Nithe i dtosach suíonna - Commencement Matters

Water Services

Cuirim fáilte roimh an Aire Stáit go dtí an Teach inniu. I welcome the Minister of State to the House and thank him for taking time out of his busy schedule to be here. I wish to discuss Irish Water and the service level agreement with local authority staff. I am not, and never was, a fan of Irish Water in the first instance. I fail to see the purpose of setting up another layer of bureaucracy - some would refer to it as a quango - which currently has 800 staff on its books. Local authorities continue to provide an excellent service to the people of this country in terms of water services.

Local authorities have a service level agreement with Irish Water in that the latter has tasked local authorities with providing water services to the people of this country. They are doing an excellent job. Irish Water has what it calls a balanced scorecard for each local authority, which rates each one on key performance indicators. In layman's language, it rates the service provided by local authority water services staff to the general public. I am delighted, but not surprised, to note that each local authority is performing excellently, as I am sure the Minister of State is aware. The percentage levels of performance are in the high 90s consistently year on year. In Monaghan and Cavan the levels are consistently above 90% and I thank local authority water services staff for the excellent job they do. Given such high levels of service, the question arises as to why we are taking the service away from the water services sections of local authorities and not keeping it where it is. Perhaps that is a question to which the Minister of State might relate.

Public ownership of Irish Water is the clear will of the Irish people. People want control of this utility into the future. There is a commitment in the programme for Government that Irish Water will remain in public ownership, but many are calling for a referendum to be put to the people in order that this can be enshrined in the Constitution for eternity. I support that call. Has the Government committed to holding a referendum? If so, does it have a date in mind?

Another issue I would like to raise is the fact that many local authority staff are quite happy to stay where they are. The 3,500 workers who are providing an excellent service want to stay with their local authority, and I fully agree with and support them in that notion. I understand talks are ongoing between the Government, Irish Water, local authorities and trade unions. We do not want local authority staff, who are doing an excellent job, to be forced down a road they do not want to go.

It is important that we take their concerns on board.

I respectfully appeal to the Minister of State to answer the two questions I have posed. I would like to think that local authority staff, who provide an excellent service, will be looked after and that their wishes will be respected.

Gabhaim buíochas leis an Seanadóir as an gceist seo a ardú. The Government published a policy paper, Irish Water - Towards a National Publicly-Owned Regulated Water Services Utility, in February which sets out its views and expectations on the next phase of transformation in the water sector. This will involve the integration of the public water system within the organisational structure of Irish Water. This will complete the broad policy and legislative reforms that have seen public water services embark on a journey of transformation from a structure based on locally organised water services authorities towards a single, national water utility in public ownership. In setting out its views and expectations on the next phase of the water sector transformation programme in this way, the Government is enabling stakeholders to engage in a meaningful change process that will give them the strongest possible say in determining their future working arrangements.

Significant issues relating to the workforce remain to be addressed in the context of integrating the day-to-day operation and delivery of water services within Irish Water. To resolve these issues, my colleague, the Minister for Housing, Local Government and Heritage, Deputy Darragh O'Brien, has tasked the Workplace Relations Commission to recommence engagement on water sector transformation with all parties aimed at reaching a collective agreement on a framework for the future delivery of water services. This engagement is currently under way, although the inability to hold face-to-face discussions due to the Covid-19 restrictions has hampered the process. I imagine the Senator will appreciate that is a challenge and it is important that these discussions can take place face to face as that is the best way forward. I understand, however, that the discussions will take place in the coming weeks in line with the current relaxation of restrictions.

Change is difficult for any workforce and I am fully aware that many in local government services do not necessarily wish to see changes to the current arrangements, as the Senator has outlined. However, the fact that the Government has decided that Irish Water is to become a fully integrated direct labour national public utility means the status quo is not an option. Continued uncertainty about the future does a disservice to everyone currently employed in water services within local authorities. It is important , therefore, that the parties to the transformation process engage intensively in the coming weeks at the Workplace Relations Commission to agree an outcome that will deliver for all parties and for the greater good. The Government believes it will be possible to reach a collective agreement that addresses the interests and concerns of all parties.

Senator Gallagher raised a second matter. It is certainly is the case that there is a commitment in the programme for Government to refer the issue of the environment, including water and its place in the Constitution, to the relevant joint committee for consideration, namely, the Joint Committee on Housing, Local Government and Heritage. My role includes responsibility for electoral reform. We have a schedule of proposed referenda throughout the lifetime of this Government. It is not my intention, and I do I believe it would be appropriate, to hold a number of referenda on the same day. I believe it is important that we hold a stand-alone referendum on this issue as to do otherwise would dilute the message - excuse the pun - and dilute what we are trying to achieve with this referendum. In any event, , I am keen to give the assurance that this referendum is significant and important in assuring the people on the issue of ownership of water infrastructure in public hands for the common good. It is important to emphasise that. The policy paper on water transformation agreed by Government further commits the Department of Housing, Local Government and Heritage to consult with the Irish Congress of Trade Unions' local authority group of unions in respect of the proposed referendum. I hope that offers some assurance to the Senator on the questions posed and to the utility workers currently within local government around the transformation process.

The process is in place for the common good of all. We hope it will lead to a robust and transformative process around regulation and the provision of critical water infrastructure for the country for nature, for biodiversity and for communities.

