Dáil Éireann debate -
Thursday, 2 Dec 2021

Vol. 1015 No. 2

Health (Amendment) (No. 3) Bill 2021: Second Stage

Minister for Health (Deputy Stephen Donnelly)

I move: "That the Bill be now read a Second Time."

I am here to today to address the House on the Health (Amendment) (No. 3) Bill 2021. The purpose of the Bill is to strengthen Ireland's ability to respond to the ongoing and emerging threat to public health from Covid-19 and specifically, as colleagues will be aware, the new Omicron variant that has emerged. The Bill is being introduced in the context of the emergence of this new variant.

It strikes a fair and proportionate balance between the protection of public health and the common good in the situation we face, on the one hand, and the limited restriction of individual rights on the other. It is of note that the UK introduced hotel quarantine very quickly in response to the emergence and the potential risk, which is still being evaluated, of the new variant. The Irish Government has decided at this point to reintroduce the legal basis for hotel quarantine should it be deemed necessary to reintroduce hotel quarantine in response to the threat posed by the Omicron variant.

Unfortunately, the threat of the emergence of variants of the disease has not gone away. The coronavirus has served up something none of us wanted to see. The World Health Organization designated the variant B.1.1.529, named Omicron, a variant of concern on 26 November. This owes to the constellation of 32 spike protein mutations which suggest the potential for increased transmissibility and immune escape. We are waiting to see more emerge from the scientific and medical communities on those very important questions.

Yesterday, as the House will be aware, the Health Protection Surveillance Centre was notified of one confirmed case of Omicron in Ireland, and my expectation is that we will see more. The Government has implemented a number of measures to minimise potential risk posed by the spread of this variant. These actions are intended to limit the spread of the variant while we await further evidence relating to its transmissibility and the impact it has on disease severity, vaccines and treatments.

From 29 November, additional restrictions have applied to travel from seven scheduled countries; namely, Botswana, Eswatini, Lesotho, Mozambique, Namibia, South Africa and Zimbabwe. We also announced that from 3 December people travelling to Ireland, regardless of vaccination, recovery status or travel history, will be required to complete a pre-departure Covid test. Work to introduce regulations giving effect to this requirement is progressing. The requirement to complete a Covid-19 passenger locator form prior to travel remains in place.

Unfortunately, these measures may not be enough. We all hope they will be. With the increasing public health concern about the impact of the Omicron variant, in particular its potential impact on vaccination effectiveness, hotel quarantine may be necessary for a limited time in the interests of the protection of public health and to control transmission. Travel measures such as hotel quarantine give us time to further increase vaccination rates, including boosters, and time to deploy some very promising antiviral drugs that are in the pipeline. We know that the system of hotel quarantine we had in place worked. During the period of hotel quarantine earlier this year, 17,846 tests took place on residents. Some 593 residents in hotel quarantine tested positive for Covid-19. These data do not take account of cases which were avoided in the community as a result of hotel quarantine or, probably the biggest benefit, incoming travellers who delayed travel to Ireland as a result of the imposition of quarantine. Essentially, once we brought in hotel quarantine, the number of incoming travellers from the countries about which we were most concerned fell very dramatically.

Many of the measures we have introduced, though challenging, have worked. As a nation, we should be very proud of the solidarity that has marked the approach in Ireland and from people here. We have one of the highest vaccination rates in Europe, and our booster campaign is going well. Every death, it goes without saying, is an individual tragedy and one too many. It is worth noting that the latest data from the ECDC show that Ireland has the fifth lowest overall mortality rate out of the 27 EU countries plus the United Kingdom.

The Bill before the House would permit the reintroduction of hotel quarantine should it be required. By having the legislative provisions in place, we will be in a better position to react quickly should a decision to move forward be taken. The legislation will be commenced if and when it is appropriate to do so. The provisions of this Bill are fundamentally the same as those contained in the previous legislation permitting hotel quarantine, but there are some changes we propose to make in response to lessons learnt during the previous experience, and I will talk through those changes.

The Bill is divided into five sections. Sections 1 and 2 set out definitions and interpretative provisions.

Section 3 is the main body of the Bill and inserts new sections 38N to 38Z, inclusive, into the 1947 Act. This section specifically provides for the reintroduction of mandatory hotel quarantine and related matters. Travellers who have been in a "designated state" within the 14 days prior to their arrival in Ireland will be obliged to undergo a 14-day period of quarantine. The Bill includes a provision to allow exit from quarantine before the completion of 14 days if travellers return a "not-detected" Covid test on arrival and a further such test on day ten of quarantine. There are a limited number of other circumstances under which travellers may leave quarantine, including, for example, for medical treatment or other humanitarian reasons. The Bill also contains provision for travellers who arrive without the relevant pre-travel Covid test to be obliged to enter hotel quarantine. Unlike the previous system, however, there is a provision which allows the Minister to designate classes of people for whom failure to present a valid pre-travel test result will mean an obligation to enter hotel quarantine. Essentially, this allows for a greater degree of flexibility to focus on those who present the greatest risk.

Colleagues will recall that in the summer, the Health (Amendment) (No. 2) Act 2021 contained some amendments to the original legislation in this area. These provisions are included in this Bill as well and allow the Minister to prescribe alternative testing to PCR testing prior to arrival in the State. Also provided for is an updated approach to dealing with any travellers who arrive in the State not in compliance with pre-travel testing requirements. Another important development is to provide that a public health doctor can permit a traveller in hotel quarantine who has tested positive for Covid-19 to be released after the initial ten-day period of quarantine where the doctor believes that the traveller does not pose a risk of infection.

Colleagues will be aware that some travellers might have spent some time in hotel quarantine and then tested positive, which could extend quite considerably the total time spent in quarantine. Travellers will be required to pre-book their accommodation in designated facilities, as before. Appropriate provision is made for unaccompanied minors or those seeking international protection, as before. As before, the Bill includes provision for travellers to appeal a decision that they be subject to mandatory quarantine. Section 38N(25) includes categories of travellers who are exempt from the requirement to quarantine, such as those requiring urgent medical treatment, drivers of heavy goods vehicles, maritime or air crew or elected officials travelling for official reasons. There is also provision for other groups to be exempted by regulation, as was the case previously.

Section 38O sets out the power to return travellers to quarantine if they have left inappropriately.

Section 38P sets out offences associated with the Bill and establishes the relevant penalties.

Section 38Q sets out the power and the process for the Minister to designate the states relevant to mandatory hotel quarantine, and section 38R makes provision for the designation of facilities and to require travellers to pay for quarantine.

Section 38S sets out the regulation-making powers of the Minister and sets guiding principles for use in that process.

Sections 38T and 38U provide the authority for the Minister to make arrangements for transport and accommodation and related matters for quarantine purposes.

Sections 38V and 38W set out requirements and obligations related to record-keeping and data protection.

Section 38X allows the Minister to make arrangements with other Ministers to carry out some of the functions associated with the requirement to quarantine as they relate to the designation of facilities for quarantine, making service contracts, and data protection.

Section 38Y establishes a requirement of travel organisers, such as airlines, to inform a traveller of their obligation to pre-book their quarantine, to check that those bookings have been made and, potentially, to refuse to allow travel where a booking has not been made.

Section 38Z provides for another important change that is new in this Bill. There will be a provision to facilitate travellers to seek clarity before travelling on the possibility of not being required to complete hotel quarantine.

This could be for medical reasons, by virtue of having to care for a dependent person, or for other humanitarian reasons. Travellers will also be able to seek clarity that they will be permitted to leave quarantine temporarily for medical or humanitarian reasons. As colleagues are aware, on the previous occasion there was considerable concern about some travellers coming in who were likely to be exempt for the reasons we have discussed previously but who could not start an appeal until they were in the hotel. In the most urgent cases we made provision for those appeals to be heard very quickly and same-day decisions were made. We want to go further with this and provide such that travellers can, where possible, get an answer before they travel as to whether they will need to enter hotel quarantine.

Section 4 of the Bill makes minor consequential amendments to section 42 of 1947 Act. Section 5 sets out the Short Title and operation of the Bill and establishes that the quarantine-related provisions of the Bill will fall three months from its passing, unless, as before, resolutions extending them are passed in both Houses of the Oireachtas. This sunset clause is an important feature of the Bill and reflects the exceptional nature of its provisions, which are required in the context of Covid-19. Of course, we are here today because the previous sunset clauses took effect and the legislation fell. We need to legislate again, which is the point today.

As I said earlier, I believe the Bill strikes a fair and proportionate balance between the protection of public health and the common good in the situation we face on the one hand, and the limited restriction of individual rights on the other. Should it be deemed necessary to respond more comprehensively to the importation of this new variant, we must be able to act quickly. Having the legislation on the Statute Book for a temporary period of time will allow for the rapid response we all hope will not be required. I hope we agree that given what we are facing, a rapid response may be necessary.

Deputy David Cullinane

Sinn Féin has tabled a number of amendments to the Bill, as the Minister may have seen. When previous incarnations of the Bill were brought before the Dáil we supported them and we will also support this Bill. At the same time, it is important that the Minister listens to what the Opposition is saying on the need for engagement and the need for proper oversight, accountability and transparency when all of these decisions are being made. I welcome the fact that at least we are dealing with primary legislation and we can set out all of our views and tease out the implications of the legislation being proposed, as opposed to tabling motions on emergency powers, which has happened in the past, whereby we cannot amend or have proper debate and scrutiny. Regulations are made without any regard to the Opposition.

I will repeat something I have said a number of times in the context of where we are now. Nobody wants additional public health measures. Nobody wants additional restrictions. Each and every restriction introduced is extreme in its own right. While we need to put in place public health measures for travel, we always have to be careful and balance out the measures we introduce and the impact they have on citizens. We all know that because of the profile of the disease now and the potential threat of the new variant and possibly other variants, we may have to look at mandatory hotel quarantine at some point in the future. If that is the public health advice, and if it needs to be implemented, measures will have to be introduced very quickly by the Government.

