are in the ten-day period when they are most infectious. For the same reason, antigen testing also has a role in indoor dining. Vaccination is the absolute gold standard, followed by PCR testing and then antigen testing. They all have a role to play.

My position, then, is that the terms of reference of the working group must include the aviation sector and must be about implementing a structured approach in terms of the role antigen testing can play in reducing the risk from the coronavirus. It is about identifying people when they are at their most infectious. If we are taking a vaccination status approach when it comes to indoor dining, antigen testing can be used to facilitate people who are not vaccinated. For crying out loud, why was there such resistance within NPHET to antigen testing? It is not the be-all and end-all but it has a role to play. Let us grab the opportunity it presents. Professor Horgan's working group must not be about continued questioning but, rather, about ascertaining what role antigen testing has to play. I hope the Minister will give a commitment today that aviation will be included within the group's remit.

I very much welcome the announcement this morning that, from Monday, people aged between 18 and 34 can go to a participating pharmacy and get the Janssen vaccine. In Limerick, like everywhere else, we have a large number of young people. I encourage them to go to the pharmacy and get the vaccine. It will benefit them, their family and the wider community. It is hugely important that they do so.

From next Friday, those aged 30 to 34 can register on the HSE online portal for the mRNA vaccines - Pfizer and Moderna. This is very much welcome. From 12 July, those aged 18 to 34 can register on the HSE portal for the AstraZeneca and Janssen vaccines. I ask young people aged 18 to 34 in Limerick to look up the HSE website, find out their participating pharmacy, contact it and get the vaccine. It will take a worry away from them, their friends and families and the wider community. This is the way forward.

It is a race against time between the vaccine and the virus. I very much welcome the fact that the Minister made the decision yesterday to bring in antigen testing as part of the toolkit in the fight against the coronavirus. Antigen testing has a role to play but it has not been allowed to feed into things for the past number of months, although it has fed into certain areas. The terms of reference of the working group must include the aviation sector. The working group must also look at how we can make best use of antigen testing rather than continuing to question it. It must be action driven. If the working group ends up being a talking shop in the public mind, it will lose its currency. This is about action rather than talk. Now is the time to drive on. We have a window of time. The digital green certificate is coming in on 19 July, which is just under three weeks away. It is hugely important that the aviation sector is included in the terms of reference of the working group and prioritised.

On my second day in the Dáil, I told the Tánaiste that it was as if the Taoiseach was driving a bus but the Tánaiste was trying to push it off the road and the Minister for the Environment, Climate and Communications was asleep in the back. Everything seems to have been the same since then. Every time the Government makes a decision, it has to change it because it does not talk to sectors such as hospitality. I spoke to people aged between 18 and 20 last week who told me that they are serving people who are dining outside or staying in hotels. Last week, the Taoiseach stated that people visiting pubs should be asked if they are vaccinated. People working in the hospitality sector asked whether it will be the case that they will be allowed to serve people all day long but, come the weekend, if they want to go out themselves, they will be told, sorry, they cannot come in because they are not vaccinated. The Government has now said it will roll out vaccination to those aged 18 upwards. This is like closing the gate when the cattle are outside on the road. The Government is second best all the time.

We always talk about European law. Under a European law adopted in January 2021, we must ensure that citizens are informed that the vaccination is not mandatory and that nobody should be under political, social or other pressure to be vaccinated. Europe is saying that we cannot use political pressure. The Taoiseach has done the opposite. What will the Government do? People are taking the vaccines. People in the vaccination centres have been outstanding but under European law, the Government was told it could not use political pressure. There is an old saying, "you will get an awful lot more with honey than you will with vinegar." The Government would want to start using a bit of honey, start encouraging people and stop dictating what people can and cannot do. People in Ireland are responsible for themselves. They are responsible for and will look after their own health.

The Government should stop messing people around. It has already messed around with regard to indoor dining. It seems to be messing everything up. I have said before that there is such a thing as an educated fool - someone who is over-educated and has no common sense. The Government is over-educated and has no common sense but members of the Rural Independent Group will give it plenty of common sense if it would like to adopt our policies.