My thanks to the Minister of State for his comprehensive reply. As he outlined, the uncertainty for local authority staff and water services staff is disappointing. They find themselves in a stressful situation.

I welcome the commitment of the Minister of State to hold a referendum and I look forward to an early date for that. The old adage holds that if it is not broken, we should not fix it. That springs to mind in the context of water services provided by local authorities. Having said that, as long as the views of staff are respected and as long as they are happy - ultimately, with the terms and conditions put in front of them - then I fully support them. The service they have provided to the public, to me as a public representative and to many others has been top class and I am keen to acknowledge the excellent service we get from them. I hope that will be respected by decision makers when a final call is made.

I wish to reassure the Senator on the matter. I wholeheartedly concur with his comments in respect of water services staff and local authorities. They provide an exceptional level of service to communities. They are constantly on call winter and summer, as well as during emergencies throughout the year. We must and do give due regard to that wonderful level of service. We want to achieve a transition towards Irish Water with which they will be happy and such that they will be satisfied that they are being taken care of.

The issue of the referendum is critical as well. I want to give an assurance that the process with the Workplace Relations Commission is inclusive. We want to ensure that all parties are brought on board to create the transformation that we all require for the country to move forward.

Community Employment Schemes

I have no wish for us to be in a situation where we have to wait until we have full employment again before women returners become a major priority for the Government. Many women did the State a service by caring for their families and loved ones. Often they did so because the supports that would have enabled choice simply were not there. I know this because I did it myself. Workplace inflexibility, a lack of accessible and affordable childcare and the unpaid nature of care continue to be key factors. We have a real issue because of women dropping out of the workforce to undertake care duties, but we have a similar problem in getting them back to work even when their children are older and even though these women are more likely to have third level qualifications. The participation rate of women is 63.7%. That is not too far behind the EU average of 64.2% but it falls far below competitive economies like Germany, which has a rate of over 72% and a figure of more than 10% between men and women participation rates.

Covid-19 has set us back again and we have been disproportionately affected. We are more likely to work in jobs where workers are more vulnerable to getting Covid. We are more likely to work in jobs where staff are vulnerable to losing employment because of Covid. Women are more likely to own businesses that have been impacted upon and are more likely to have taken leave or to have worked longer hours in trying to juggle work, home schooling and care duties. Women who spent more time in unpaid or domestic duties prior to Covid became the brunt bearers during the Covid lockdown.

The roles played by the Department of Enterprise, Trade and Employment and the Department of Social Protection have been phenomenal in getting people through the crisis with access to the pandemic unemployment payment, wage subsidies and grant schemes.

As we emerge from the crisis of Covid into addressing the long-term effects of Covid on labour participation rates, are we going to do enough to address the female labour participation gap? This is relevant not only for those who lost their jobs because of Covid or those still vulnerable to losing their jobs if the recession sticks, but for those who previously took career breaks and may now be further down the pecking order when it comes to labour activation policies.

I welcome the Minister of State commenting on the matter today. I know that work is ongoing with Springboard opportunities. Over 10,000 places are available on nearly 300 courses for unemployed, self-employed or returners to work. ICT graduate conversion courses are on offer for upskilling and reskilling in important new areas like cybersecurity and climate sustainability. In 2019, the then Minister for Employment Affairs and Social Protection, Senator Doherty, announced a new returnship programme. In the programme for Government, it is acknowledged that there is a commitment to returnships through new education, training and personal development programmes. This is especially important to the Department of Further and Higher Education, Research, Innovation and Science as part of the Her STEM skills programme. Yet, there seem to be disadvantages for women who have not worked for more than two years and who were not claiming social welfare during that period.

They cannot access community schemes that might suit them. A woman from Donegal got in touch with me to say that she has experienced this herself. She completed a two-year FETAC level 5 course in childcare in 2019 and got a distinction in all the modules except one, in which she got a merit. It was a massive achievement for her, having been out of work looking after her own kids. There were many opportunities to apply for part-time roles that would have been ideal for her but she could not because she was not eligible for any schemes. The Minister of State might have some advice for her. People in my community and in organisations that benefit from community schemes want access to women like her and she wants access to them as well. The hours suit, the locations suit and the situation suits. I ask the Minister of State for an update on how this will factor into the Pathways to Work 2021-2025 strategy.

Gabhaim buíochas leis an Seanadóir. I am taking this question on behalf of the Minister for Social Protection. The Department of Social Protection, through its Intreo service, provides a range of employment supports to assist individuals, including women returning to work, to gain and sustain employment. Intreo's teams of case officers and job coaches across the country provide a one-to-one career advice service and tailored employment supports for all jobseekers, including those who wish to return to work. These supports include the community employment scheme, which aims to provide work experience and targeted training interventions for long-term unemployed people within their communities. The programme is designed to help break the cycle of unemployment and improve a person's chances of returning to the labour market.

Community employment is open to women who want to return to work after a break, provided they meet the standard eligibility criteria. In order to qualify, a number of conditions must be met, including being in receipt of a qualifying social welfare payment for a specific period. In addition to the supports currently provided by Intreo, the Government is supporting a range of further initiatives and measures to assist people in their journey back to employment under the economic recovery plan and the forthcoming Pathways to Work 2021-2025 strategy. As set out under the Government's economic recovery plan, which was launched on 1 June 2021, a central focus of the recovery process will be supporting people back into employment, with an overall ambition of exceeding pre-crisis employment levels by reaching 2.5 million people in work by the end of 2024. It is important, as the Senator outlined, that people have quality employment and pay equality.