Every time regulations have been introduced I can say without exception the first I have learned of them is when they have been put on the website. Often, the media contacts us waiting for our response to what those regulations mean. We can be sitting in front of laptops refreshing the HSE website waiting for the regulations. There is no email, no heads-up or no sense of what time the regulations might be published. This was raised in the health committee recently. It simply is not good enough. I do not believe that if the Minister was standing where I am, he would see it as an acceptable way of working with the Opposition on introducing very difficult measures. There are very strong feelings, as the Minister knows, on any and every public health measure. It is very important that as much as we can, we have maximum transparency, maximum accountability, proper debate and proper scrutiny. I have to say, once again, as I stand here that this has not happened. We have had very few briefings for the Opposition from the Minister, the Chief Medical Officer or the Department of Health. We have had very few briefings at the Oireachtas health committee. Many members of the health committee feel that in recent times we have been treated with contempt with regard to legislation being brought forward and permission being sought for the waiving of pre-legislative scrutiny. On occasions I gave consent for it and on other occasions I did not, depending on the Bill. I supported waiving pre-legislative scrutiny on this Bill because of the urgency. Overall, what I see as a lack of respect to the Opposition is not good enough. I say this at this late hour because we could be looking at more restrictions in future and nobody wants them. We will certainly be looking for proper engagement on public health measures on travel. We all have to evaluate properly any decision made.

The reason I support the Bill is because of the threat the new variant may potentially cause. I have been at pains to point out, as have others in recent days and weeks since we first found out about the variant, that we have to listen to the science and the medical experts. We have to wait and get the expert opinion as to precisely how difficult and challenging the variant will be. There is little point in speculating. We are learning more about it every day and over the coming weeks we will learn even more. It is also appropriate that we respond as quickly as possible. In responding, what we need to do is not move ahead of public health advice or fall behind public health advice when it comes to international travel. We had many debates on international travel in the past where my party was very strong in supporting mandatory hotel quarantine where it was necessary. Equally, every time it was introduced I always said it is an extreme measure that should only be introduced and used in exceptional circumstances when absolutely necessary and for only as long as is necessary. The same logic should apply here. I have some questions on the Bill and I spoke to the Minister privately about some concerns I have about testing requirements pre-departure. I will get to these in a few moments and the Minister may have some answers to them. It is important that we put this legislation in a wider context with regard to where we are with Covid.

The response from the Government generally with regard to many of the tools that the State has at its disposal, and that the Minister for Health has to deploy, has not been adequate. Mistakes have been made. I mentioned the lack of consultation certainly with the Opposition and colleagues in the Dáil and Seanad. I fully stand over this. There has also been an appalling lack of consultation with stakeholders in many areas. The most recent example of this has been the decision to ask children aged between nine and 11 to wear face masks. It is the public health advice and I accept it. The difficulty is that this was a decision made very quickly with no consultation whatsoever with teachers, teaching unions or the National Parents Council. It was simply brought in. As usual, there were mixed messages in the early stages when it was first introduced. It was landed on the laps of school principals and teachers. The direction given to schools was seen as an overly confrontational approach, which I believe is unnecessary. We need to be very careful when dealing with public health measures, particularly when they impact children, that we do not take a confrontational approach and that we take a commonsense approach. In my view, this is what should have been taken in this instance.

When there is no engagement and when something like this is landed on schools, teachers and parents at the eleventh hour without any consultation or engagement, it causes concern and presents challenges. The Minister needs to re-examine the way this particular piece of advice was given and re-examine exactly what instruction is being given to schools.

He needs also to ensure there are sufficient flexibilities within that advice to acknowledge this will be very difficult for schools, parents and teachers.

I return to what I have said over the past while. We have talked for some time about personal responsibility and about how the vast majority will do the right thing most of the time. I think they will do the right thing on all these issues, but we have to ensure we do not take a confrontational approach that could create unnecessary tensions and difficulties for everybody. That needs to be examined by the Government. I do not want to see any situation, and I am sure the Minister does not either, where a child could be refused entry to school. That would be an appalling issue that would create significant problems for the Minister and his Government and for the child and schools generally. We need to be careful about how we approach that issue.

I raise also the issue of antigen testing, one solution being considered for international travel. If someone has been fully vaccinated and is returning to this country, a lab-based antigen test will suffice. I accept and welcome that. It shows we are finally using antigen testing, albeit not in all the settings in which I would want it to be used. Even so, I was flabbergasted when I heard the Minister's interview earlier in the week in which he said that because the market had adjusted the price of antigen tests and some retailers had reduced their price, that was it and the State was off the hook. He indicated that the State, and he as Minister for Health, had no responsibility to consider costs and subsidising the roll-out and use of antigen tests.

I have often accused Ministers and Governments of being out of touch, and statements like that prove me right. The advice from the Government is that if someone in a family of five or six contracts Covid and tests positive, all the members of that family have to restrict their movements and, possibly, go on to self-isolate. They will be asked to take three antigen tests over a five-day period. Let us consider the cost of that for a family of five of six, and that may happen a couple of times within a household, as has happened. That is a lot of money for a lot of families who do not have it. It fits in with the wider issues relating to the cost of living and all the other issues families face.

When we talk about rolling out antigen testing, we have to look at the success of the vaccine roll-out and the general success of PCR testing, despite the great pressures on the system currently. Again, I am seeking to have the capacity of those centres in some areas beefed up, given the wait times. The success of the booster jab, PCR testing and the vaccine roll-out is, in part, down to the fact they were free and cost was not an impediment. There was very good engagement and very high levels of uptake of people using the walk-in testing centres and being vaccinated. We should take the same approach to antigen testing. I cannot understand why the Minister and his Government did not simply do the right thing, make antigen tests freely available and hardwire antigen testing as an additional tool into our overall response to combat Covid.

I reiterate the advice I have been given, and that I have been giving the public, such that they should not use antigen testing when they are symptomatic. If they are symptomatic, they should restrict their movements, get a PCR test and await the outcome of that test. If they are asymptomatic and working in high-risk environment, or have put themselves in such an environment or are in one, they should use antigen testing regularly. That is the advice I have been given and it is the advice I am giving others. It is how I believe antigen testing should be used, and the tests should be made freely available. That is the type of response people want to see. They want strong leadership and to see we are deploying all the resources available to us as a State as best we can.

We all accept there is a level of fatigue and tiredness. We are almost two years into this pandemic and great sacrifices have been made by the public. There has been a great cost, socially and economically, to society in general. People's mental health has been deeply impacted. Every time we have to move backwards and reconsider public health measures, it increases that tension and level of fatigue people feel. It is really important in that context that the Government get it right. If it does not and if people see that a clumsy approach is being taken by the Minister for Health, the Cabinet or the Government, whereby we do not get right antigen testing or the roll-out of the booster jab, or if we fail in respect of ventilation in schools, that is something parents cannot get their heads around. We were told by the Government for weeks and months that schools were the safest environment and that we could stop contact tracing in schools because they were so safe. Schools are not being resourced to install HEPA filters or any type of ventilation. Schools were asked to open the windows, when it was 2°C or 3°C, with children freezing in classrooms, yet that was acceptable. We did not provide those resources and then, almost overnight, children and schools became the problem. They now have to wear masks, they cannot exercise and all the mixed messages we have seen in respect of that advice have been ridiculous.

Finally, the requirement for pre-departure PCR testing is an issue I raised with the Minister yesterday. In his closing remarks, he might clarify this. If someone has been fully vaccinated, he or she will be asked to carry out a lab-based antigen test and that is a requirement to get back into the country. If someone is unvaccinated, he or she will have to get a PCR test. The difficulty with somebody who may be unvaccinated and currently outside the country is that if he or she had Covid one, two or three months ago, it still might turn up in a lab-based antigen test. If he or she does not have a negative PCR test, will he or she be denied entry back into the State even if he or she can produce proof of recovery, which people were able to do in the past? It is unclear what somebody in those circumstances should do. What is the timeframe between when a person has had Covid and has recovered, and how long will it take it to work itself out of the system whereby it will not come up in a PCR test? I am not sure whether the Minister has that information but if he does, he might share it with the House.

Deputy Darren O'Rourke

Mandatory hotel quarantine is an important tool in our defence against the virus, particularly when the number of cases is low or, as is the case now, when dangerous variants break out. Sinn Féin will support this legislation and has tabled a number of amendments, as my colleague Deputy Cullinane outlined. The emergence of the Omicron variant is a concern and we must take appropriate measures in response. My party will support the reintroduction of mandatory hotel quarantine in exceptional circumstances for a limited period if expressly warranted by public health experts and officials, and we await that advice. Anyone who has listened to Dr. Mike Ryan or Dr. Maria Van Kerkhove of the WHO, or to the doctors and scientists in South Africa who identified the Omicron variant, will have heard that travel bans or restrictions are not the answer in and of themselves, although they might have a place, and nor is economic isolation. The answer, ultimately, is vaccination and public health measures.

In July, Dr. Mike Ryan described vaccine inequity throughout the world as an abomination. He stated:

We’ve developed highly effective vaccinations, and what’s our next move? To distribute them in an inequitable fashion so that we can stop the tragedy of the pandemic in some countries, and we will allow that pandemic to continue in so many others. It’s a tragedy and it’s an abomination that today there are frontline workers going to work in Covid wards in many countries that still have not been vaccinated. That is a disgrace.

No one is safe until everyone is safe, and the Government and its leaders are complicit in their role. In recent days, the former President and the chair of the Elders, Mary Robinson, lent her voice to the same subject. She stated:

The coronavirus pandemic is far from over. In the wake of the discovery of the Omicron variant and the risk it represents, the World Trade Organization’s (WTO) deadlock over a TRIPS intellectual property waiver on COVID-19 vaccines and treatments is simply unconscionable.

