Ceisteanna ó Cheannairí - Leaders' Questions

Last night the Taoiseach announced measures to curb the Covid-19 surge. Nobody wanted a backwards step in the progress won over a long, hard and often heartbreaking 18 months. We now find ourselves in a very difficult situation. Difficult situations require decisive leadership, forward planning and thoughtful management, all of which are absent from the Taoiseach’s Government. Indeed, there has been Government paralysis facing into this wave of infection. The surge in Covid-19 numbers did not happen overnight. Public health officials have been ringing the alarm bells loudly for weeks. That is why it is so very difficult to understand the Government’s dithering, delaying and indecision on antigen testing, the resourcing of our health services and on the booster vaccination campaign.

The use of antigen testing was recommended as far back as last April, but on the radio this morning the Minister for Health, Deputy Stephen Donnelly, still could not detail any plan. Other countries are streets ahead of us on antigen testing, with free and subsidised schemes to reduce costs for people. The Government's failure to prepare to increase capacity in our health service is demonstrated in its winter plan and it leaves us dangerously exposed. The lack of pace and planning around the booster campaign has also set us back. The majority of healthcare workers were ready for their third dose in October, but many will not now be done until December. A quick and efficient roll-out of boosters was a no-brainer and, again, other countries have been up and at it much faster.

The only thing the Government seems capable of doing quickly is shutting things down. The Taoiseach can call it whatever he wants, but he has effectively shut down the late-night sector with less than 48 hours' notice and no consultation. Three weeks ago, the Taoiseach announced the reopening of this sector and last night he closed it back down like the flick of a switch. This is a massive blow to workers and businesses in the live entertainment and late-night industries that have endured a devastating 18 months. Now, weeks before Christmas and with the cost of living soaring, these workers are prevented from earning again. The Taoiseach told the Dáil yesterday that there is no plan to reopen the pandemic unemployment payment, PUP, or to delay cuts to it. The Minister, Deputy Stephen Donnelly, reiterated that position on the radio this morning. This is not a runner.

This shutdown stops thousands of workers earning the money they need to pay their bills. They and families must be protected. The message from the Government to these workers so far, that they should go and find another job, is deeply insulting. These are skilled people, such as musicians, event planners, DJs, comedians and entertainers, and it is important that their skills are maintained within their sector so that it has the chance to flourish when it reopens. Tá easpa pleanála agus ullmhúcháin an Rialtais leis an mborradh Covid seo do-ghlactha. Ní mór a chinntiú go gcoinnítear tacaíochtaí d'oibrithe agus do ghnóthaí a bhfuil thíos leis an dúnadh. I want the Taoiseach to tell the workers and employers affected by this shutdown that they will be provided with the PUP, that the cuts will be halted and that they will be supported.

It has always been a source of regret for me that since this Government was elected and officially nominated that the Deputy and her party have taken a divisive approach to Covid-19. She has always sought to exploit the pandemic for political and electoral ends. I regret having to say that, but it is absolutely clear.

The hallmark of her position from the outset has been one of running with the hare and hunting with the hound. She has undermined NPHET advice at different stages of the pandemic, with calls for pubs to be opened in advance of any advice, then rushing to get the airports closed and then rushing to get them opened again. It has been the classic presentation from the Deputy from the get-go.

I want to keep this in perspective, however. If we look at where we are now, connectivity has reopened and travel into and out of the country is happening. Hospitality, personal services, sports events, schools, construction and childcare have all reopened at a time when we have 4,500 thousand cases daily. The challenge now, as we move through different phases of the pandemic, is that we must assess the most appropriate response to that increased socialisation. Thousands of people have been brought back to work because of a very effective and successful vaccination programme that the Deputy lacks the generosity of spirit to acknowledge. That is a fact. The people have stood up and were counted by coming forward and getting vaccinated.

The effectiveness of the vaccines is waning; that is a global phenomenon. There will be a need for a booster campaign and close to 400,000 people have already received a booster vaccination. I do not know if it is the Deputy’s position that we should just simply up end the process that we have for recommending the use of vaccines. Is the Deputy saying to me that the advisory processes we have should be put to one side? If so, I ask the Deputy please to say that and not just do the generalisation of attacking the Government because it suits on each and every occasion.

