Health (Amendment) (No. 2) Act 2021: Motion

I move:

That Seanad Éireann resolves that Part 2 of the Health (Amendment) (No. 2) Act 2021 (No. 24 of 2021) shall continue in operation for the period beginning on the 10th day of October, 2021, and ending on the 9th day of January, 2022.

I welcome the Minister, Deputy Stephen Donnelly, to the House. It is great that he is here to take this motion. It is appreciated. I now ask the Minister to address the House for up to ten minutes or whatever is appropriate.

I am in the House today to introduce a resolution to extend the sunset clause of Part 2 of the Health (Amendment) (No. 2) Act 2021. The Act is due to expire on 9 October. The sunset clause of Part 2 provides that each House of the Oireachtas may, on or before 9 October, pass a resolution to continue Part 2 in operation for a period not exceeding three months.

For the purpose of giving the House some background on this, Part 2 of the Health (Amendment) (No. 2) Act 2021 provides for the reopening of indoor hospitality under certain conditions. The Act was passed by the Houses of the Oireachtas last July and gave effect to the Government's decision taken then that provided for indoor hospitality premises to reopen to persons who are fully vaccinated and persons who are immune from Covid-19 on the basis that they have recovered from Covid-19, as well as certain children and staff. The decision was made in line with the public health advice. Ultimately, the Government's decision made it possible to get pubs, cafés, restaurants and other licensed premises reopened for business in a safe and sustainable manner. This Act and associated regulations were of vital importance in ensuring that hospitality businesses could reopen safely and begin to recover from a very difficult period of closure. It occurred against the backdrop of the Delta variant. In a lot of ways, this last period, coinciding with the introduction and subsequent dominance of the Delta variant, has been the most demanding on us as a people. Our resilience has been tested by the variant's virulence. This variant of concern has continued to circulate extensively, especially among people who either have not yet been vaccinated or are not yet fully protected by vaccination.

From the outset, the Government has been guided by the public health advice provided by the National Public Health Emergency Team as to what restrictions might be necessary to manage or suppress the disease. Along the way, extraordinary measures have been introduced to protect public health and the most vulnerable in our society. These were difficult and challenging decisions in a crisis scenario, with an evolving understanding of the disease, its impact, how best to manage the situation, what vaccines might offer and what variants might do to undermine our plans.

The decision to require proof of vaccination or recovery to access indoor hospitality arose in the context of advice from the National Public Health Emergency Team, NPHET, on 28 June last. That advice was that indoor activities expected to reopen on 5 July "which, by their nature are high risk activities involving significant levels of social mixing in indoor environments, should only be permitted for those who have been fully protected by vaccination or who have had Covid-19 infection in the previous nine months". NPHET advised that easing of these measures should proceed only when supported by a robust, non-reproducible and enforceable system of verification of vaccination or immunity status. The Health (Amendment) (No. 2) Act 2021 embodies this system of verification.

This House has already recognised the intrinsic value of the measures in the Act in order, on the one hand, to get indoor hospitality businesses open and, on the other, to protect public health from a variant that continues to be dangerous, unpredictable and virulent. The measures in the Health (Amendment) (No. 2) Act 2021 balance both these requirements and have enabled and permitted indoor hospitality premises to continue trading while maximising the opportunity to protect public health.

This is about maintaining an equilibrium between the social, economic and public health interests of the State. Ireland has endured a profound shock to its social and economic life as we have dealt with the impact of this disease at an individual, community and societal level. It has had an impact on almost all aspects of our lives and, for many, their livelihoods. It is in this context that the Government agreed Ireland's next plan in its response to Covid-19, entitled Reframing the Challenge: Continuing Our Recovery and Reconnecting. This recognised that Covid-19 has had a global impact, sending shockwaves around the world, with its effects felt in every section of Irish society. Reframing the Challenge declares that if it is not possible to eliminate Covid-19 completely, we need to move to manage Covid-19 in a more "mainstream" way rather than as an exceptional threat requiring society-defining interventions and actions which are increasingly burdensome and scarring on our economy, society, health and well-being. We must manage the burden of Covid-19 on the basis that it will likely continue to be constantly present into the foreseeable future.