Epidemiologists warned us time and again that allowing the virus to spread around the world is a recipe for new mutations to develop and that they will indiscriminately harm us all. This waiver, which has now dominated WTO talks for over a year, is a necessary global solution to end the pandemic. Yet one powerful voice at the WTO has continued to undermine this effort ...

The European Union represents the biggest roadblock to this effective solution to ramp up the supply of lifesaving vaccines, treatments and tests, hasten the end of the pandemic and put solidarity at the heart of the world’s response.

The Government is complicit in this opposition to a TRIPS waiver. Former President Robinson wrote:

By temporarily removing legal barriers preventing developing countries from producing billions of vaccines and treatments through qualified manufacturers, the waiver would suspend the monopoly control of pharmaceutical corporations, which guarantees them eye-watering profits while sacrificing lives. It would unlock the strong manufacturing capability and capacity that exists worldwide to upscale vaccine production, which is still being underutilized.

Led by South Africa and India, the initiative is already supported by over a hundred countries worldwide, not to mention over 175 former world leaders and Nobel Laurates, prominent jurists, the World Health Organization (WHO), the Pope and millions of people.

I have no doubt that millions of people in Ireland also support the initiative. Former President Robinson went on to state:

United States President Joe Biden reiterated his support for a waiver just days ago, and has urged progress in response to the new variant. Yet the EU continues to meet this lifesaving proposal with intransigence.

It is shameful, disgraceful and disgusting. It must change.

Deputy Duncan Smith

We will support the legislation, but we will also support our own amendment and a number of other amendments that have been tabled by Sinn Féin and the Social Democrats. Mandatory hotel quarantine is a tool in our response to Covid-19. We want as many arrows in our quiver on this. However, given the experience we had with mandatory hotel quarantine, and more importantly, given where we are with the virus now, I have significant concerns about it being applied in the current circumstances. The virus is running rampant in every community around the country at the moment. If we have not had the virus, we all know many people who have had it or have it. There is no feeling that there is a national suppression strategy that is working. Our testing regime is under stress. Our vaccine roll-out is not operating as strongly as it was in the summer. We are playing catch-up with the booster campaign. People are still circulating and living their lives in a way that is bringing them into contact with each other and that is spreading the virus. That is the reality; that is a fact.

We have seen reports that since it was announced that people should work from home a few weeks ago, there has only been a 1% decrease in traffic at key points. That is just one indicator, but we could all take an agricultural estimate that things have not actually changed that much in terms of activity over the past number of weeks. The measures that have been brought in do not seem to be having the desired impact in bringing case numbers down. When I talk about case numbers, I am not just talking about cases; I am talking about hospitalisations and ICU numbers. We have plateaued at an incredibly high level. Any unexpected deviation in the virus will have an impact and could collapse our health service. The service is already under a type of pressure that is unimaginable for anyone who is not working in it or is not a patient. A few weeks ago, the health service was the centre of our discussion in the Dáil. Last week, the discussion was about PCR testing; this week, is it about antigen testing and mandatory hotel quarantine. In the intervening couple of weeks, our health service has not improved. The pressure on staff and front-line workers has not lessened; it has worsened, if that is even imaginable.

We are going to need to start making some very hard choices. Mandatory hotel quarantine may be one of them, but many others will have to be made along the way. With schools, for example, the fact is that kids are wearing masks, coats and scarves, with windows open in classrooms, yet we do not have an investment strategy for HEPA filtration. HEPA filtration is not going to solve everything in and of itself, but it is proven that it improves airflow and reduces the ability of the virus to spread in enclosed spaces. HEPA filters have worked on aeroplanes, where they have been used for many years. There is no more enclosed environment than an aeroplane. We need to be looking at this before we begin to implement mandatory hotel quarantine.

There were extreme views on mandatory hotel quarantine. People either think it was the best thing in the world and worked or that it was an absolute disaster. It was neither. It did have an impact and caught some cases. There is not doubt about that. I have big concerns about how it was applied. Perhaps the other Opposition Members present recall getting calls almost every weekend from a couple of media outlets for comment on the latest state that had been added to the mandatory hotel quarantine list. It was almost always a state from the global south. It was never a state in Europe, and it certainly was not the UK. I remember the week of so-called freedom day in the UK, when it was opening up and there were D-Day-like celebrations. The UK's virus numbers remain off the charts. We added Cuba to the list that week. The other states that were on the list that week included Burundi, Cape Verde, Eritrea, Ethiopia, French Guyana, Haiti, Kenya, Lesotho, Malawi, the Maldives, Oman, Sudan and Tanzania. We could see a pattern emerging. Any time we would ask for details on why a particular state had been added to the list, we were never given the answers.

Last week, the Omicron variant emerged and was sequenced in South Africa. Straightway, the punishment and the restrictions were applied to that region, even though Omicron is everywhere. It is here, it is in the US, the UK, Europe, Asia and Israel; it is everywhere. Hopefully, we do not need to bring in measures such as mandatory hotel quarantine again. Hopefully, we can use our powers within this House and our own domestic powers to suppress this virus. There are many more things that we can do. However, as a very privileged, rich country, when we bring in a mandatory hotel quarantine strategy and apply it in such a manner that seems to be directed towards the global south and poorer nations, that reflects badly on us. It is a shame. When we tie that in with what is going on with the TRIPS waiver and the work and advocacy that we need to do, it reflects poorly on us. We pride ourselves, as a State, on advocating for states that are oppressed, and on our charity and helping those in need. There is no greater need, at the moment, than the TRIPS waiver. Instead of actively imposing travel restrictions, we should do more to get vaccines into the arms of those who need them all over the world. Until that happens, none of us will be safe and no country will be safe. We are never going to be able to hermetically seal our State, or indeed, any state. With a virus as airborne and transmissible as Covid-19, we need to get real and to approach things slightly differently.

I understand that the legislation is being introduced to put the framework in place, as we put the framework in place for other restrictions. However, this cannot be used as a distracting measure. It does suck up a lot of media and political attention. If it is implemented, while it will have some utility, it will not have as much utility as a PCR testing system that is firing on all cylinders and does not have two-day waiting times.

We are going to have to start making very hard choices, and mandatory hotel quarantine may be one of them. Many other hard choices are going to have to be made along the way. With schools, for example, we have kids with masks on, coats and scarves on, with windows open in classrooms, but we do not have an investment strategy for HEPA filtration system

It does not have as much of an impact as a properly rolled out and subsidised antigen testing regime that is being used effectively in environments where it should be used.

Regarding antigen tests, last week I asked the Taoiseach whether he saw a role for them being used regularly in households in 2022. I did not refer to serial, but rather regular, use. He said he believed there was a role for them. The Minister said earlier this week that he had dropped the Government plan to subsidise tests. That is a mistake and I would like him to revisit that because the costs of tests are still high for a household of two or more people if they are doing serial or regular testing.

Antigen testing has worked very well throughout this year in areas such as construction on big building sites where, twice a week, workers have to take an antigen test. Case numbers were low and if anyone was found to have Covid, it would not impact the work of a site or the ongoing operation of a project. The person concerned would isolate and then return to work when he or she was well. Given the numbers and the rate of community and household transmission, we will need to do that in households.

If we are to catch the virus early, we need a proper education campaign on antigen testing. We need to stop using language describing them as a snake oil product or a silver bullet. They are certainly neither of those, but there is a role in the middle if we have proper consistent communication, education and, most importantly, affordability and access. For people on low pay or in receipt of social welfare, even at the lowest price of €2.99 per test for a family of two, three or four, it is still a massive imposition on a weekly household budget. There are no two ways about it; it is the role of the State to tackle that. It is as simple as that. The market is not going to meet the public health need for antigen testing.

I mentioned HEPA filters in schools. The Opposition has put forward proposals for filters earnestly and in good faith. If they were used, we would have some faith that everything necessary was being done.

We have to get back to what we were talking about a couple of weeks ago in a more focused manner, namely, our health service, front-line workers and ICU and hospitalisation capacity. We are plateauing at too high a level in terms of hospitalisations. That is impacting on non-Covid care. Too many operations and procedures are being cancelled, and that is having a cumulative effect. Waiting lists in this country have always been at crisis level, but they are now almost beyond that. We can barely comprehend how long the waiting lists are because of the impact of this virus. We cannot continue to operate as if this is the new normal. We need to start making hard decisions. Whether it is Omicron or something else, there will be another unexpected turn with this virus because this is not going to be the last wave. We have to start listening to the WHO. It has said the virus will be with us until at least 2023, so we have to plan accordingly. The message I want to get across is that we need longer term investment.

This is not easy. We are doing 220,000 PCR tests a week, which is a huge number. However, it is not enough and we need to do more. We need to get antigen testing and the booster programme working. I know things are ramping up and drop-in clinics have opened. We saw long queues of traffic because there is a real desire for people to get the booster vaccine. People are as scared of this virus now as they were in February, March and April 2020.

Despite the figures being put forward by the Minister and the Government, our booster campaign is behind and the virus is still too far ahead of us. If we need to redeploy staff and resources in the short term this side of Christmas to enable us to redouble our efforts and go beyond what we did during the summer for the regular vaccine roll-out, that should be done. We need to have confidence that the vaccine programme is working.

The Labour Party has tabled an amendment on mandatory hotel quarantine which I will mention, even though we are on Second Stage. The Bill is being guillotined and we do not know what way the debate will go later today. In case we do not get to our amendment, I want to put it on record. The Minister may come back to it in his reply to Second Stage or we may get to it this evening. People ordinarily resident in the State who are returning, having travelled to another state for an unavoidable, imperative and time-sensitive medical reason or a termination of pregnancy where the reason is certified by a person who is a registered medical practitioner or person holding an equivalent qualification outside of the State, need to be dealt with in the Bill. We cannot have any ambiguity there.