The difference between the booster program and the primary vaccination programme is that the booster programme will take place five months - the recommendation is six months but can be given after five months - after people's second doses and not sooner than that. The advice, from the European Medicines Agency, EMA, or nationally, does not allow for it earlier, unless people are in one of the eligible categories, such as those who received a Johnson & Johnson vaccine. It is a period of three months for people in those eligible categories who are advised and recommended to get a booster vaccination. The national immunisation advisory committee, NIAC, keeps this continually under review.

In the Dáil, yesterday, I outlined the various sectors and categories now involved in the booster campaign, from the residents of long-term care facilities aged over 65, who were substantially completed by the end of October; to the residents of long-term care aged under 65, who will be completed by early to mid-December; to healthcare workers who will be completed by the end of December; and then those aged 80 and older, who will be done by mid-November. The programme continues with those aged 70 to 79, followed by those aged 60 to 69 and now those aged over 50 have now been advised-----

The Taoiseach has 30 seconds to answer the question.

Deputy Carthy is not the leader of the Sinn Féin Party yet.

I came in here to hear answers to the questions, but the Taoiseach was not answering them.

I would appreciate it if the Deputy would allow me to answer the questions without being interrupted, which is again a further tactical parliamentary device that he is prone to use.

Please, Deputies.

That is where our booster campaign stands and we will drive it forward, just as we drove the primary vaccination programme forward. What is crucial now is that we have to reduce socialisation. I did not do anything with a switch. Deputy McDonald talked about planning, but two weeks ago her party’s spokesperson on health was saying that the time had come when the powers under the health legislation were no longer necessary. He was so far ahead of planning that he wanted to get rid of them, and he was not supporting them.

He was not giving them-----

The time is up, please.

Equally, Sinn Féin did not support vaccination certificates. The party opposed them as well. It has been so behind the curve on Covid-19, and the only reason it has been behind the curve is that it has suited it to be so politically, because it has only sought to exploit it at each and every turn.

We are way over time. I call Deputy McDonald.

It is a source of deep regret to me that not alone can Mícheál Martin's Government not take decisive action, but that he is singularly unable to answer very straightforward questions again.

The facts are these: the Government is behind the curve on antigen testing and on the booster programme and the facts stack that up.

They do not. We are ahead of many other countries on the booster programme, and quite significantly.

Attacking me and conjuring up all of this does not prove anything.

Let us deal with the most immediate matter at hand. The Government has taken a decision which shuts down late-night industries, such as events, hospitality etc. This is going to have an impact on thousands of workers who can no longer earn their living. I ask the Taoiseach to forget his political smoke and mirrors, and I put it to him as a matter of just straightforward fairness that those workers and businesses have to be supported.

They are and have been supported, and the Deputy knows that well.

I thank the Deputies.

I again invite the Taoiseach to make clear that workers will be able to avail of the PUP, that businesses will be supported and that he will not throw thousands of workers under the bus as a consequence of his poor management and lack of decisive leadership. I call on him to support those workers and their families.

Last night, I thought you supported the decisions we took. Which way is it? Do you support what we decided? You might confirm that in the fullness of time.

Do you want to trade seats? When I am in your seat, I will answer questions. You should not worry about that.

I will tell you now. As you know well, we have supported industry and businesses throughout the pandemic to an unprecedented scale. We will continue to engage with the night-time economy, in this case, in respect of the supports such as the Covid-19 restrictions support scheme, CRSS, that we have made available. People in any sector will acknowledge that although, of course, the Deputy will not. Those people will acknowledge that extraordinary supports have been provided to businesses across the length and breadth of the country, and rightly so. It is incredible that the Deputy comes in here and tries to suggest they have not been. It is the hallmark of the Deputy's approach.

The Government cut the PUP this week.


Antigen testing has been extended to meat plants, nursing homes and close contacts. Antigen tests are now being sent out free to close contacts of Covid cases. The Deputy knows that. The same situation applies in third level education. They will be deployed more widely. That must be done in the proper way in accordance with the public health advice we have received.

Will workers be able to avail of the PUP? I am asking for a "Yes" or a "No".

I said to the Deputy that we will continue to work with the sectors and support them. In respect of the PUP, the most consistent message we are hearing is that businesses cannot get people to work in different sectors and are short of staff. We will engage with the sector through the various schemes we have had so far to keep enterprises together. Where Government decisions affect those enterprises, we will support them to get through this period.