Central to achieving this ambition will be the forthcoming national employment services strategy, Pathways to Work 2021-2025. By increasing labour market supports and providing employment support, activation and skill opportunities, the Pathways to Work strategy will act as a key delivery mechanism of the economic recovery plan's second pillar, Helping People Back into Work. Pathways to Work will outline how the public employment service will work with people through its existing and expanded capacity to deliver job support services in a post-Covid labour market. Measures under this new strategy will include provision of an additional 50,000 education and training places and a new work placement experience programme. This new programme will be open to all jobseekers, including women who have been out of work for at least six months. That might offer some support in respect of the case the Senator outlined.

As part of its work for those seeking to return to the workforce, Intreo hosted the first Career Pathways for Returners event in Trinity College Dublin in March 2020. The event provided jobseekers with information on work placements and opportunities to upskill or retrain and offered them the opportunity to take the next step in their careers. The event including testimonials from people who had re-launched their careers and the supports that assisted them on their journey. Attendees also had an opportunity to meet and speak with employers, some of whom had dedicated returner initiatives. The Department of Social Protection plans to build on these kinds of initiatives under the new Pathways to Work strategy, which the Minister for Social Protection hopes to launch alongside the new work placement experience programme later this month. These are worthwhile initiatives.

Post Covid, many people, and many women in particular, are thinking about going in a whole new direction in their lives and careers and we want to provide the opportunities for them to do that. The gender pay gap Bill that was introduced by the Minister for Children, Equality, Disability, Integration and Youth is another supporting mechanism, as is the work being done around community development by the Minister of State, Deputy Joe O'Brien. Community development pilot projects could provide an opportunity for women who have a valuable set of skills to offer a community to find work.

I thank the Minister of State for that positive response. It is good to know that returners are firmly on the agenda. It is very difficult when people are facing going back to work, and if the odds are stacked against them or if there are unnecessary barriers it just makes it harder. We are definitely moving in the right direction. As part of this, we have to ensure that the Pathways to Work strategy covers the spectrum of situations and scenarios, as well as the skills and experience people want. What appeals at the moment about access to community schemes is that they are in people's communities. People could work in the community centre where the crèche is, for example, which would feel familiar to them. We have to put ourselves in those people's shoes and think about what it is like to return to work. We must deliver opportunities for everyone.

I agree wholeheartedly with the Senator. I know from experience that many women who started off in community employment schemes in family resource centres, FRCs, or community development projects, were able to move on through additional training or returning to education to fantastic careers and could offer something valuable back to their communities. It is vitally important that we offer those supports through the Pathways to Work strategy, for women in particular, to ensure they have a viable path forward.

The childcare issue is also critical and the Minister, Deputy O'Gorman, is keen to ensure there is a set of reforms in place to support the childcare sector to provide a wide range of services for women who wish to return to full-time or part-time employment. They might have a flexible arrangement in order to balance their work and life in a way that manages their families and provides the opportunity to give back to their communities, as they wish to do. The Senator made her point extremely well and I hope these combined initiatives will provide that level of support.

As a mother who had to leave the workforce because of the lack of childcare I look forward to more being done in getting women back into the labour market.

Covid-19 Pandemic Supports

I thank the Minister of State, Deputy Rabbitte, for coming before Seanad Éireann this morning. As we are all aware, the hospitality sector has been hammered since March 2020. Having worked in the sector for over 20 years, I retain many close friends and colleagues within the sector. Many have contacted me since the Government's decision not to allow reopening on 5 July and most said that this was the lowest point of the pandemic for them so far. I am not sure whether those who do not have the experience of the hospitality sector appreciate how important the summer season is for it. That period allows these businesses to survive the dark and wet nights of winter when very few people venture out. Many hospitality businesses take in as much turnover in a week in July as they would for most or all of November.

Yesterday, thankfully, we reached a level of over 50% of adults being fully vaccinated, including all those in the most at-risk categories. It is simply unacceptable that indoor hospitality remains closed under these conditions. I looked through the membership of NPHET yesterday and while these are obviously capable and qualified people, I did not see one name with economic expertise. I did not see one person who ever ran his or her own business and understood the stresses involved. The members of NPHET are entirely focused on managing this pandemic as best they can, which is their job, but at this point we need a much broader view. We need to recognise the impact recommendations are having on thousands of businesses. Many small family-run enterprises across this country have been denied the ability to earn a living for the past 15 months, as have some 150,000 staff in restaurants, bars and the hospitality sector in general. The situation cannot remain as is.

Frankly, to extend it any longer into August, whereby Irish indoor hospitality businesses will be the only such businesses in Europe that are unable to operate, would be ridiculous. I noted the NPHET letter referred to high case numbers potentially having an impact on children returning to schools in person. I interpret that as a suggestion that indoor hospitality may be closed until September. It is crazy. It is not clear why we cannot use antigen testing across the sector. It could be used for a concert in Dublin last weekend, but we cannot use it for indoor hospitality despite six countries across Europe using it for that purpose. Ultimately, NPHET advises, but the Government must decide. The Government must take action and resolve this within the next two weeks.