Through advocacy groups and people who have contacted us, we know that women have been turned away at airports because of this. If people are travelling at this time, it is usually because they are later on in pregnancy and have been given tragic emergency news. People are travelling at very short notice. To impose added PCR testing, mandatory hotel quarantine or other measures on top of the traumatic experiences women have to go through is immoral and unjustified. I want to put that on the record, but I hope to come back to it on Committee Stage. I hope we reach the amendment and the Opposition has an opportunity to examine the issue. It is to be hoped it will support the amendment.

I will leave it there for the time being. I look forward to what I hope will be a more robust debate this evening. I am disappointed that it is being truncated into one day. In my relatively short period in the Dáil, taking all Stages in one day has never worked. I hope we have a better quality of debate which, ultimately, has to be led by the Minister in terms of making sure we get through amendments. I know the Opposition will play its part.

Deputy Jennifer Murnane O'Connor

In October the mandatory hotel quarantine system was no longer considered necessary and was wound down and mandatory home quarantine requirements were removed. Now, we need them again. Omicron is among us and we have to do what we can to protect the whole of society. When the power to make regulations was introduced it was not expected that the Covid-19 pandemic would last for so long, restrictions would be so intrusive or things would change and we would have to react.

Our recovery and fight against the Covid-19 pandemic is challenging because of the Delta and Omicron variants. I do not underestimate their risks. The unknown is what is difficult for all of us. This Bill makes an exceptional provision in the public interest to protect us against the grave risk to human life and public health posed by the spread of the disease known as Covid-19 and its variants. I am conscious that we initially introduced such a measure on a temporary basis, but we removed it when we were able to. We now need to reintroduce it. We do so to protect lives, and I am fully supportive of that.

The rate of Covid-19 in children aged between five and 12 has risen by 240% in November alone, which is worrying. These are small children and public health measures and the usual mask wearing, advertising and social distancing will help. I know we need such measures to protect us all. We need to protect our children in the same way as we protect older and vaccinated people.

The booster roll-out is absolutely brilliant. In my area, Carlow-Kilkenny, there will be walk-in booster clinics from the end of next week. Some 93% of adults have been vaccinated. That is really important and shows the Government's commitment to protecting people.

I have received a lot of calls about mask wearing and the fact we have said it is not mandatory for children aged nine and upwards, yet schools are being told they can send home children without masks who do not have a medical certificate. We need clarification on that. I spoke to the Minister for Education, Deputy Norma Foley, yesterday. The advice on wearing masks comes from health professionals and NPHET, but I ask that there be more communication with schools and we ensure that there is no issue where a child has a medical need.

We should be able to come to a solution through the doctors and the schools. I would like to ask about proper ventilation and filtration systems. They will go a long way to keeping our schools open. I have been speaking to a lot of parents who have said to me that it is so important that we keep our schools open. I acknowledge that is a priority for the Minister and for the Minister, Deputy Foley.

None of us wants to be back here today introducing new restrictions. Unfortunately, we see that the daily case figures are over 4,000. All of us here in government have a duty of care to make sure that we protect lives. We all want to protect the lives of children and adults. We want to protect everyone. No one wants to be back here again. I welcome these provisions. It is unfortunate that we are here again. We have to make sure that we protect everyone.

Returning to schools, we must reinstate contact tracing and other public health supports for our school communities. At the moment there are a lot of changes within the school system. I compliment the schools. They have done a marvellous job. The teachers, principals and parents have been outstanding. We have to try to keep everything as normal as possible. Keeping the schools open is definitely a priority for us. I ask that there be more communication with the schools and refer again to information, particularly when there is a medical issue.

Deputy Aengus Ó Snodaigh

Ní raibh mé ag súil le bheith istigh chomh luath seo tar éis an oíche aréir. Tá mé beagáinín scattered sa mhéid atá le rá agam. My colleague indicated we would be supporting the Bill but we have tabled a number of amendments. They are similar to amendments we have tabled in other instances where this type of emergency measure was brought in. I am in the Dáil long enough to understand how the Dáil works and how it should work. When we are bringing in measures that impact on people's rights there has to be some sort of oversight. I am a firm believer that we often do not need to bring in measures such as this. If there is a specific emergency we should be able to rely on the fact that the Dáil can be recalled. The Dáil should not be recalled at a moment's notice except in the case of an emergency. Sometimes we bring in legislation just in case something happens and we might need the provisions. That has been part of the problem with the measures to do with Covid. We are a Legislature and we need to take steps to ensure that we have proper oversight and are fully informed of all steps and all legislation that is introduced, especially where it concerns people's rights. The party is favourable towards and has called for mandatory hotel quarantine in the past.

We support this measure but sometimes it is hard to support measures when they are taken in the round with other measures. It is hard to take it when we have low confidence in the approach of the Government in respect of many of the issues to do with Covid. One of the reasons I am out of breath is that I was taking a call from a distraught mother who has been told that her two children are not allowed into school without an exemption from her doctor. I had informed her that this was possibly going to be the case. She went to her doctor who is refusing to issue certificates. Where is the regulatory impact assessment? Decisions taken by the Government are now starting to affect parents and their children. It is not just willy-nilly. These are not people who have issues just with a mask. One of the children has asthma and another has had an operation on his nose. They cannot wear masks for the whole day. They are not refusing to wear masks but they cannot wear them. There is a need for the message from the Government, which is supposed to be based on public health advice, to be clear and understood properly not by parents and kids but by those who are implementing the measures. In this instance, where is the contact with the doctors? Where is their understanding of what they are being asked to do? Where is the form that goes to the doctors around the country who are now being approached in droves by parents of kids with issues? Similar to other provisions, the Minister needs to ensure that this is not extended for too long.

Deputy Róisín Shortall

I do not have any problem with the reintroduction of these measures and the Social Democrats will be supporting the legislation. I have a number of queries about this and other announcements the Minister has made in recent days. I want to make a few general comments as well. I hope there will be support across the House for the legislation. It strikes a reasonable balance between protecting public health and the need to ensure that we limit the risk of the importation of the new strain of the virus. We must act in a measured way. We all hope there will not be any need to commence this legislation but it is wise to get it onto the Statute Book so that in the event that things go in the wrong direction, there will be a facility to address the issue.

I welcome the fact that the UK moved very swiftly on travel. It is in marked contrast to last Christmas, when we found ourselves in this situation with the Delta variant and the critical time that was lost, which had awful consequences for us in this country, the UK and further afield. I do not have a difficulty with the Bill and the Social Democrats will be supporting it.

The Minister has made some good changes to the previous arrangements which are welcome, particularly in respect of the application for exemption prior to travel. That is sensible and practical. The Minister also talks about the grounds on which people will be exempted. The first is for medical or other exceptional reasons, including providing care to a vulnerable person. What is the definition of that going to be? It seems extremely loose. Lots of people are travelling for reasons such as visiting an elderly relative, seeing grandchildren or whatever. There is a need to be clearer about that because it could cover a multitude. What are the definitions and criteria that will apply?

There are other questions about the criteria that will apply, who sets them in a general sense and who oversees this. None of that is very clear. The Minister often signals things. Things are mentioned that seem to make sense but then there are questions about enforcement. The matter of who enforces and the criteria that apply are often quite loose. It would be very welcome if there was further clarity on that. On practice generally and legislation, while I completely accept that there is urgency about this as we are coming up to the recess, it is always good practice to have pre-legislative scrutiny. If there was a request, as there was in this case from the Department to waive it, the least the health committee could have expected would be to have a briefing on it. No briefing was provided. It would have afforded an opportunity for us to get clarity. That was a mistake. We all appreciate the urgency of this matter but people need to be treated with respect in here.

They need to be given adequate opportunity to ask questions. I endorse the point that has been made earlier about the infrequency of briefings. In the main, it has to be accepted that the Opposition is supportive of Government regarding steps that have to be taken to control the pandemic. Most parties on this side of the House have been exceptionally supportive. If anything, we have been calling for better enforcement or stricter application of the rules and, generally, to do things that are not being done. It is not that we are saying “don’t do this”. We are saying “do it better”. From that point of view, it is a missed opportunity not to work more closely with the Opposition, or to provide the kind of regular briefing that we used to get. Certainly, in the last Government, in the first six months of the pandemic, we used to get briefings at least every week and sometimes twice a week. They happen rarely now. I think we had two since the summer. I am just making the point we should be working on a cross-party basis. The response would be all the stronger for that. It would also send out a much clearer message. Not all wisdom resides on the Minister’s side of the House. People on this side of the House also propose actions. It would be encouraging and much more effective if some of the ideas from this side were taken on board and if there were closer co-operation.

In that regard, one of the amendments that I tabled asks for notice to be given about the introduction of regulations. It has been difficult to keep track of what is going on. The legislation tomorrow and, to some extent to this piece of legislation, are enabling pieces of legislation. When regulations follow on, they will have an impact on people's lives, on what people can do and what people cannot do. It is only reasonable that people are given some notice of when regulations are to come in. I have tabled an amendment asking that we would be notified 48 hours in advance of regulations, and that we would be told when the regulations are being laid before the House. That would be good practice. We know from past experience that when regulations were introduced, or when they were talked about, the gardaí were expected to implement and enforce them, but the regulations had not even been signed. Again, this idea of making an announcement without the follow through or without keeping people in the loop is not good practice. I would hope that the Minister might consider some of those amendments about providing notice at least.

Along with this piece of legislation, the Minister made an announcement in the last few days. It came out somehow, but it was not a very clear announcement. The Minister has repeated it here now today. He said: “We have also announced that from 3 December, people traveling to Ireland, regardless of vaccination, recovery status or travel history, will be required to complete a pre-departure Covid-19 test. Work to introduce regulations giving effect to this requirement is underway.” What does that entail? We have heard that the Minister is talking about the possibility of an antigen test within 48 hours of travel or a requirement to have a PCR test within 72 hours. The 72-hour window is too long.