When I was a member of the Oireachtas Special Committee on Covid-19 Response at the beginning of the Covid crisis, it was the only Oireachtas committee operating at the time. I was lucky enough to represent the Rural Independent Group on it. From the word go, I called for both PCR and antigen testing. Every time I called for it, the Tánaiste, who was Taoiseach at the time, and other Ministers were against it. Everybody was against something that eventually proved to be a help. Nothing is ever 100% but certainly antigen testing would help get this country up and running again.

I look at the hospitality sector and the way it has been treated so shoddily by the Government, not only in the past week but for over 400 days during which most businesses in the sector have had their doors shut. One could nearly predict the announcement made this week. It could have been made somewhat sooner because some businesses were painted and made ready with staff organised and even some food or drink products purchased. To have that pulled from under them was a disaster. To add insult to injury, the Government told them that when the restaurant or pub opened, staff would have to stand at the door and stop people from coming in unless they are vaccinated. For the love of God, where is the Government coming up with such things? As somebody said, if it was a sketch from "Killinaskully", it would be a great laugh but it is not a laughing matter. It is a very serious matter. People's livelihoods are being ruined.

We have a situation where Mary and John want to go for a drink but their two children are not vaccinated so they would be left outside the door. Is that what the Government expects? Is this how it thinks this will work? Alternatively, we have a situation where 18-year-olds working in a bar cannot be vaccinated, through no fault of his or her own. The Government may have announced today that this group can be vaccinated but those aged over 60 cannot even get a second vaccination, so never mind seeing the 18-year-olds. It is a nice announcement and sounds good. A worker in a bar who may not be vaccinated can serve drink to vaccinated people but if he or she sits down for a drink at 11 p.m. when the pub is closed, he or she could be arrested or the publican could be charged with allowing him or her to be inside the premises. It is insane. It is not workable and no publican will work it. My advice to Fianna Fáil or Fine Gael politicians is not to call on publicans and the restaurant sector because they will run them out the door and chase them down the road for the way they treated them. They are absolutely livid and rightly so.

The second issue I wish to raise concerns the over 60s. Some of this group have not received their second vaccination. They are asking and calling me and I will always stand up for people who want to get vaccinated. That is their choice with which I am in full agreement. Why has this not happened?

I spoke about supports for nursing homes in the Dáil yesterday. It is incredible that the Government is saying we no longer need supports for nursing homes and grants for material or equipment to help save people from getting Covid in nursing homes because we are moving on but, at the same time, we cannot open the hospitality sector because we are not moving on. What is wrong? These are two conflicting messages. The Government should come out with one clear message. The Tánaiste is saying no confirmations or first holy communions can take place but NPHET says it never advised that. What is going on?

Forgive me if I avoid niceties in the two minutes and ten seconds available to me. The Minister spoke about the role of pharmacists. It is emerging that pharmacists learned about it this morning when the Minister went on "Morning Ireland".

Then we learned there are only some approved pharmacists so it is not a question of all pharmacists being involved. We understand there are no approved pharmacists in Connemara.

I stood up in the House in March of last year and gave my full support to draconian legislation on the basis of full and frank disclosure and no spin. What we have got since has been spin, more spin and then "unspin". This week, which marks the lowest point in my political career, I lost all faith – I say that most reluctantly – when the Minister came out with a statement that only vaccinated people could go to restaurants, pubs and so on. I find that shocking and unacceptable. It lays bare the worth of the rhetoric to the effect that we are all in this together. We never have been. Nursing homes were certainly not in it together. I did not need "RTÉ Investigates" last night to tell me there were problems in nursing homes in early 2020. We knew there would be because we have privatised and segmented our public services. We have segmented knowledge. We are here today with a little discussion and a certain amount of information on vaccination, but we have no overall discussion. I have said before that I do not entirely blame the Minister for that but I certainly blame the three unwise men at the top. We have had no discussion on the cost of vaccination and the cost of the indemnity. We are facing circumstances in which we need a passport. This morning, the Minister tells us that digital passports will be posted out. How people are going to get those under the Office of the Taoiseach, I do not know. I find the whole thing unacceptable.