I acknowledge that the Government has implemented unprecedented supports, which have been excellent, and I talk to business people every day across Galway city and county. The supports include the wage subsidy scheme and the Covid restrictions support scheme, CRSS, which the Taoiseach announced last week will double this week and next week for businesses that are still closed. However, it is clear now that these businesses have missed their peak periods of the year and will require additional supports both in the short and longer term. The stimulus for the hospitality sector which the Government has promised to implement will need to have a significant focus on the businesses across this sector.

I thank Senator Crowe for tabling this Commencement matter. I am responding on behalf of the Minister of State at the Department of Enterprise, Trade and Employment, Deputy Troy. However, I wish to make a few points before I give the Senator the Minister of State's response.

Last week was not just a low point for people in the business, it was a low point for the country. Everybody was looking forward to the reopening taking place on 5 July. I am also aware that one week in July is equivalent to November, as the Senator correctly stated. However, there are positives. One of them is the current position of 50% of adults being vaccinated. The Senator is right that the situation cannot remain as it is. I acknowledge the work the Minister for Health, Deputy Stephen Donnelly, and his team are doing and the Minister's agile approach. Last Friday, the twin-track approach was announced for the vaccination programme. Not only will there be an age approach, but there will also be a bottom-up approach that includes the youth. The youth have been held back for far too long, so this is absolutely welcome. It is a multifaceted approach within all Departments, including the Department of Tourism, Culture, Arts, Gaeltacht, Sport and Media, the Department of Enterprise, Trade and Employment and the Department of Health.

The Tánaiste and Minister for Enterprise, Trade and Employment, Deputy Varadkar, the Minister for Tourism, Culture, Arts, Gaeltacht, Sport and Media, Deputy Catherine Martin, the Minister for Health, Deputy Stephen Donnelly, and the Minister of State at the Department of Public Expenditure and Reform, Deputy Ossian Smyth, met with the hospitality sector last week to discuss the issue of indoor hospitality. Since then, officials from Department of Enterprise, Trade and Employment, the Department of Tourism, Culture, Arts, Gaeltacht, Sport and Media and the Department of the Taoiseach have set up a working group and met with the sector again to discuss a way forward.

In addition, the Department of Enterprise, Trade and Employment's small business assistance scheme for Covid, SBASC, provided €908,000 to 227 businesses in the food and accommodation sector in phase 1 and 25 grant applications, for a total value of €93,000, have been received in phase 2. The closing date for phase 2 is 21 July. This is a scheme that many businesses do not realise is available. It is available through their county councils. It is a fantastic scheme if one is unable to avail of the CRSS. The Government wants to find practical, workable solutions to enable hospitality to reopen and stay open throughout future waves of this pandemic.

I hope I have addressed some of Senator Crowe's questions.

I thank the Minister of State, Deputy Rabbitte, for her detailed and excellent response. I wish to make a few points, and the Minister of State will know where I am coming from with regard to the frustration. The notion of the hospitality sector having to police who is coming into a premises to ensure that only vaccinated people do so is just not going to work. I do not see it working, to be honest. I understand that representative bodies such as the Vintners' Federation of Ireland, VFI, the Licensed Vintners Association, LVA, and the Restaurants Association of Ireland, RAI, which the Minister of State will be very familiar with and with Mr. Adrian Cummins working day and night, are working with the Government on this. That is what has to be done to reopen indoor hospitality. Naturally, we all welcome that. I acknowledge that the Government has put unprecedented supports in place, but they must continue and more will probably be needed if the sector will not be able to reopen. Otherwise, jobs will be lost in the long run and the sector will not survive the crisis. I appreciate that the hospitality sector stimulus is likely to be some time down the line and probably for next year, but a portion of that must be earmarked in some way for bars and restaurants which only provide indoor hospitality and which have been shut for the past 15 months.

I again thank the Senator for giving me the opportunity to respond. The Senator is right. The working groups of the VFI and the RAI, under Mr. Adrian Cummins, have been working tirelessly since the start of the pandemic. At all times they have approached it in a very measured format of what is right for their industry, the employers and the associated employees. There is a great deal of stress attached to this at present. There is no doubt about that. The Senator and I are from Galway and we know that the businesses are under incredible pressure. Basically, people want to get back to work. They want to get back in to meet their customers and so forth. However, the most important thing that arose from the Senator's Commencement matter this morning is that this new working group on finding a way forward for indoor dining and which includes the Department of Enterprise, Trade and Employment, the Department of Tourism, Culture, Arts, Gaeltacht, Sport and Media, the Department of the Taoiseach and the industry is very welcome at this time. There is a real commitment in the Government to finding a workable, sustainable solution so there will not be stops and starts and we can take it into the future.

Finally, it is important to point out that there will be no cliff edge financially for the supports for these businesses. That is the one thing the Minister of State, Deputy Troy, asked me to articulate this morning. There will be no cliff edge for businesses.

Health Service Executive

I wish to raise the issue of what are called patient private property, PPP, accounts. These accounts are administered under section 2 of the Health (Repayment Scheme) Act 2006. Essentially, they are accounts that are administered by the HSE on behalf of vulnerable people who are in long-term residential care facilities run by the HSE or on its behalf. In the main, it applies to elderly people, people with mental health issues or intellectual disabilities and to wards of court. These accounts in the central unit of the HSE hold the property of these persons. That property can be administered and used by representatives of the HSE directly or by a third party or agent of the HSE for the benefit and care of the person involved. Guidelines are in place to ensure this is done ethically and in a transparent fashion in the best interests of the vulnerable person. I understand there are approximately 15,000 such accounts being administered by the HSE at present.