This question was put to the Minister on "Prime Time" the other night. The Minister was asked about what happens if a person gets their test three days before travelling, and then they go out clubbing that night, go to a football match, or mix with large numbers of people over the following two or three days before they go away. Surely, then, there would be risks involved in traveling, because the person will not know the virus status in those circumstances. Therefore, 72 hours seems like a long time for a requirement for a negative PCR test. My main concern relates to the other aspect of that, the requirement for a PCR test or an antigen test within 48 hours. I cannot understand the science behind this or the evidence that supports this measure. The Minister, NPHET, and others in government have been telling people for the last 18-plus months that antigen tests are not reliable. They kept on saying that. The Minister has now come to the position where he accepts that antigen tests are very reliable for positive results. Now, late in the day, there are recommendations on using antigen tests. A positive result from an antigen test is regarded as being 80% reliable. However, the Minister keeps repeating - and nobody argues with him - that a negative result from an antigen test is completely unreliable. Yet, he is saying an antigen test is an acceptable measure to provide assurance that a person who is traveling is not infected with the virus. That does not make sense any sense whatsoever. The fact that the antigen test would be done professionally does not make a difference. If one does one antigen test before travel that gives a negative result, that result does not mean very much. How can the Minister defend that measure? This has to be about real measures that actually make a difference.

Yesterday, I listened to Assistant Professor Gerald Barry, a virologist from UCD on "Morning Ireland". He was very critical of these proposals. He described them as a box-ticking exercise. We are introducing travel restrictions, but as long as one has a negative antigen test within 48 hours or a PCR test within 72 hours, that is fine. Professor Barry said that the science does not support that at all. Other people have made that comment as well. Will the Minister address that in his wrap-up? How does that provide any protection? I cannot understand that. Professor Barry went on to say that this does not stand up to any kind of scrutiny. He finds it hard to understand why the Minister is doing this.

Professor Barry also said that we should be much better performers in testing. We know that tests are not available for large numbers of people. We should, of course, be doing sequencing. The scientific community has been calling for this for a long time. Currently, we are only sequencing 10% of tests. It would be much more effective to up that number, so that we can track down cases of the new variant. We would be on top of what kinds of variants we have in this country, as well as what is the spread and so on. All I can say is that this does not make any kind of sense. When the Minister is giving advice, it has to make sense to people. It is not just about “we're going to take this action and that action”. The actions have to mean something and they have to be effective. Can the Minister please address that specific issue?

I want to go on to talk about the general issue of antigen tests. I raised this earlier in the week. I raised it with the Taoiseach as well at Leaders' Questions. It was a mistake for the Minister to promise to introduce a subsidised scheme for antigen tests because they are a very useful tool and then do a U-turn on that. The Minister said the market has delivered. The market has not delivered. Some places have cut-price antigen tests available. In lots of places, they are not easily available. The first question is on affordability. If somebody does not live beside a discount supermarket, how do they access affordable tests? Many people buy them in a pharmacy. In some places, antigen tests are still being sold for €7 or €8. The fact that some supermarkets on particular weekends get into the business does not mean that antigen tests are generally available at affordable prices. Even €4 for an antigen test is expensive for a family of four. People are advised to do the right thing if they are out mixing, if they are in college or at school and so on. They are advised to do two antigen tests a week.

For a family of four, that can amount to €30 a week and that is a fair deal of money if they are on a low income. The tests are not generally available at an affordable price. That is the first point.

The second point is that the Minister seems to have washed his hands of any question of standards as regards antigen tests. If there is competition in the market, the big danger is that there will be a race to the bottom in terms of making the tests very cheap but we have no guarantee about quality whatsoever. I examined and researched this over recent days. There is no standard set in this country for diagnostic testing. There is no regulation of that whatsoever. There is very tight regulation of medicines, and that is only right, but there is no regulation of diagnostic tests, including antigen tests. We have no idea about the quality of the tests available and the Minister seems to have walked away from any responsibility for that. The concern is that the Government will now be encouraging people to use antigen tests but some of those tests are hopeless and completely misleading.

Looking at this from a European perspective, in the last five months alone the health directorate of the European Commission rejected 160 tests that were looking to come on the market. We do not know where those tests are now because there is no regulation. It removed some of the tests from a previously approved list. There is no requirement to have approved tests for sale here so there could be any kind of cheap ineffective tests on the market, in a situation where the Minister is saying the market will deliver. That is a serious abdication of his responsibility to ensure proper standards for people. I ask the Minister to address that. It may have been an off-the-cuff remark or a knee-jerk reaction because there was an estimate of what free or subsidised antigen testing might cost. In the context of the overall situation where we are trying to encourage people to do the right thing, the Minister needs to revisit that. I believe that very strongly.

The other question relates to things that have not been done properly. Many of us and others outside this House have been calling for very practical things to be done so people can be encouraged and supported in taking steps that are achievable and can greatly reduce the risk of spread of the virus. The outstanding question is what is happening in schools, or what is not happening. The Minister has been told by the expert group on ventilation that ventilation is a key issue and must be centrally addressed in order to reduce risk. The first of those two expert group reports came out in January and the second came out in March, but they have been largely ignored. The first one was ignored by NPHET and the second was ignored by the high level officials group. They were just buried. The public health messaging on the steps people can take avoided referencing ventilation until the last few months. Ads were continuing to go out and there were new ads on the radio and there was no mention, or hardly any, of ventilation. It is a clear thing. We have known for a very long time that Covid is an airborne virus and it should have been front and centre. It is just unbelievable that those comments were made yesterday by NPHET about measures to clean the air and HEPA filters. It underlines the need to have a broader range of expertise within NPHET, as it is quite limited. We must ensure it has the kind of scientific expertise that understands air filtration. It is very disappointing that this was not addressed at an earlier stage. People who have expertise in the area should have been drafted onto NPHET from that point of view.

NPHET has a very narrow focus. It is very much male-dominated and the voice of public health advice is very much male-dominated. I spoke about this over a year ago. The weakness of that is that sometimes people operate from a theoretical perspective. The announcement on mask-wearing in primary schools was coming from that perspective, without any understanding that you cannot make an announcement after 6 o'clock in the evening and expect parents to be prepared to implement that at 8 o'clock the next morning. It just shows a lack of understanding of how families operate. That caused a lot of concern. There is a need for a much wider perspective to be taken in terms of the advice. We need a much more practical approach to mask-wearing and having good quality masks, because there has been very little information on that and the Government should be setting the standard there. There are lots of things people can do with CO2 monitors, air purifiers and so on and the Government should be supporting them in doing that. Antigen testing is the stand-out issue there and I think the Minister made a mistake on it this week.

Deputy Ruairí Ó Murchú

We will be supporting this legislation, although we will be tabling a number of amendments. There has already been much discussion this morning on the need for a greater level of interaction between the Government and the Opposition, whether in dealing with legislation and proposals or the conditions prevailing at the time. It is about all the information being known. In fairness, there has been serious constructive engagement across this floor and in other forums on the operation of Leinster House. We need to see a greater element of that, accepting that there is a need to move quickly.

We need to look in the whole at how we deal with the pandemic. We had all hoped to be beyond this period but we are not. It is unfortunately part of the lexicon at this stage. We are where we are. There has been a failure to deal with certain sets of circumstances and there has been a failure to move quickly enough on antigen testing. There may have been particular reasons people did not want to engage in the conversation at an earlier stage but there had been huge acceptance of it across Europe and wherever else. I am glad we are making moves on that. Some of the chaos around schools was due to the proclamations, guidelines, declarations or whatever you want to call them from NPHET and then there was an absence of a narrative directly from the Government. We cannot have that sort of problem. People want to do the best they can but they need clear instructions. They do not want that element of confusion. I say that while accepting that this is an incredibly difficult situation to deal with.

We hope mandatory hotel quarantine will not need to be engaged. We are in the mouth of Omicron and there is the possibility of future variants. The fact is, as Mike Ryan has said, that travel bans will not deal with this. This is about our failure to vaccinate people across the world. This Government has to play its part with the TRIPS waiver. We have to push, particularly at European Council and Commission level but also at every other forum, to have a real conversation about this. A huge amount of public money has gone into the pharmaceutical industry. It is about delivering for people and none of us are safe until all of us are safe. That is the biggest thing that we need to get ahead of.

Deputy Gino Kenny

Hopefully we will not have to use or implement these powers.

Everyone in this House understands the legislation that we have passed over the past 20 months to tackle this constantly evolving virus, but Members would not be honest if they said they were not uncomfortable with some of the powers that have been provided, regardless of whether we opposed or sanctioned them. Those powers have been draconian in the face of a pandemic. People have lost their liberty and there have been travel restrictions. If we had told people two years ago that there would be these powers, they would have thought we had lost our minds, but the constant evolution of this virus has changed the nature of things, not only in Ireland, but across the world. The virus is on the counteroffensive at the moment in various jurisdictions and people have to act in whatever way they must.

One of the narratives of the past 20 months has been that of social solidarity across the world - people coming together and health systems being challenged by the virus. However, there has also been inequality in the vaccine roll-out globally. It is not abstract to ask whether the rich nations of the world, if they cannot at this stage give vaccines en masse to humanity, will ever do it. We are at war with a virus, and in such a war, all rules go out the door. All of humanity, regardless of where in the world, needs access to the vaccines. If we do not give the developing world access, the virus will evolve, as has happened in the case of the Omicron variant.