Respite services have never been restored to Galway. Those between the ages of 60 and 69 have been told that they will go to the bottom of the list. The information coming out is that they should have mixed vaccines, that is, the AstraZeneca vaccine they got with no choice followed by a different one that is much more effective.

I will be very quick. Again, I will have to avoid niceties because I only have two minutes. I support an immediate public investigation, not on the back of the "RTÉ Investigates" programme last night, even though it was harrowing to watch, but on the basis that it should have happened a long time ago.

I note the change to the vaccine programme. I hope it works and that there will be a positive uptake. I ask the Minister to supply a breakdown outlining all the groups that are outstanding and the numbers involved. I would like him to link that information with the information on the vaccine that is coming now and the expected position on the vaccine roll-out over the next month or two. That will be very important for transparency.

A revised module is required immediately, as has been asked about already. My concern over indoor dining is simply that workers in the indoor dining environment will have to be safe and protected by public health measures. The worker should return to pay and conditions that are the same or better than those they had before March of last year.

The Minister raised this morning the major concern that there could be a surge if the predictions on the pessimistic side are correct. Could the Minister state in his reply or as soon as possible thereafter how the hospitals are managing and preparing for this in regard to elective surgery and normal healthcare?

I want to raise a point that has been raised on numerous occasions. The Minister said that we have entered agreements through the European Commission for the delivery of millions of doses of vaccines in 2022 and 2023. While I welcome that, will the Minister apply the same determination to ensuring the international population will be vaccinated to protect us all?

I have tried to consider this issue based on where we were and where we are now. I remember when we debated the roll-out of vaccines and asked whether we would have enough vaccinators, etc. The truth is that we have heard largely positive outcomes in this regard. Admittedly, we have had setbacks but we have done well. It is important that all of us in this House recognise the incredible work of everybody - I am not singling out anybody - who has been involved in the vaccination process.

There are two matters on which I wish to comment. The Minister needs to move on the issue of mixing vaccines. I will say no more about that; I just wanted to put it on the record. The Minister should also move on the issue of antigen testing.

The other issue on which I really want to focus today is nursing homes. I did not see the programme last night but believe it was heartbreaking and heart-rending. I cannot believe I am about to say the same thing for the third time in the Dáil. I ask the Minister to consider again the temporary assistance payment, TAP, scheme, which ensures enhanced infection control in nursing homes. I asked the Taoiseach about this in the convention centre this week and he was quite negative. I asked the Tánaiste about it yesterday. He was not as negative and said I might engage with the sector. Since the decision was taken, we have had the figures at the beginning of this week. Nobody, including the Minister, was expecting them. They change everything.

The HSE in Donegal has restricted visits to certain nursing homes. That indicates the point we are at. We recall what we have heard from other countries, including Belgium, but I am not going to get into it here this morning. In all sincerity and honesty, I ask the Minister again to re-examine the TAP scheme and continue it, even for a short period until we get over what everybody is saying is going to be the fourth wave.

On a point of order, Members of the Opposition like ourselves are fighting for speaking slots in this debate. The Government had 21 minutes in this discussion that could have been used by the Opposition.

I thank colleagues right across the House for their time and for the questions, ideas and challenges they put to me. It has been really useful to listen to the various ideas, concerns and issues raised. I have about ten minutes. I took notes throughout the session. Given that we are a little ahead of ourselves, the Acting Chairman might indulge me a little at the end if I run out of time. It is up to him. I have tried to group the issues raised. I will not get to every specific one but I want to try to address the various themes.

Many colleagues spoke about rapid testing. I hear and understand the agitation from within the Oireachtas for rapid testing to play a bigger role. I believe it can and must play a bigger role. We are aware that there are strongly held expert views on both sides of this. I fully respect the views on both sides. Everyone who is advising me, from those in the medical community to those in the scientific community, is doing so with only one objective, that is, to find the best possible outcome for Ireland in this pandemic. That is the only thing motivating people.