I have been in this House a few years and have never accused anyone of telling porkies, let alone the Taoiseach. I asked him about schools yesterday because I am genuinely concerned about them. My colleague, Deputy Ó Ríordáin, has been articulating those concerns for some time. When I spoke to the Taoiseach after Taoiseach's Questions, I said that schools will be additionally affected by the new five-day rule. I have young kids and my wife is a teacher. The Taoiseach told me that teachers are exempt. He knows that.

I know the Taoiseach is annoyed because he messed up, but this was not a total misconstruction. He even denied we had a conversation in the Chamber, which made him look rather silly, considering there is a video of it. I will not dwell on it because there are more serious things to discuss but if he wants to call me a liar during his reply, he can. The Taoiseach messed up and had to reverse immediately, which I am glad he did. Teachers, special needs assistants, SNAs, and early years workers cannot be treated differently. The public do not care about such a schoolboy row.

My party, as the Taoiseach knows, is the only Opposition party that has supported the two most recent extensions of public health measures. We will support and work with the Government. However, there is now widespread confusion among the public about what actions they should take. I say this to be constructive. We are sleepwalking into another lockdown. Financial supports need to be put in place for businesses and workers. People out there now are being told to get another job. How is that a way to treat workers?

I spoke this morning to Ms Trina Golden, the exhausted principal of Owenabue Educate Together primary school. She believes schools are going to close all over the country. She had to tell parents not to send their kids to school yesterday. That is in the Taoiseach's constituency. He should ring her and talk to her.

The Minister for Education is absent without leave. The Taoiseach is so embarrassed by the Minister for Health that they have not been seen at a press conference together for more than a year. The Minister for Education said this morning that antigen testing would be operational in schools by the end of the week. Will the Taoiseach confirm that is going to happen? It is a year since I raised the issue of antigen tests. I have been taking them for a year because I have elderly parents. They are not a panacea but they help. Will a subsidy be put in place for antigen tests? Will the Taoiseach consider giving them away for free until 1 January? I would do that, and then subsidise them, so people can get used to them. Will the Taoiseach provide a public information campaign on antigen tests? What additional measures will be provided for schools? As the Labour Party has suggested because of the situation we are in, will the Government provide boosters for schoolteachers, SNAs and early years staff? Is the Taoiseach going to consider taking over private hospitals again? I have never seen the HSE as worried as it is now. Will the Taoiseach commit to putting back in place the PUP and supports for businesses that are now closing because of decisions the Government has had to make?

I have been in the House longer than the Deputy.

That is right.

You learn something every day. I learned something about the Deputy yesterday-----

And I about the Taoiseach.

-----that I will not forget.

Is that a threat?

What I learned will govern our relationship from here onwards in terms of the nature of the engagements we will have.

That is good.

I have never before seen the likes of what transpired. As I was engaged here, the Deputy came along over here. I will refer him to what he asked me on the record of the House immediately before our exchange. The Deputy asked, "Given the complication RSV causes, will the Government consider prioritising front-line workers such as gardaí, retail workers, transport workers and, most of all, teachers, SNAs, and early years workers for boosters, primarily so that the schools system does not fall over?". He asked me nothing at all about the household contacts or the decision the Government took and publicised yesterday.

I asked the Taoiseach about those things over there.

I just want to put that on the record. The Deputy came over to me for a 30-second or 40-second engagement. He scampered off and told his education spokesperson who tweeted something that was then reported as fact. It is extraordinary.

The Taoiseach told me that. If we wants to call me a liar, call me a liar.

I am putting it straight. I have learned some things about the Deputy.

What is the difference between a misconstruction and a lie? Was it a misconstruction? You are not denying you said those words.

I am. I never said those words.

Was it a misconstruction? You are calling me a liar so.

I never said what the Deputy construed I said. I rang you afterwards to make it very clear to you how I regarded the interchange. You cannot do things like that.

You roared and shouted down the phone. That is what you did.

If I may say, the issue is that we have 4,500 cases a day. We have expanded the use of antigen testing. The Deputy knows that public health advice has not been very enthusiastic about the wider deployment of antigen testing. Progress has been made. Antigen testing is being used in meat processing plants, nursing homes and third level education and for close contacts. Those tests are being sent out to people. In many ways, we can learn from the UK experience where the wider deployment of antigen testing did not all go to plan. The deployment of antigen testing will be expanded. I take the Deputy's point about a public information campaign and a wider communication campaign. That is what the public health advice was saying as recently as Monday evening. Our public health teams have said, because of the research they have been doing, that there is a need to communicate with the public extensively on the best way to use antigen testing. However, even the expert advisory group is saying it is not a silver bullet. We have dramatically expanded PCR testing. We have done 196,000 PCR tests in the past seven days and tribute should be paid to the HSE and its teams in that regard. People here were lambasting the HSE about PCR testing. Our capacity for PCR testing is now one of the strongest in Europe. That will be supplemented by antigen testing, which will be operational in schools. However, it is not a silver bullet by any means.