I was struck by what Mr. António Guterres, Secretary-General of the United Nations, said yesterday. He hit out at the travel apartheid in respect of some of the states in southern Africa. People living in those countries will immediately not be able to travel to Europe or some other jurisdictions. Countries have acted arbitrarily. People Before Profit has supported mandatory hotel quarantining, but we will not in this instance because of its arbitrary nature and the blanket travel ban. Mandatory hotel quarantining is not warranted on the basis that has been provided. It sends out the wrong message to countries, particularly South Africa where scientists identified the variant. A blanket travel ban was applied to those countries. What does it say to scientists in the developing world who identify variants if, just days after, their countries are punished? There are question marks over how wealthier countries have acted in this regard. That is why we will not support the Bill.

Deputy Michael Creed

I welcome the opportunity to contribute briefly on this legislation. I am starting from the position that I believe that everyone in the House, including the members of the Government, all of the outside bodies, such as NPHET and the National Immunisation Advisory Committee, NIAC, and departmental officials are endeavouring to do their best, but that does not mean that we are infallible. Despite our best efforts, this virus has been challenging, not just for us, but globally, and the responses we have had to take at various times have needed to change. The messaging around changing advices is not widely appreciated, but it would be equally to the detriment of public health if we did not change advices as the circumstances around the virus changed. While people are undoubtedly depressed with the recent developments, it is incumbent on us to keep public health to the fore and to support measures that are clearly focused in that regard. Without doubt, the first and foremost duty of the Government is protecting public health.

Having made the point that none of us is infallible, I wish to raise a specific issue or two with the Minister concerning the most recent decisions in particular. International travel had resumed and people were looking forward to it, but there are a cohort of people who are out of the country and have been caught mid-stream by the changing advices. I understand that the regulations are yet to be finalised, but surely there is a case to be made for people who departed the country for a week's holidays or a fortnight's holidays and are now attempting to return to be exempted from those regulations, as they departed in good faith under a set of circumstances and regulations that changed while they were abroad. That is not an unreasonable request, and whether it can be accommodated within the regulations that are being drawn up is worth considering.

In the language used to communicate the changes as regards people returning from abroad - I am not referring to people who are returning from southern African countries that are now on a red list, but from the UK, EU countries and elsewhere - there is a requirement for a clear PCR test or a "professionally administered antigen test", which I believe is the term. As much as I can, I have tried to navigate Government websites to find out what a "professionally administered antigen test" is. If someone is in Heathrow, Orly, Schiphol or Frankfurt and is trying to get back into the country, who will administer an approved antigen test? At this short notice, does the Government already have an approved list of professional antigen testers that my constituents or I can access as they seek to return to Ireland? As I understand it, a self-administered antigen test is not fit for purpose. In his reply, the Minister might address what an approved antigen test is, who administers it and whether there is a list. Would it be done in a Boots pharmacy in Heathrow Airport or would people have to go to the Harley Street Clinic in London? Who will administer the approved tests in the various jurisdictions from which people will be flying? This is a reasonable question. This provision should also only be applied to people who have departed the country in full knowledge of what the regulations are.

I am not convinced by another change. I anticipate that, in the coming weeks, there will be large numbers of people who have planned their return home for Christmas from far away places only to be confronted at transit airports with the reality of failing PCR or antigen tests. The floor of this Chamber will be dominated by Deputies representing their constituents who are in Heathrow, Amsterdam or Frankfurt having tried to come home from New York, Sydney, Ontario or wherever. Since they will not have clear tests, they will by regulation and by decision of this Government be forced to stay out of this country for Christmas. That is undesirable and I am not convinced that it is a proportionate response. Will the Minister address this issue when replying to the debate?

In the context of the broader challenge we face, I have twice attempted to raise another challenge with the Minister by way of parliamentary question.

I refer to the challenge facing service providers, in particular in the disability area, of reopening services currently because of associated issues to do with the Covid challenge. One service provider said to me recently that for the first time in a while, money was not the issue in terms of their endeavours to reopen, but staff availability was. I want the Minister to consider that in terms of the other side of coin. I refer to people who have been locked out of disability services. I want to focus in particular on disability services in the context of this issue and I hope the Minister can reply to it. People have been locked out of disability services for 18 to 20 months. I can give the Minister an example from my constituency of an elderly gentleman who looks after his adult daughter. He is farming in rural Ireland. The man, who was in a distressed state, said his daughter is quite agitated and that she had not attended a service in almost 20 months. He must work the land, and with the best intention in the world, while he is out, he locks the door when he leaves the house and leaves his adult daughter alone in it. I am all in favour of HIQA standards. HIQA has been critical to raising the standards and quality of care.

An Leas-Cheann Comhairle

I thank the Deputy.

Deputy Michael Creed

I will conclude on this point. Would the Minister consider waiving HIQA standards? We have done so on previous occasions. Macroom district hospital is being rebuilt to new standards at the moment, but we did get a dispensation.

An Leas-Cheann Comhairle

Deputy Creed is way over time.

Deputy Michael Creed

I am not talking about a diminution of standards but a temporary waiving of standards, by agreement with all stakeholders, so that some services could be restored, which is better than no service at all.

Deputy Pat Buckley

I too welcome the opportunity to speak on the Bill today. I am pleased to see both the Minister for Health, Deputy Donnelly, and the Minister of State, Deputy Butler, are present. We have tabled a number of amendments to the Bill. I do not think they are life-changing, but they could mean an awful lot when it comes to accountability, clarity and information tracing and sharing.

I wish to touch on a few points. We are well aware there is a pandemic, that it is new, and that everybody is learning. As other speakers have said, various Departments are trying to work together. The main focus is on trying to quell and control this new virus. What is more important is to get the information out to schools, principals and families. There has been a lot of panic and mixed messaging on foot of statements that were made.

The previous speaker who mentioned disability services is correct. People who require those services have suffered traumatically since Covid arrived because the services have practically shut down. The Minister of State with responsibility for mental health and older people, Deputy Butler, is present. Mental health services are going backwards. Businesses do not know what they are doing next week or the following week.

I tabled a parliamentary question on PCR tests last week. I inquired about getting pharmacists involved at local level. The reply I received from the Department is that it would much prefer a person to travel from Youghal in County Cork to Cork city to a designated centre than for the person to stay in the town. The majority of these people use public transport. I do not think it is a very good model. I believe more services should be provided locally. If we are to tackle the virus, we must tackle it locally as well and put services in place.

Returning to the Bill, I appeal to the Minister to take our amendments on board. It is not a test of who is better, it is about making sure that things are going well. We will all work together in the House. It is about getting clarity and accountability and making sure the system is working properly.

The Minister of State, Deputy Butler, will hate me for it, but I am here and she is also here. I was reading the latest minutes of a meeting in Cork County Council regarding the Owenacurra centre. It is ironic we still do not have clarity in Midleton on the centre. In the middle of a pandemic, we do not know if the long-term respite beds will remain or where the mental health day care services will go. I spoke to a number of patients last Monday. I will conclude on this point and put the situation in context. One gentleman said to me it was great to be out that morning. He said he had got his bottles of water. He said he can still get the bus and the train, and he can go for coffee. He asked where he would go if they were to take him from the Owenacurra centre. He said it was his forever home and he wants to die there. He asked me if I had an answer for him. I could not give the man an answer. I appeal to the Minister of State to please make sure those services remain in Midleton, County Cork.

Deputy Seán Canney

I wish to share time with Deputy Shanahan, if he comes in.

An Leas-Cheann Comhairle

Is that agreed? Agreed.

Deputy Seán Canney

I welcome the opportunity to speak on this Bill. Everybody tells the Minister stories about what is not right in terms of what we are doing. What has happened in the past two years has never happened before. It is unprecedented. The Government makes decisions, and the House supports it on the basis we are doing the right thing on the day. There are a few things we need to look at. All rules have gone out the door. We have had the implementation of rules, regulations and restrictions that are unprecedented. Two years ago, if we conducted a general election campaign on the implementation of these policies, we would have been told we were entirely off the wall to consider introducing all these restrictions. Some people are concerned we are taking more power than we should be taking. The reality is the vaccine has power. It has no other agenda, and it has no conscience, so we must work accordingly.

I compliment everybody on what has been achieved in the past two years for the safety of the population. The vaccination roll-out is something we can all be proud of. I encourage those who still have not got the vaccine to go for it. The booster programme is up and running also and it is going well. When people get vaccinated or get a booster, they feel that bit safer and more secure and they have a bit more confidence. That is what we need to give.

Deputy Creed referred to an issue in his constituency. Such issues arise in every constituency. Some in society are feeling the brunt of this situation who do not have a voice. I refer to people with disabilities and those in school with special needs. It has been horrible for them, their parents, and families over the past two years. We must make a special effort to seek out those people and make sure they are not left to survive on their own.

It is like going back in time to hear about a person who has to lock the door on his daughter so he can go out and do his farming. That should not be the case. We must do something about this kind of thing. When I say "we" I mean we must act collectively. It is important that where we come across such situations, we should try to deal with them through existing services.

In my constituency, a day service in Loughrea that was catering for approximately 30 people has not reopened since the arrival of Covid. The service was located in the St. Brendan's home and it has now been incorporated into the nursing home. It is proving difficult to create a space that will be safe. I know the Minister is aware of it. We could perhaps make an extra push to ensure a service is provided. It is 30 people a day, five days a week and there are 165 people in a catchment area from Athenry and around Loughrea and Gort. They miss this service, which acts as a lifeline for them. We must look at the way we do things for what I call the forgotten people. It is not that they are forgotten, but we appreciate that Ministers cannot think of everything.

It is important we use all the tools available to us. I know there has been a struggle with trying to get antigen testing over the line and to get the experts to provide coherent messaging on that. What was even more disturbing this morning was the debate on national radio about whether there should be filters in schools.

We have one set of people from NPHET making their suggestions and giving their advice and there is then another expert committee giving its advice and both are contradictory. This is being debated where there is an argument as to who is the best person to deliver the advice to the Minister. The Minister is in a hard place when this is what is coming at him. No more than many other things, the message we are giving out has to be very clear and the kites are being flown at times to see how people will react.