My view is that rapid testing has a role to play, or has more of a role to play, and that is why I set up the expert group some time ago. After setting it up, we began to implement its recommendations. It recommended the running of multiple pilots in multiple sectors. That is exactly what we did. Pilots have been run in education, meat processing and various other sectors. The Minister for Tourism, Culture, Arts, Gaeltacht, Sport and Media, Deputy Catherine Martin, and I are working on a pilot right now for the entertainment sector. The Minister of State responsible for sport, Deputy Chambers, and I are examining pilots for sport and so on. All of that has happened. The next thing that happened is what I announced yesterday. I believe it was yesterday but it has been a busy week. I am referring to the setting up of an expert implementation group. It is chaired by Professor Mary Horgan. It has fantastic members who are tasked with supporting State agencies and Departments on pilots, validation, full roll-out and implementation. In this regard, several Deputies referred to the aviation sector, for example, and asked whether it can be included in pilots and validation. It absolutely can. The Government is running this model as a decentralised one so it does not require me or the Department of Health for any Department to say it is going to run a pilot. The Department of Health and the HSE have been providing expert support and now the group to which I have referred will also be providing that expert support. If, for example, the Department of Transport wants to engage with the aviation sector to run pilot programmes, that is entirely up to it. My Department and the group will provide the support for that to happen.

The establishment of the group this week has been warmly welcomed. I thank Professor Horgan, who was also a member of the expert group, and all of the other people who have agreed to give their time, effort and expertise to the new group.

Some questions were asked seeking clarification on the opt-in model I announced this morning. This is very exciting and we all agree it is very positive. Ultimately, it comes down to ensuring that every vaccine dose we have can be used. Whether people choose to make use of them is a separate matter. As the State, the Oireachtas and the Government, we need to ensure all vaccines are available. That is why I asked some time ago for a review of NIAC's position and contingency planning for whether, in a scenario in which it looked like there would be a serious Delta wave, it would allow for a further use of AstraZeneca and Janssen. The answer NIAC came back with this Monday was "Yes". A tremendous amount of work was done during the week. The HSE, the task force, the Department and I worked through the details late last night and turned that NIAC advice around and into implementation in one week. I thank everyone in the task force, the Department and the HSE who has worked non-stop to implement that very quickly.

Deputy Joan Collins asked about the numbers of people in the 18 to 34 age cohort and the amount of vaccine we will have. I will give the Deputy the exact figures, as I have them. The estimate is that the number of people yet to be vaccinated in this group numbers approximately 800,000, comprised of approximately 550,000 from the 18 to 29 age group and about 250,000 from the 30 to 34 age group. We do not know how this will work but my expectation, given that the portal will open for the 30 to 34 age group next Friday and they will start being vaccinated through the established process with the mRNA vaccines approximately one week later, is that many people in this cohort will register on the portal and proceed with the mRNA vaccine. Some will opt for the other vaccines but that is what I imagine will happen. I expect many people in the 18 to 29 age group may decide to opt in because the mRNA vaccine cycle does not start for them until mid or late August and they will want to be vaccinated earlier than that.

The number of vaccines we have available and in our line of sight for July includes approximately 205,000 Janssen vaccines and 100,000 AstraZeneca vaccines. AstraZeneca is contracted to deliver significantly more than that but that is what we have in our line of sight and confirmed right now, so that is all we can plan for. Essentially, through July, we have between 300,000 and 305,000 vaccines but we have no confirmation from AstraZeneca for August. I can tell the House what we are contracted for but that does not really matter because what we need is confirmation of what is coming and that is yet to be determined. We have confirmation from Janssen of 285,000 vaccines for August. This is a considerable number of vaccines. If we assume that most of the 30 to 34 age group will continue to be vaccinated through the Pfizer vaccine and most of the AstraZeneca and Janssen vaccines will then be available for the 18 to 29 age group, that will cover a very sizeable portion of the latter group. Ultimately, it boils down to the fact that this group now has the option of being vaccinated one to two months earlier than anticipated. That would have been welcome even if we had not received the news on Delta but in the context of the latest NPHET modelling, it is very welcome news.

Did the Minister mention the number of Pfizer vaccines coming in?

I will get figures on the Pfizer vaccines for the Deputy but we have sufficient numbers coming in to be able to open up vaccinations next week for the 30 to 34 age group.