The Taoiseach also said that the banks were not bailed out. His roaring down the phone and threats in here do no bother me. I will let the public decide who they believe. I think we already know.

The Taoiseach does not seem to be getting that this is Groundhog Day for this country. People around the country are very worried. The Taoiseach is consistent in his inconsistency. Will the Taoiseach consider giving antigen tests to everyone until 1 January? That is a reasonable request. Will the Taoiseach please put it out there and consider it? Will he give boosters to school teachers, SNAs and early years staff? Schools are going to fall over. It is happening already in the Taoiseach's constituency. Is the Taoiseach going to do something with the private hospitals? The situation is absolutely untenable. A record number of people are on trolleys in University Hospital Limerick, my closest hospital. Those numbers have never before been seen in the history of the State.

We are not even at the crux or height of it yet. On these three matters, I am asking the Taoiseach, on behalf of the public, to help. I am making the suggestions as someone who supported public health advice and the Government in its measures. Will the Taoiseach consider the three suggestions, please?

The Deputy is being populist-----

-----in saying the boosters should be given to everybody.

The teachers.

Keep the schools open.

Keep your voice down and calm it down. Cool it.

No, you cool it.

The bottom line is this: NIAC has advised as to the cohort that should get the booster. Why? Who is in the ICU departments at the moment? Those in the ICU departments are the immunocompromised, the unvaccinated, people with underlying conditions and those in older age cohorts.

We can do both.

Who are most at risk? They include those in older age cohorts, the immunocompromised-----

Does the Taoiseach want the schools closed?

-----and people with underlying conditions. The advice is that they need the booster before anybody else. We have been through this before. I have heard it suggested in this House that the booster should be given to this group, that group or the next group. It is all popular stuff; it courts the group and it courts the sector but-----

The Taoiseach knows the reason. When the schools close, what is he going to do?

-----the most effective thing we can do is proceed in accordance with the medical advice, public health advice and advice of those who advise on immunisation, which is to give the booster to those who need it most first. I thought we were all in agreement on that.

On private hospital capacity, 1,100 to 1,200 beds are already being used on a continuing basis by the HSE in this respect. That figure will grow. That will go up to 2,800 bed days per week. That is where we are right now. It will expand significantly-----

At this point, it would be cheaper to buy them.

-----under agreements that have already been arrived at and planned for in respect of growing numbers of cases and pressures on the health system.

Some 63 days ago I said to the Taoiseach that budget 2022 must be different. I pointed out that we had a once-in-a-generation opportunity to restructure our economy. Sadly, that did not happen. Budget 2022 was just a little bit for everyone. The families who are just over the income thresholds for various State supports have again been forgotten. These are the hard-working families, the so-called squeezed middle, who pay for everything and who have remained invisible when it comes to State supports because they may be just a few euro, or sometimes just as little as €1, over some arbitrary income threshold. Take childcare as an example. It is one of the challenges faced by many of the families in question. An average family spends 12% of its disposable income on the care of a three-year-old child. That is, of course, if it is lucky enough to be able to secure a childcare place. While the budget 2022 childcare changes are welcome, the families will see an average disposable income gain of 0.2%, according to the ESRI. However, low- or middle-income families will actually lose part of their subsidy due to the freezing of the childcare income thresholds for 2022.

At the other end of the age spectrum, the story is not much better. Take the case of Stephen, for example. His father is a school caretaker and his mother is a school cleaner. Stephen, because he earned an extra €1,000 from his part-time job just to be able to afford to go to college, ended up €2,500 down as the extra income brought him over the SUSI income threshold. Budget 2022 increased the SUSI grant thresholds for the first time in a decade but this will do little to alter the trend we have seen over the past six years, which shows that while student numbers have risen by more than 17%, the number of students in receipt of the SUSI grant has fallen by 6%. I am afraid that the €200 increase to the grant next year will just about belatedly cover the increasing cost of energy, and little else.