The same has happened on the schools and the masks for children from third class upwards in that there has been a mixed message and confusion as to how this will be done. Is it mandatory and up to the parents or the teachers and the school principal to decide? What responsibilities do the schools have if people do not put on or refuse to put on their mask and how do we deal with that? A very significant burden is being placed on our schools and school principals and we need to give them more guidance immediately so that they can implement as best they can the restrictions and the measures that we need to put in place. I am receiving calls from distressed parents or a teacher asking how they should deal with this or that. It is important therefore to have clear messaging and guidance.

Returning to the situation where people have gone abroad, how do we deal with where they are trying to get back? Last Saturday evening, all of a sudden all hell broke loose and now we have a situation where we have to bring in this legislation. How are we going to ensure that we can deal with the exception and with people in order to have the flexibilities? Where will this professionally-taken antigen test take place, how will it be made accessible and where is the information on this?

With the Minister of State, Deputy Butler, here, I wish to commend the nursing homes around the country for the great work they have done. In particular, now that they are in the position of having another exposure and risk, it is important that we continue to support them at the HSE level to ensure that nursing homes are safe. Back at the start of this pandemic, the exposure of nursing homes was perhaps not treated seriously and that is something that we should learn from. We now need to refocus on nursing homes and give them the supports they require, especially as we come up to Christmas where there is a greater demand for visitors to come into these homes. How will they deal with and manage that demand to ensure that the people in these nursing homes are kept safe?

It is important to also say that special needs schools need to be kept open right through this situation. When I say “need to be”, we have heard stories on this. As a member of the Oireachtas Joint Committee on Disability Matters, we have seen and heard first-hand from witnesses the trauma that families have been through in the first lockdown. Again, these families were left in abeyance because we did not know how to deal with it. We have had that experience and we need to ensure now that the special needs schools are kept open and functional so that these families of special needs children have the comfort of knowing that the schools will remain open. A statement needs to be made on that as a matter of urgency.

The other area that I have a concern about is the economic well-being of our hospitality sector, our live music industry and all that goes with that. Right now, there is not a lockdown on pubs or restaurants but there is by stealth, because people are being advised not to go to restaurants or pubs. The proprietors and owners of these premises are facing constant phone calls cancelling bookings which is causing this closing by stealth. They need to be supported in a way that they will survive this Christmas that they were all looking forward to in order to make up some of the ground they have lost. Recognising the supports that have been there for business and for everybody over the past two years, it is important that we do not walk away from them right now. There are many small family pubs and restaurants which are on the brink and we need to publicly state that we will support them and give them that support until we get over this hump and hopefully into the new year where we will see a new dawn.

Finally, it is important to repeat that we have fantastic people working in our health service. They have been under severe pressure for so long and are constantly under pressure. People talked about the loss and challenge of trying to get staff to manage disability services and to do all of the things that we need to do in society to protect our people. Our health workers have done Trojan work and are heroes to us.

The general public in this country have also contributed so much to try to save and create a healthy environment that we can all live in. We need to keep reassuring people, recognise the effort that everybody is making and to encourage them to do more. This House has been unified in its approach to things. We may argue about how we do things and hindsight, I inform the Minister, is a great thing but on the day-to-day issues we are doing very well in dealing with the crises as they arrive and come at us in a wave. There are many heroes in this country at this stage. We need to continue to encourage people to do the right thing and to ensure that we have a clear and concise message at all times. We need one voice and not many experts expounding the virtues of what they think on the public airwaves and creating confusion. I believe that that and I thank the Cathaoirleach Gníomhach.

Acting Chairman (Deputy Bernard J. Durkan)

The next speakers from the Rural Independent Group are Deputies Danny Healy-Rae and Michael Collins.

Deputy Danny Healy-Rae

I do not see the other Deputy but he will probably arrive. I thank the Cathaoirleach Gníomhach for this opportunity to speak. The first thing I wish to raise with the Minister is the issue of masks which have been ordered in for children in schools. Many parents are very hurt and concerned because even yesterday morning and this morning, many mothers have spoken to me to say that they cannot get the exemption letter from their doctors. As the Members may know, doctors in Kerry are very busy and sick elderly people are even waiting for appointments. It can take anything up to a week to be seen by a doctor if one has an ailment in Kerry. Many of our GPs are very busy. They will not give a letter exempting a child from wearing a mask because of asthma and all of the other ailments. One child has breathing difficulties and had Covid-19 a number of weeks ago. I do not know if the Minister is listening and if he is not I have no business talking then.

Deputy Stephen Donnelly

To clarify out of respect for the Deputy, we are discussing exactly the point that he has raised so that we can give him the best possible answer.

Deputy Danny Healy-Rae

That is all right but this is very serious. The Government has not spoken to the GPs and I am being told that no one has given them direction. They are only hearing about these requests on the radio, the media, the television, or whatever and that is not fair to that profession. These are professional people doing a professional job and they are at the pin of their collar to look after their communities and sick people. The Minister for Education said clearly yesterday on Radio Kerry that children over nine years of age cannot go into school unless they are wearing a mask or they have a letter of exemption. That is where the trouble is because the parents are not able to get the letter of exemption.

If they can get one it takes time to get it. An understanding has to be arrived at with the GPs to ensure that children and parents are not disenfranchised because children's health has to be prioritised. Their need for education has to be recognised as well.

I am in a difficult spot because I wanted to raise more things, although they might have been raised already. The following matter was not raised by Members. I want to ensure that families can go into hospitals and nursing homes to visit their sick relatives. Many elderly people have died after spending a number of weeks in hospitals and nursing homes without visitors. There must be some way that visitors can dress up in the same manner as the nurses and go in. Exceptions must be made to provide for visitors to go in and see the people who are in nursing homes or hospitals. That has to be done. It is unfair that people who gave their lives to this country and brought us to where we are die alone, are sick alone or stay in nursing homes alone without visitors. I do not want us to arrive at that situation because that is unfair on these people. I will leave it at that and I will be listening to the replies of the Minister and the Minister of State.

Deputy Catherine Connolly

I welcome this opportunity and I often claim there is no debate but we got time today to debate this Bill. However, I deplore the fact that the Bill only became available to Deputies late on Tuesday night. We had yesterday to look at it and it is up for discussion this morning. I could not possibly get through that Bill and analyse it in the manner that it deserves in that time so that is unacceptable. It should have been teased out in a committee.

I am probably one of the few who does not welcome this Bill. I always preface my comments by saying it is a serious virus with variants which were eminently foreseeable from the start. I gave my permission to draconian legislation, and I use every opportunity because sometimes I only have two or three minutes although on this occasion I have longer, to say I reluctantly gave that permission and agreed with the Government because we were facing a serious threat. I did so on the basis of a contract of information with the Government that it would come back proactively on a regular basis, which never happened. We have reacted over and over.

I want to put what I have read of the Bill into perspective. I look at the human rights aspect of this and I will put it in the perspective of the Irish Council for Civil Liberties, ICCL. Mandatory hotel quarantine was introduced on 26 March and came to an end at about 25 April. I want to examine the human rights issues because Members have overwhelmingly welcomed the Bill, which I understand. However, I do not understand the failure to put in context the constant encroachment on human rights without any analysis or assessment whatsoever. The ICCL stated:

Mandatory hotel quarantine undoubtedly amounts to a form of State detention. Persons who travel into Ireland from designated States [and this is going back to April] must make a booking and so on.

The main point is that it is "a form of State detention". If a person is deprived of his or her liberty we have law and judicial pronouncements on this going back a long time. In the context of the mental health tribunal, Justice Dunne stated in the Supreme Court in 2019 that: "It has always been a hallmark of a constitutional democracy such as ours that the deprivation of the liberty of an individual is not to be lightly undertaken." When we do that it must be a last resort and proportionate because other ways have failed. The ICCL went on to state:

Ireland has strong constitutional protections for individual liberty. The detention of persons by the State must adhere to very strict rules in order not to fall foul of these protections. In its current form [and this is going back to April], mandatory hotel quarantine fails to meet these standards and encroaches unnecessarily on the right to liberty. The present system has significant deficiencies which call into question the ongoing legality of the system as a whole, and the necessity and proportionality of the detention of certain categories of persons.

That document, dated April 2021, goes on to talk about the inadequate appeal system, stating that it:

Fails to meet essential standards for an effective review of detention. ICCL is concerned at reports of conditions and the behaviour of staff in MHQ [mandatory hotel quarantine] and the failure to put in place an independent inspection system. For all of these reasons, ICCL believes the present MHQ [mandatory hotel quarantine] system is not compatible with the Constitution and with Ireland’s human rights obligations.

The ICCL is not a way-out radical organisation; it was moderate in its statement in April.

Some changes were made, although not enough were made in my opinion. Mandatory hotel quarantine lapsed in September and rightly so. The Government is coming forward to be ready in case the situation gets worse and I understand that. However, I have no analysis before me of what the Department has done to examine the mandatory hotel quarantine system to date. We know from some of the content of the Minister's speech, from a reply to a parliamentary question asked by my colleague, Deputy Pringle, and from other Deputies that at its peak eight hotels were in use and that the busiest day was 9 May 2021, when 1,008 persons were in accommodation in mandatory hotel quarantine. Some 10,398 people entered mandatory hotel quarantine accommodation. We know from today's information how many tests were done. The Minister said that 17,846 tests took place on residents and of those 10,398 people, only 593 residents tested positive. I understand that the Minister goes on to say that does not take into account how the community was saved from transmission by that but it is extraordinary that so few of those 10,398 people tested positive.