I will address now the issue for those aged 60 to 69, which has been raised by many Deputies. I have also spoken to people in this group, some of whom have contacted my constituency office. We all hear the frustration and the very urgent desire and, indeed, demand of people aged between 60 and 69, and many other people as well who have had one dose of AstraZeneca. This is not just confined to the 60 to 69 age group. What have we done? First, this group has been prioritised. I know that everyone is looking for a second dose but let us remember that the first dose gives a great deal of protection, particularly against severe illness. That is very important. A lot of protection has already been afforded because this is a priority group. The good news is that because of the NIAC changes, we have been able to go from a 16-week interval to a 12-week interval, then an eight-week interval and now a four-week interval. For this reason, we are expecting to complete, in the next week and a half, second doses for the 60 to 69 age group and all those in other cohorts who have had one dose of AstraZeneca. We are moving very quickly because the NIAC advice has allowed us to accelerate the process and we are doing that immediately. We all hear the demands from this group and the urgency involved. Deputies should rest assured that we are doing everything we can to accelerate that. I hope that message will be well received.

I will now address indoor activities because there has been a strong focus, rightly, on the public health advice the Government received and accepted on indoor activity. There has been a focus on hospitality but we must remember that this also involves dance classes and indoor exercise. Much more than hospitality is involved. It has been very difficult for people who were planning to open their premises and were ordering stock and scheduling classes to hear they had to cancel those plans. We hear that very clearly.

The unambiguous advice that we got from NPHET in light of its modelling and based on what is happening in Scotland, Northern Ireland, England and Wales is that, in terms of becoming infected, it is not safe for unprotected people to engage in what NPHET would describe as high-risk activity. This advice is not given based on what is fair or unfair but on what is safe and unsafe. The State believes it is unsafe for there to be smoking indoors in bars but safer for it to be done outdoors, if not for the people smoking but for other people. The State believes it is unsafe for people aged 17 and under to drink alcohol in bars but over the age of 18 it is considered safe. The framing for this is what is safe and unsafe and the only motivation is to try to keep people safe.

I will give some context on the level of contagion that we are dealing with. NPHET laid out a case in Waterford recently where a super-spreader event was linked to socialising at a pub. That was outdoors. In Scotland, there are now 2,000 Delta Covid-19 cases linked to the European soccer matches outdoors. That is what is happening outdoors with Delta. Can we imagine what would happen if people are not protected indoors? If we accept, as I do, that the public health advice is right, although obviously colleagues are free to refute or not accept it, then we have only one of two options available to us. We can keep indoor activities, including hospitality, closed for everybody. That is absolutely legitimate and it would treat everybody in the same way. We would just say that it is closed for everybody, regardless of whether it is safe for most people, because that is to treat everybody in the same way. That is a completely legitimate view to hold. The alternative view, which is the one we have taken, is that we need to help the hospitality sector and facilitate people to go to exercise and dance classes or go out for dinner. We need to help the people in those sectors who need jobs. If we can open them for most people, should we do so? My view is that “Yes” we should. Hopefully, today’s announcement of the parallel opt-in model for the AstraZeneca and Janssen vaccines will go a long way. Anyone who works in a bar or restaurant and wants to be able to have a drink or a meal in that bar or restaurant can now do so because he or she can now opt in and get vaccinated.

We all accept that there is nothing fair about this virus. It is not fair that this virus kills older people much more than younger people.

It is not fair that last year people over the age of 70 had to isolate themselves in an extraordinary way and other people did not because other people did not need to do so for safety reasons. None of us suggested, however, that because those over 70 had - I hate the word but we understand the concept - to cocoon, everyone under 70 should have had to do so as well because we should all do the same thing. What we said was that for this group of people, for safety reasons, we needed to apply different public health measures. I fully accept anyone here saying they disagree with that and that if everyone cannot do something, then nobody should be allowed to do it. That is an absolutely legitimate view to take. My view is that, on balance, if we can support the sector, support jobs and allow people to go about their lives like they are doing in Germany, the Netherlands, Denmark, Austria and various other countries, that is probably the better way, but I fully appreciate there are different views on that.