If the Minister of State could confirm the overall number, that would be helpful.

There is a problem with how these accounts operate. Under section 2 of the Act, a patient's private property account is defined as meaning "so much of the money and personal property ... that is managed, on behalf of the person, by the Executive or by another person under an arrangement with the Executive". It refers to the property of a person in various categories, including "a person otherwise being cared for by, or on behalf of, the Executive due to a physical or mental disability or ill-health". In other words, the facility whereby money is held centrally by the HSE and then accessible in appropriate ways to pay for services only applies to people being cared for in the public system. It does not apply to people being cared for in private nursing homes regardless of how vulnerable they might be. For example, a person may be going into care who has, God forbid, an alcoholic son or daughter. It might not be possible for that person to manage money or a bank card and nor might it be desirable for it to be managed by a family member. That person might wish to have access to the facility of a patient's private property account provided to people in the public service.

I received representations on this matter from people who are familiar with the sector and work in the area of the rights of elderly and vulnerable people. They indicated they believe this puts patients in private homes at a disadvantage. They believe the accounts and property of such people should be capable of being administered and applied, on their behalf and for their welfare, where appropriate circumstances exist similar to those of a person being cared for in the public system, the only difference being that the latter is being cared for in the public system.

It would be helpful if the Minister of State could indicate to the House the number of these accounts currently in place under section 2 of the Act. I believe this developed in the context of the repayment of charges wrongly levied on people originally but it has evolved since then. Payments to people who were in institutional settings was the context for setting up this system but it has since evolved in the way I described. People who are familiar with the sector believe elderly and vulnerable people in private homes are at a disadvantage. It would be helpful to know how many such accounts exist, whether they are operating in a satisfactory manner and what safeguards are in place.

I thank Senator Mullen for raising this topic. I am taking this Commencement matter on behalf of the Minister for Health, Deputy Donnelly, but I am also acutely interested in the nature of the question the Senator raised.

On foot of the challenges experienced due to the recent cyberattack, which required a temporary shut-down of the HSE IT system, the HSE is currently unable to access some of the information such as the relevant data from its patients’ private property accounts system, which my Department mighty usually obtain from the HSE for inclusion in a Commencement matter debate response to provide context. The disruption of the service is ongoing. The HSE is working hard to restore its IT capacity and resume normal services.

However, I am pleased to acknowledge the legal basis for patients' private property accounts is set out in the Health (Repayments Scheme) Act 2006. The scope of these provisions relate to the HSE’s duties and responsibilities to offer appropriate safeguards regarding the finances and private property of patients in the care of the HSE and of the service providers which act on behalf of the HSE. This system provides approximately 6,000 patients and residents with an option to avail of what is, essentially, a free banking service operated by the HSE on the basis of strong published guidelines which safeguard patients’ money and private property while in our care. The Senator asked how many accounts there are and he will note there are 6,000.

The question of whether the same or similar provisions could be put in place for patients in private healthcare facilities and, if so, how that might be resourced and the appropriate role, if any, of the public healthcare system, has not to date been reviewed in any detail. However, as the Senator may be aware, my Department is currently at a fairly advanced stage in the development of the national policy on adult safeguarding in the health sector. I have asked the relevant team of officials leading that work to consider whether there may be merit in exploring the expansion of the existing patients' public property legislation or the introduction of any new provisions to offer similar safeguards to private patients and residents who might wish to avail of such a service.

It is also important to bring to the Senator’s attention the decision support service. I secured funding in last year's budget for that service. Hopefully, the decision support service will be in operation by June of next year. Advocates or the persons concerned would have different levels of needing support to be able to make decisions and they would be supported in making those decisions. That service will be open to all, whether in a public or private capacity. Hopefully, that will also provide support to people in private facilities.

I thank the Minister of State for her reply. We have seen from attempts to deal with the Covid crisis, particularly in the context of nursing homes, that it really makes no difference whether people are being cared for in the HSE sector or in the private sector when it comes to certain responsibilities the State has to keep people safe. People who go into private nursing homes often do so under the fair deal scheme, which is a system set up to enable them to access their rights as citizens.

In matters related to healthcare and their financial welfare, there must be a view that all should be entitled to the same level of protection. I have said this matter could be remedied by a very small change to the 2006 Act. We live at a time when bank branches, building societies and post offices are continuing to close and are moving their services online, following a decade in which there has been significant consolidation in the number of credit unions. Older people cannot have the types of personal relationships with the staff of financial institutions as they had in the past and they have far fewer ways to manage their money. This facility could improve the situation by addressing the needs of vulnerable people and ensuring they to are protected to some degree at least, but hopefully to a large degree, from any kind of exploitation or financial misfortune.

I thank the Senator for raising this matter in the Seanad, for his comments and for drawing attention to the HSE’s important and valuable patients’ private property accounts service, which provides a high standard of security for the finances of those in our care who would not otherwise be able to manage that themselves.