The point I am making is that, by the end of December, the invisible middle – the people who get up early in the morning, who keep the doors of our businesses and services open and who pay their taxes every week, fortnight or month – will, because they do the extra hour of overtime, find themselves worse off for working hard, just like Stephen. That is why I believe the Government must restructure our whole economy.

There is a need, as we emerge from Covid, to restructure the economy. That is why the economic recovery plan and national development plan focus so strongly on the digitalisation and digital transformation that are occurring and will occur here and globally. There is also a focus on the green economy, through significant investments in areas such as public transport and retrofitting, and on the jobs that will be created in the retrofitting sector and a range of others related to the green economy, where thousands of jobs wait to be developed. For example, there will be jobs associated with offshore wind generation in terms of the development of ports in various areas. That is how I look at the restructuring of the economy.

I take the Deputy’s point on the necessity to improve income thresholds and increase them in a number of categories, one being local authority housing. This has to be done along with other reforms – there is a review under way – and along with addressing interlocking issues to do with housing more generally. For the first time in a long time, the Government decided to extend the SUSI grant, improve the income threshold and increase the adjacent rate. This will help thousands of students. I would like to go further in respect of that.

On healthcare, we took a number of steps in the budget, including, for example, the reduction of the drugs payment scheme threshold. We made it more favourable for hard-pressed families in respect of prescription charges. Regarding universal healthcare, there was a significant move in the budget, including through the extension of free GP access to children. We would like to do more in the next budget. In the area of health, in particular, and in higher education and education more generally, we want to do more. There was a tax package of about €520 million, which is of value. It is not enormous, and I am not going to pretend it is, but at least it is an additional contribution to people’s take-home income.

The biggest challenge we have had this autumn has been the global rise in inflation, much of it caused by the energy crisis and the issues concerning gas and energy supply globally. Supply chain interruptions and difficulties arising from Covid are other causes. We have managed to some extent to weather the Covid supply-chain issues so far although we are not immune from them by any means because we are part of a global system. On the energy front, there is concern. Through the fuel allowance and other measures, we sought to help people to deal with exceptional increases owing to inflation, not only in Ireland but also across the rest of Europe and the rest of the world. Inflation is the big issue of the day right now. The European Central Bank is saying it believes it is a temporary phenomenon. There are various academic perspectives on it. Economists have a view on it but the majority are still of the view that it will bottom out, certainly towards the early part of next year.

I am glad the Taoiseach mentioned the issue of energy because, this winter, increased electricity and heating costs will hit every single family hard. Working families will not only have to meet their own additional costs but they will also have to pay for the increases associated with the fuel allowance scheme. Despite this, the value of the retrofitting grant has decreased from one third of the cost to just over one quarter due to the rising cost of materials. There is genuine concern that the value of the grant will continue to diminish. For the invisible middle, grants are of little use when the families do not have the €18,000 to €20,000 to put with them to reduce their heating bills, improve their health, increase the comfort of their homes and help our climate. Over the next decade, the Government is asking these families to pay an extra €100,000 to deliver on its climate action plan, yet they are being pushed further and further away from the financial supports needed to make this happen.

In my initial reply, I did not deal with the issue of childcare. As the Deputy knows, we are making very substantial funding available in the budget, and we will do so next year, to ensure the existence of proper income supports for workers in the childcare sector and to create a career pathway. Employers and unions can work in the knowledge that there is a financial envelope to deal with the deliberations of a JLC in respect of childcare.

On retrofitting and the grant, as referred to by the Deputy, we have provided additional funding for retrofitting across the board through the budget and the recovery and resilience plan that we submitted to Europe, and more generally through the national development plan and economic recovery plan. Within that financial envelope, we will do what we have to do to make sure we can incentivise more people to engage in retrofitting.

I do accept there is a gap to be bridged between affordability and what people can spend. We do not want people getting into excessive debt at high rates, so there may be opportunities for low-interest loans as well as additional grants for people. That is being worked on.

There are many issues I could raise, such as the national maternity hospital or redress for mother and baby homes, but I wish to raise the inability to recruit and retain staff across the public health service. It is now reaching a crisis point. This is particularly the case in the crucial area of home care services. Despite the increased allocation of hours by the Government, people dependent on the service are actually receiving cuts in their hours due to staff shortages.

I give the example of Kevin, who suffers from multiple sclerosis. Kevin needs help getting into and out of bed and feeding himself. He had carer visits four times a day but, just over a week ago, he was given two days' notice that he would have no more visits due to lack of staff. In his own words, he felt that he was being left to die. The situation changed after he went public, and the hours were reinstated. That is an extreme example of what people are facing, but many people dependent on these hours are losing them due to staff shortages.