I was asked some very reasonable questions about the modelling. Will we update the modelling now that we have a plan as of this morning as to how we will implement the NIAC advice? Absolutely, we will. Also, we will keep updating the modelling based on what we are learning from the UK in the main. There is a big question the scientists are looking to answer. We know the cases have shot up in the UK, and NPHET is telling us they will shoot up here. Thankfully, to date, the hospitalisations and fatalities in the UK have not shot up. They have increased and are going up. The latest data I have been given show that for every 1,000 people who get the Delta variant in the UK, three people are dying. Therefore, if there were a super-spreader event at which 1,000 people at some large stadium or something got infected, the information we have is that three of those people would die from Covid. That is still pretty stark. We are therefore watching the UK very carefully to see, as their cases shoot up, what happens with hospitalisation and death. Obviously, the advice and the measures will change depending on what we see happen there.

Very reasonable questions were raised about the pharmacists and whether this has just been landed on them. The Irish Pharmacy Union, IPU, was central to the detailed planning for this. About 700 pharmacies have opted in so far; more may join. People can go onto and find the full list of pharmacies that are engaging and find a pharmacy near them and on Monday engage with that pharmacy to see if they can get registered.

It is worth saying we will have to appeal to people's understanding on this. We are moving really quickly on this. Going back to when the GPs started rolling out the vaccine programme, we will all remember that there was a lot of debate, sometimes very robust debate, about a GP in one county or another not getting the supply he or she was meant to get on Monday and having to cancel a list of people and that being deeply frustrating - and it was deeply frustrating. However, as Dr. Mike Ryan of the WHO said, in a pandemic the perfect is the enemy of the good and we have to operate like that. The HSE did phenomenal work with the GPs, a call centre was set up and, over time, those supply chain issues were ironed out but it did not start perfectly. I expect that it will not start perfectly with the pharmacists either. We are moving really quickly and moving supplies to 750 pharmacies all over the country. Is it possible that any given pharmacy may not get the supply it was expecting on Monday? It is. Is it possible the pharmacy will have to contact people it had scheduled to tell them the supply has not arrived and that it will get back to them later in the week? That is entirely possible. I will be surprised if that does not happen. What I can tell the House is that we will do everything we can to get this as right as possible and that when mistakes are made we will learn and respond, just like we tried to do with the GPs. I ask Oireachtas colleagues and the public just to bear in mind that we are doing this really quickly, it is logistically very complex and it will not run perfectly. There will be people looking for a Janssen vaccine, for example, that may not be available in their local pharmacy. The local pharmacy may have run out and those people may get frustrated. Right now, there is not one for everyone in the audience in July. There is a lot. We do not know what the uptake will be, but I ask for people's understanding on this.

There were a lot of questions about planning for the future. Are we looking at boosters? We are. We are looking at the scientific and the medical evidence as to how and when they may be appropriate. We have pre-purchased a large volume of multiple different vaccines for both this year and next year, planning for vaccination programmes for next year as well. We are also planning for the autumn and winter vaccination work. I have no doubt but that we will have ongoing Covid vaccinations, a flu vaccination programme and all the school-based vaccination programmes. We now have this wonderful new infrastructure in place which we have never had before. The Department, the HSE and I are working to figure out how best to consolidate that into planning for the autumn and the winter.

Lastly, one colleague asked about public health. Are we building to protect ourselves for the future? Are we putting a state-of-the-art pandemic defence system in place, which we need? The answer is "Yes". What are we doing? Colleagues will be aware we have agreed an historic deal with public health doctors to move to a consultant-led contract. That is really important. Last year in the budget I sanctioned a doubling of the workforce. The HSE is hiring to double that workforce, and the Chief Medical Officer, the HSE and my Department and I are engaged in an established reform plan in place for public health as it relates to the regions, local autonomy, responsiveness and so forth. That is all being looked at to be implemented.

I asked the Minister about nursing homes. He did not respond.

I am happy to talk to the Deputy about that at a later date.

Sitting suspended at 11.27 and resumed at 11.47 p.m.