I acknowledge the Senator's reference to the reduction in the number of post offices bank branches, with the Bank of Ireland recently closing a number of its branches. Older persons do not have that same access to those institutions or the familiarity they may have had with staff working in local branches. Regardless of whether people are in the public or private system, we need to be able to support and protect them from financial abuse.

Safeguarding the finances of the people in our care is a very important matter for the Government, my Department and the HSE. That is why this system was established under the Health (Repayments Scheme) Act 2006. As previously mentioned, the question of whether the same or similar provisions could be put in place for patients of private health facilities has not been reviewed to date. It is a welcome and timely opportunity to have that discussion now and to examine the merit attached to it.

Considerations of any such reforms would have to include an examination of resourcing implications and the appropriate role, if any, of the public healthcare system. The Senator referred to the fair deal scheme and we support patients in that respect. We already support people in accessing healthcare and we should adopt a holistic approach to supporting a person.

An opportunity to consider the potential merits of broadening the application of this important service or developing a similar service for non-public patients may arise in the context of the Department's ongoing development of a national policy of adult safeguarding in the health sector. I have therefore asked the relevant team of officials to consider whether there would be merit in exploring the extension of the existing patients' private property account legislation or the introduction of any new provisions of similar safeguards to private patients and residents who might wish to avail of such a service. It would not apply to only to persons in nursing homes but to persons accessing services under mental health services, people in group homes or persons with intellectual disabilities in houses. I welcome the Senator’s question and look forward to working with the Minister on it.

Covid-19 Pandemic

I tabled this Commencement matter to bring a degree of proportionality and transparency to the debate on the true impact of the pandemic on the hospitality sector.

I believe that information is sorely missing.

I thank Senator Crowe for his intervention today. Every time, the industry's hopes are raised and then dashed. This has happened six times. The impact cuts deeper each time this happens. I am not just referring to the financial impact. At Christmas, our industry was blamed for the serious outbreak of the Oxford variant. Everyone in this Chamber and everybody in the public domain knows that they probably were more at risk of getting the disease if they were in a public space like a shopping centre that was packed before Christmas. Let us not forget the number of household parties that were being held before Christmas and the number of families that gathered for Christmas dinner in a small close environment. Yet the only thing in the media was "why did you open the hospitality sector?" It was not just the hospitality sector that was open before Christmas. As all retail and personal services opened, proportionality and transparency need to be brought to the debate. Seven months on, when our industry, that is, the restaurants and the pubs, were about to open again, the only thing in the media leading up to it was whether the Government would open indoor hospitality because of the arrival of the Delta variant. Then NPHET produced its modelling and referred to a narrow opening of indoor social activities or a wider opening of indoor social activities. To the public, that means indoor dining. One then adds the other variable. The question of whether someone is vaccinated refers to indoor dining. In respect of the doomsday scenario given to Government by NPHET, hospitality will not lead to 680,000 cases of Covid and will not lead to 2,127 deaths over the three months, as projected by NPHET. How society as a whole reacts in every sector, both in the workplace and in public, will lead to that. Perhaps the Government's message should be around how if we continue the way we are going, it will not be just hospitality that closes down. The whole country will be shut down. Perhaps if the Government gave out that message and showed the true transparency behind these figures, people might behave better and might stop being so relaxed, as we all have become in the current environment.

I know the Cabinet cannot answer my question. What percentage of the figures presented in the modelling by NPHET relate directly to hospitality and indoor dining because they do not exist? These are modelling figures. The Government and NPHET framed the debate around indoor hospitality and how, again, we are the sector that has brought this pandemic and will be the ones that will cause the exponential surge in cases, which is factually incorrect. I ask the Government and NPHET to be a bit more conscious of our industry and when they present figures, to present them in a transparent and factual manner and not lay the blame totally on our sector.

I thank Senator Casey for raising this Commencement matter, which I am taking on behalf of the Minister for Health. I will clarify how the data presented by NPHET and communicated by Government relate directly to indoor dining and specifically in each of the five scenarios presented in table 1.

I welcome the opportunity to address the House and will begin by highlighting the significant and sustained progress that has been made in suppressing the virus over recent months due in no small part to the significant efforts of people across the country. This progress has been sustained during the recent reopening in April, May and June. Our vaccination programme continues to make significant progress. However, the increase in cases of the more transmissible Delta variant poses a significant threat to the progress made. Modelling shows that had we proceeded with the proposed relaxation of the public health restrictions from 5 July 2021, over the period to the end of September, under the most optimistic scenario, we could see 250 deaths, more than 1,500 hospitalisations and nearly 200 ICU admissions. Under the most pessimistic scenario, these modelling figures ranged to over 2,000 deaths, over 1,500 ICU admissions and nearly 13,000 hospital admissions. Even the central scenarios modelled would result in significant mortality and pressure on our hospital system that we simply cannot contemplate.