When you consider the pay and conditions for home care workers employed by agencies funded by the HSE, it is very easy to see why people are leaving or not taking up these jobs. The norm for agency staff is a minimum wage of €10 per hour with a zero hours contract, no sick pay or pension, and the constant stress of getting from one client to the next. They have to provide their own transport and do not get any allowance for doing so. A carer in Dublin, for example, might have two to three clients in an hour. If carers use their own car, they have the problems of traffic and parking fees. Many of them use buses. The reality of their travel costs means that they actually earn below the minimum wage. In rural areas, they are being forced to speed and take risks on country lanes.

The HSE pays these agencies €30 per hour per client. If a carer sees two to three clients in that hour, that is €60 to €90 for the agency and €10 for the carer. Why does the HSE not directly employ these workers? It used to do so until the decision nearly to privatise these services. It should directly employ these workers on a decent wage with a travel allowance, sick pay, a pension etc. These workers provide a crucial health service for which they need certain qualifications. They are not just being overlooked; they are being undervalued. They are being abused and treated like dirt and certainly not treated like the heroes they are. They were the ones on the front line who went door to door and client to client and lost money during the height of the pandemic because families were afraid they could bring the infection into their homes.

First, there has been a dramatic expansion of resources for home care hours. I think the Deputy would have to acknowledge that. There were 5 million hours last year in respect of-----

It is not having any impact.

It had a huge impact last year in terms of reducing the number of people waiting for home care packages. There is a critical skills and ineligible occupations list review of sectors of the economy that we need to liberalise in terms of getting work permits and so on. The review has not so far recommended the removal of the occupation of care workers or home carers from the ineligible occupations list. The issue is that we have to work with those who are providing these services in terms of the conditions and improve them. The big concern at the moment is the issue of securing enough people to work in the service itself.

To be fair, the Minister responsible secured additional resources in the budgets last year and this year. The issue is securing enough people to work in the service. The Minister of State, Deputy Butler, is working now in terms of engaging with the stakeholders involved on all sides and looking at the workforce challenges in terms of home support and nursing homes. It is a critical issue for those who need the care. It is also a critical issue for hospitals in terms of the alleviation of pressure on them and flow through the hospitals. As a result of the additional hours last year, the flow through the hospitals last November and December was very efficient and effective and had a clear impact. The issue is skills shortage.

I am not disagreeing with the Deputy. We do have to look at terms and conditions in respect of home care workers and the Minister is working with a workforce advisory group to engage and deal with those challenges and improve on them because, across the board, caring is an area that does need to be improved and enhanced.

The fact of the matter is that in recent times workers from the private home care sector have been going into the HSE because the jobs are better paid, they are respected more and they get a pension and sick pay etc. In addition, people are not taking up the jobs in the private sector because of the conditions. It is a fundamental issue facing the healthcare service across the board. Last night we discussed the Sinn Féin motion on ambulance services and learned that the annual spend on private ambulance services rose from €2.1 million in 2011 to €10.1 million in 2019. How much are these private companies getting from the State to serve clients and people who need support in their homes? They are getting €30 an hour. The Secretary General of the Department of Health was offered a salary of €400,000 a year, which works out at approximately €200 an hour. That salary was not implemented but I presume the head of the HSE is on something similar. What a contrast that is with the pay of agency workers on a minimum wage, doing the work they are doing, having to travel in the way they must travel and paying for parking and petrol or bus fares. Will the Taoiseach move to employ these people directly in the HSE?

First, 75% of those working in the home care support sector are working part time. As I stated, last year the Minister secured additional funding of €150 million for home support and the HSE national service plan sets a target to provide 24 million hours of home support.

Would it not be better to employ them through the HSE?

That is throughout 2022. At the end of September, some 15 million home support hours had been provided to more than 53,000 people. There is an enormous programme in place that is being resourced by the Government through the HSE and it has grown significantly beyond previous years. However, that, in turn, has created pressures in terms of availability of people to provide the home supports. For the moment, in terms of employment permits and so on, home care does not satisfy the conditions and the groups reviewing this believe we should first look at terms and conditions as they apply to home care workers and that is what we are doing to see if we can improve those terms and conditions to improve recruitment domestically.

How can that be done when these workers are being paid by the private sector?