I know the Minister has five minutes at the end of the debate so I would love him to answer why a human rights assessment has not been done. I realise we are back in a crisis situation with high figures in Ireland again in recent weeks. I come back to the new variant from southern Africa which has given the impetus to this but there have been many months in which a human rights assessment should have been carried out so that we could learn. I realise that a review was carried out and low costs have come forward but we still do not know the cost of the last six months of mandatory hotel quarantine.

I refer to appeals. We have no idea why some appeals succeeded and others did not. We have no idea if it was consistent, what themes emerged as appeal issues or anything like that so that we can learn from the process.

Looking back, we know that it was very inconsistent. The Irish Council for Civil Liberties pointed out that it was "not clear that the appeals process was effectively or consistently applying the criteria contained within the Act". For example, a man who flew in from Israel to be with his dying father who was in intensive care and was expected to pass shortly, was denied two appeals for an exemption on humanitarian ground six. It is difficult to imagine what could constitute a humanitarian appeal if being with one's dying parent does not. I recognise that this case was dealt with and I am not asking the Minister to go back into the detail of it in his response. That is over and various appeals were made subsequent to the two appeals that failed. What I am asking is what we have learned. What mechanisms have been put in place to improve the appeals system so that similar situations do not arise again? I am really disappointed that this type of information is not before us this morning. From day one, when I agreed to the original legislation, I did so in the knowledge that what I was agreeing to was draconian and represented the most severe encroachment on basic human rights. I did so because of a threat but almost two years down the road, I expect a completely different approach to legislation from the Government that is based on proportionality and analysis.

Every time that I stand up in this House, whether it is for 20 minutes or two minutes, I am conscious of Galway and I always use it as an example. In Connemara I know two people, well into their seventies, who cannot get home care. Why is that? It is because there is no home care available from the private company upon which the HSE relies to provide such care. There are also issues with the pandemic. I understand those practical issues but what I do not understand is the failure of the Minister to come proactively before the Dáil to explain the situation on the ground; to explain that we have not opened our respite and day centres, that we have huge difficulties with providing home care and to provide an analysis of that. I have my own views on it. I foresaw this happening because I sat on a health forum for ten years of my life, every two months and rarely missed a meeting. I saw the dismantling of our health system and the privatisation and commodification of it on every level. Sometimes I am utterly filled with frustration when I listen to the level of the debate from all sides in relation to the health system when it was the absolute policy of various Governments, but particularly by Fianna Fáil and the Progressive Democrats, to privatise the health service and break it down. As I have said previously, back in 2006 language such as "the beds are being refurbished" was used. I had heard of houses being refurbished, but never beds. A new language started to creep in.

Back to the present day and the topic we are discussing this morning. I make my comments in the context of a crisis being used to further encroach on human rights without any analysis and the easy acceptance of this by a lot of Deputies. The latest crisis or threat comes from omicron. I am sure the Minister will not take this very well but that is actually an anagram of moronic. I nearly forgot the word anagram in my tiredness because it was 2 a.m. when I got to bed. I looked up the word moronic. I do not want to insult anybody but it means idiotic or stupid and to me, that is what has characterised the Government's approach generally, not just the approach of the Minister for Health, to the Covid pandemic crisis over the last two years. We had a situation a few weeks ago where we were talking about nightclubs. We saw images of young people and older people on the streets with no social distancing. Our time was consumed with debating whether nightclubs should open and whether people should wear masks inside when at the same time, day centres and respite centres were not open and people were at home without care. There was no analysis of that. Instead, the Government's time was taken up with whether people could go into nightclubs. There has been no analysis in relation to ventilation although many Deputies, including Deputy Shortall this morning, have raised it repeatedly. The message is always to wash our hands, which we all do to the point of damage at this stage because it is the right thing to do but there is absolutely no mention of ventilation in any of the announcements.

This legislation was published on Tuesday. I got to look at it today and while I was sitting in the Chair on occasion. It will be guillotined later and passed through even though there is no emergency today. The Oireachtas Library and Research Service managed to produce, under pressure, a briefing paper. Once again, for the umpteenth time, I want to thank them for their work. The service clarified that it was not publishing a Bill digest because of the timeframe between the Bill's publication on 1 December and the Second Stage debate on 2 December. The Minister is introducing this legislation so that he will be able to act in the future but he has not given the House time to analyse, reflect or discuss. There are one or two good points in the Bill which I welcome. I welcome that there will be a ministerial mechanism available to allow a person to leave mandatory hotel quarantine. I also welcome the pre-application process and the clarifying of same. What I do not welcome is the fact that the Minister will have more power and will be able to decide what is right and designate same in writing, without any discussion in the Dáil. Forgive me for flicking through papers but that is reflective of the way we have been led into this debate. The Minister will be able to designate in writing and make certain orders under this Act. In the past, regulations have been published way after the event. Deputies have been left with no information, with staff scrambling to try to understand the regulations and we are doing that all over again. I see no provision for hardship cases in this. This is a very costly business but I see nothing in the Bill about hardship cases, even though this has been raised many times.

The constant confusion and obfuscation in relation to PCR and antigen testing is simply unacceptable. Reference is made to three days for a PCR test and two days for an antigen test. I heard the interview, mentioned by others, with an assistant professor from UCD, a virologist, who had huge difficulty understanding the science behind this. We are told all of the time to respect the scientific advice but this man, this academic said that he had great difficulty understanding it. Each and every one of us must try to read, listen and come to our own conclusions and make our own decisions, as best we can, in the knowledge that we must protect ourselves and each other. Instead of that type of debate, what we have is a demonisation of people who, for many reasons - they are not a homogenous group - have decided not to be vaccinated. We have unacceptably gone down the road of "them and us" or "us and them". Now we are looking at children, with an announcement that they must wear masks. Whether that is right or wrong, I have the greatest difficulty with it. I am delighted, although delight may not be the best word, that my sons are older and I do not have to make those decisions for them. The flippant way that we are referring to this, that it will do them no harm, is simply appalling. It is unacceptable to me. It is so wrong that these decisions are being made in this manner.

Tiredness has got to me, actually, from last night. I only use that as an example. I would say tiredness has got to all the Deputies given what has been done with the Clár Oibre for the Dáil, the number of items put in and the late sittings and the early sitting this morning. It is difficult to deal with this. However, I want to use my voice to say I am unhappy with the continued encroachment on our human rights without any analysis or the Government framing the debate within that and an acknowledgement that, when we do so, it must be temporary, proportionate and, when it is discriminatory, it must be based on fact, targeted and for a short time.

I refer to the latest variant. The word is moronic. We have punished South Africa for being good and for analysing the virus and sharing that knowledge with us rather than embracing them. We now know that virus is in Ireland and other countries, not necessarily from South Africa or any country at all. To say we have gone down the demonisation route might be too strong but certainly it is a punishment route in our approach to dealing with Covid. For all those reasons, I will not be supporting this legislation.

Minister for Health (Deputy Stephen Donnelly)

I thank Deputies for their contributions to this morning's very productive debate. I acknowledge the very broad support across the House for the Bill while acknowledging there are Deputies who will not be supporting it for the reasons they have outlined. It was always going to be the case that any extension to legislation providing for mandatory quarantine or its reintroduction would only be proposed on the basis of strong public health rationale. The Bill before us permits the reintroduction of hotel quarantine. A decision on whether to proceed with making hotel quarantine operational will be taken in line with public health needs, but I strongly believe that having the system ready to go if we need it is the right decision now, based on the level of uncertainty and how quickly things are moving. Given the emergence of the new variant of concern, Omicron, however we say it, and its impact on vaccine effectiveness, we need to be able to reduce its transmission so that we can safeguard the community. There are a large number of measures in place domestically around transmission reduction. They have been pointed at the Delta wave but they are also there for any additional variants. The measure we are discussing relates to the importation of cases.

It is also very important the House reflects the values and standards we have set for ourselves in constitutional and EU law. The Bill was drafted in close co-operation with the Attorney General in such a way to ensure the necessary measures it may introduce are justified on the basis of evidence, that they are proportional to the dangers posed, that they are targeted towards those specific dangers, and that they are limited both in scope and time. All those requirements and safeguards are very important.

Earlier, Deputy Duncan Smith raised the process of designation of states. As before, it will be a dynamic process in response to epidemiological changes around the world. Ultimately decisions by the Minister for Health on the designation of states are taken in line with and with the support of very robust evidence, as per the Bill. States are also removed from the list where the evidence supports that. We saw that previously.

In parallel with the legislative process, cross-governmental work is ongoing to put in place the practical measures necessary for the implementation of the measures that are set out in the Bill. Obviously, a significant amount of operational work is required, including ongoing work on the procurement of services for accommodation, food, medical and transport services and to put in place the procedures, protocols and protections necessary to ensure the smooth and safe operation of the system.

There are other issues. I am sorry I do not have much time but there is considerable time on Committee Stage later which will give us the opportunity to address some of these matters-----

Deputy David Cullinane

What about testing arrangements?

Deputy Stephen Donnelly

-----but in the short time I have I will try to address some of the issues. One that Deputy Cullinane raised, which I think he is mentioning now, is incoming testing protocols. I do not think that is related to this Bill but to regulations coming in for broader testing. The short answer is the PCR test applies for those who are unvaccinated. The antigen test for 48 hours applies to those who are vaccinated and-or recovered. That covers the issue. If you are unvaccinated but you have confirmed Covid in, say, the past two or three months, you will have a Covid certificate because of that and then, as with someone who is vaccinated, you just use the antigen test. The public health advice I have is that is the pathway that works internationally.

There was a question of whether we could have exemptions for people who have already left the State, for example, who have travelled to a listed country when, say, quarantine comes in. These things can be examined. Last time, it was felt that would not be appropriate as their presence meant they had incurred the risk we were trying to manage.

I am out of time but I have taken note of the questions which, no doubt, will be raised again on Committee Stage, when we can give it all the time we can to address them.

Question put and declared carried.

Sitting suspended at 10.47 a.m. and resumed at 12 noon.