The models work by examining the levels of viral transmission that occurred in summer 2020 and inferring from that, having factored in the protective effect of vaccination but also the increased transmissibility of the Delta variant and the likely level of viral transmission had we proceeded with the proposed relaxation of public health restrictions from 5 July 2021, including the full resumption of indoor hospitality. The phase 3 reopening of 29 June 2020, which included the reopening of the cafes, restaurants, pubs and hotel bars serving food and holiday parks, was associated with a step change in viral transmission, which was sustained through July and August with effective reproduction numbers increasing from below 1.0 to somewhere between 1.4 and 1.6. The models assume that the reopening of indoor hospitality would lead to at least similar levels of close indoor social mixing, which is an opportunity for viral transmission. This is a reasonable assumption and it is worth noting that the reopening of 29 June 2020 was more limited than the original plan for 5 July, as only pubs serving food opened in June 2020. The model then factors in the additional protection of the vaccination but also the additional transmissibility of the Delta variant. The models clearly demonstrated that if the Delta variant had not been introduced, we could have safely proceeded with the planned reopening of 5 July 2021. However, the models also clearly show the Delta variant becoming dominant and the very high risks that increased close social contact in the unvaccinated and partially vaccinated group would lead to a significant fourth wave of disease in terms of cases, severe disease, hospitalisation and mortality. The epidemiology of SARS-CoV-2 in respect of infection in Ireland and internationally shows that the primary sites of transmission are private households; social gatherings, including hospitality; and workplaces. They are not independent, in that increased social mixing in hospitality and workplaces drives transmission into and between households. It is not possible, therefore, to precisely quantify how many cases, hospital admissions, ICU admissions and deaths are directly attributable to indoor dining in each scenario. Based on the national and international epidemiological evidence, the resumption of indoor hospitality as a whole is likely to be the major contributor to the increase in cases, hospital admissions, ICU admissions and deaths in each scenario. The Delta variant poses a very serious risk and I cannot overstate that.

NPHET advised that higher-risk activities involving significant levels of social mixing in indoor environments should only be permitted for those who are vaccinated or immune. Last Tuesday, the Government announced the next phase of reopening the economy and society. I will hand back to Senator Casey.

I thank the Minister of State for her answer. All I am trying to do is get an open debate around the true impact of hospitality in respect of this virus. An example was given the other day of a pub in Waterford and how it caused 200 cases. That was an outdoor event. We need to bring some clarity to this. Our industry has behaved and responded in the best way it could, so we cannot question how it reacted to this. We have tried to find solutions. All I am asking for is a level of transparency regarding the true impact of our industry on this pandemic. I believe this is missing at the moment. All we are doing, and we did it at Christmas, is driving this activity underground. We are driving it into uncontrolled environments, which will only make matters worse than would be the case were the industry open.

I am sorry for taking up the time. I thank the Minister of State for attending.

I again thank the Senator. He is quite right. We all agree that we must have an honest conversation about the matter. It is not just one group or one sector which has responsibility. As a society, we have a responsibility for our actions. The public health guidelines have not changed since the very beginning, including a wearing mask, keeping one's distance and washing one's hands. The Government is committed to working with stakeholders across the affected sectors in the coming weeks. We must continue to protect the significant progress. Only yesterday, I was in Ballina with Deputy Calleary and, no different from anyone else, I sat outdoors. We have to wonder what the next step is. It is not sustainable for the industry. We need to get businesses back up and running. We need to get employees back to work. That is what Senator Casey is advocating for today and it is what we are hearing within Government, that we need to find a sustainable solution to get businesses back up and running, for livelihoods and for the economy.

Termination of Pregnancy Legislation

It is nice to see the Minister of State. She is very welcome. I want to raise the issue of the promised review of the Health (Regulation of Termination of Pregnancy) Act 2018. I begin by quoting what the then Minister for Health, Deputy Harris, said when that legislation was passed. He stated:

I am purposely seeking a review clause in the legislation as a result of looking at other jurisdictions where legislators thought all they needed to do was pass a Bill and that they had dealt with the issue forever. For us to do that would be a dereliction of our duty. It is appropriate that we return to the issue and make sure the legislation continues to be in line with best international practice.

During the Second Stage debate on the legislation in question, the then Minister also gave a very clear commitment that the there would be a full external review of its operation. It is crucial the this review be external.

I want to know where we stand in respect of this issue. We have heard that the current Minister for Health, Deputy Stephen Donnelly, apparently told the Cabinet in March that the review had started. We also know the Secretary General of the Department of Health, Mr. Robert Watt, said in March this year:

The Department will collate the findings of the three strands of the review. Upon completion a full report, with any necessary recommendations, will be submitted to the Minister for Health for consideration ...

My first concern is that the latter does not sound like an external review. It does not sound like the commitment that was given in the wake of the regulation of termination of pregnancy legislation being passed. I want to understand clearly from the Minister of State that the commitment will be upheld; that it will be an external review and that we will see a fully independent chairperson who is a specialist in reproductive rights and equality-based healthcare at the head of that review. I want to hear that the review will be expansive in scope, that it will be conducted in line with international human rights standards and the terms of reference and review process should be public and transparent. I am indebted to the National Women’s Council of Ireland, NWCI, which made these points in an excellent document it produced just a couple of months back.

We have some crucial issues. Having made so much progress in repealing the eighth amendment, we understand now that actually only one in ten GPs are actually providing abortion and termination services. I repeat it is only one in ten. We also know almost half of the maternity hospitals in the State are not providing services. That is not what the people of Ireland voted for. We need, therefore, to see action and to see an urgent review. There is a further issue, namely the ancillary recommendations of the Joint Committee on the Eight Amendment of the Constitution, of which I was a proud member. There was a great deal of agreement on the importance of these ancillary recommendations and, specifically, the need for free contraception. That was clear and is in the programme for Government. We have not seen progress yet and I want to understand from the Minister of State when that progress will be made because it is urgently needed. We know that contraception is linked directly to reduction in unwanted pregnancies so that is a key issue. Crucially, in those ancillary recommendations, we promised it would not matter where a woman lived and that regardless of where a woman lived all women would have access to the same standard of obstetrical care including early scanning and testing. That is clearly not the case. Women are being failed. I must be clear that this is not what people voted for, they voted for the provision of services and it is clear these services are not being provided as they should be.

I have one final point to raise with the Minister of State, that is, the need for safe access zone legislation. In my city of Limerick there was a protest each day during Lent outside the maternity hospital. There was a commitment in the programme for Government to enact safe access zone legislation. I am very fearful this Government is now trying to walk away from that commitment. Again, I am looking for a clear assurance that legislation will be enacted.

I thank Senator Gavan for raising this matter, which I am taking on behalf of the Minister for Health. The Health (Regulation of Termination of Pregnancy) Act 2018 was signed into law on 20 December 2018 and commenced on 1 January 2019. Section 7 states: "The Minister shall, not later than 3 years after the commencement of this section, carry out a review of the operation of this Act." This review clause, introduced by the Government on Committee Stage in the Dáil, was included in the Act in order to facilitate monitoring of the impact, operation and effectiveness of the legislation in practice, as well of the delivery of services in the area.

The Minister has asked me to confirm that the review will be led by an independent expert in line with similar reviews of legislation under the aegis of other Departments. The Minister expects the independent expert appointed may wish to have input on the methodology and may wish to undertake his or her own detailed consultation with particular individuals or groups. At this point, however, he anticipates that a three-part approach will be taken to the review of the operation of the Act. The three strands of this approach will focus on women who have used the service, service providers and public consultation.

Women who have used the service are clearly a crucial group to consult in reviewing how the Act has operated during its first two and a half years to date. For the review to be effective, it must find out whether the legislation provides access to termination of pregnancy services in practice to those who wish to avail of them. In this regard, independent research exploring women’s experiences of termination of pregnancy service and gathering their views of how the system has operated since January 2019 will it be essential.

Information from service providers we will provide the second key strand of the review. In this regard, we will need to gather the views of those involved in providing termination of pregnancy services in both community and acute settings in Ireland. This research will encompass input, for example, from hospitals and GP surgeries providing termination services, from individual medical practitioners in both settings, from the medical colleges and from the HSE.

In order to ensure that all those who wish to do so are given a chance to share their views on the operation of the Act, it will be important to include an opportunity for members of the public, special interest groups or any other interested parties to submit their views for consideration in the review. This will be achieved through a public consultation process.

Once the review has been completed, it is expected that a full report correlating the findings from all three strands, and including any necessary recommendations, will be submitted to the Minister for Health for his consideration. The Minister has held a number of meetings with stakeholder groups to discuss this approach to the review. Thus far, there appears to be broad agreement that it would be appropriate and effective. The process is continuing, however, and the approach will be finalised in due course. In the meantime, the Minister has asked me to assure the House that the Department continues to work with the HSE to ensure that all women can access this service quickly and easily and without bias or judgement, and that we continue to provide a compassionate and dignified termination of pregnancy service. The most important thing is that women accessing the service can do so with certainty of the quality and safety of the care they will receive.

I thank the Minister of State for her reply. It is good to hear that there will be an independent person appointed to lead the review. I would, however, appreciate a timeline for this because we are quite some way through the year at this point. I am also not clear about exactly how external the overall review will be so I am looking for some further reassurance in that regard. Fundamentally, the point I wish to make in the time available is that each day last year at least one woman had to leave this country to go to Britain for a termination.

There are a number of issues that arise in the context of the Act.

There is no medical reason for the three-day waiting period and that is causing concerns. There are real concerns that women who are pregnant in circumstances where there are serious or fatal foetal abnormalities involved will run out of time in the context of the 12-week period.

There is also the major issue of access to services. We know that access is not there at present. I am an old-fashioned republican. I believe in a complete separation of church and State. We need to see full reproductive healthcare rights for women in this country. This review is urgently needed. It would be helpful if the Minister of State could provide a timeline.

Regrettably, I cannot answer as to the specifics. I can only answer in the context of what is in the script provided by the Minister for Health. The Minister has asked me to assure the Senators that implementing the Health (Regulation of Termination of Pregnancy) Act 2018 and ensuring access to services under the Act remains a priority for the Department of Health. All the indications are these services are both operating and available. They are being delivered throughout the country in hospitals and community settings.

The review of the operation of the Act required under section 7 gives us an opportunity to examine the matter in more detail and hear the views of all those involved, particularly women who have used the service. The review is being progressed this year and will be led by an independent expert. It is anticipated that a three-stranded approach will be taken to review the operation of the Act and that these strands will focus on women who have used the service, service providers and public consultation. Research to inform the service users and service providers strands will be commissioned and carried out independently and a public consultation will be held. Reading from that, it seems that there will be movement on the matter before the end of the year. The Minister is confident the information gathered during the review of the operation of the 2018 Act will provide us with evidence as to how to proceed in future, to continue to ensure the service mandated by the people in May 2018 is operating effectively.

Sitting suspended at 10.12 a.m. and resumed at 10.30 a.m.