This House will know that extraordinary measures have been introduced to protect public health and the most vulnerable in our society. These were difficult and challenging decisions in a crisis scenario, with an evolving understanding of the disease, its impact and how best to manage it. Our plan provides that the public health management of Covid-19 should transition, in broad terms, from a focus on regulation and population-wide restrictions to a focus on public health advice and personal judgment and personal protective behaviours, subject to certain criteria.

Reframing the Challenge includes a series of planned measures, such as the transitioning of the public health response and interim arrangements pending transition. The Government decided to remove further statutory restrictions in respect of events and activities from 22 October next based on criteria which include the achievement of at or close to 90% of people aged 16 or over being fully vaccinated. In effect, the statutory regime in place to support the protection of public health is to be largely wound down in line with the agreed removal of restrictions. For indoor hospitality, the Government's plan specifies, "No further changes are proposed to the current arrangements in respect of the hospitality sector until the final transition point is reached".

I am mindful of the precariousness of this virus. The Chief Medical Officer has advised that the future trajectory of the disease cannot be predicted with certainty. As a result, a response to this disease that is agile and flexible, with an ability to pivot rapidly and respond to any emerging threat, needs to be ensured. The Health (Amendment) (No. 2) Act 2021 is a key part of that response should the potential for one arise in the future and, while unlikely, it cannot be fully ruled out because of the uncertainty of the future trajectory of the virus, given how novel it is. I assure the House that existing regulations under the Act will be revoked with effect from 22 October, pending a Government decision, in line with the Government's plan for this phase of Covid-19.

However, the Health (Amendment) (No. 2) Act 2021 is being proposed for continuance for a period of three months, without any regulations being imposed providing for restrictions on the indoor hospitality sector. The continuance in operation of the Act is solely to align with the public health advice that the possibility of the reintroduction of any given measure cannot be fully ruled out in order to enable us to respond to the disease and the challenges its transmission might pose for us. We must continue to ensure our response is agile and flexible, with an ability to pivot rapidly and respond to any emerging threat that might arise.

It is in this context that this resolution to extend the Health (Amendment) (No. 2) Act 2021 is being presented to the House. The continuance in operation of the Act maintains the potential and flexibility to respond to an emerging Covid threat that could jeopardise public health and safety were it to go unchecked. The Government, while working to reframe the challenge and reopen society, must act cautiously and prudently to ensure the most vulnerable continue to be protected to the best of our ability, should the need arise, from this unpredictable and virulent disease.

In summary, the measures for indoor hospitality are due to expire on 22 October. I cannot pre-empt a Government decision before that date. The current trajectory is encouraging and, because of the policy measures taken previously, we are broadly aligned to the optimistic scenario of the four we were presented with, as was the policy intent. I cannot predict what will happen between now and 22 October but progress to date is steady and stable and we are tracking the best scenario we were presented with. If all were to go to plan, from 22 October all restrictions for indoor hospitality would be removed. The current Act and timing would remove the ability for those to be in place earlier, I believe from 9 October, which is in the next few days. There was broad agreement that we would extend at least to 22 October. I seek the House's agreement that we extend the legislative framework for about 11 weeks, to 9 January. The restrictions will not be in place but if things were to change rapidly, it means we could move rapidly in terms of putting the restrictions in place. The restrictions are not broad, sweeping societal ones. They apply specifically to indoor hospitality. It is just those restrictions and speed could be of the essence.

The week before last Christmas, on a Friday evening, the UK Government sent out an international signal about the Alpha variant. We met all through the weekend and on Monday and Tuesday made some serious decisions. That is how quickly this can move and how quickly we need to be able to respond. Some have suggested letting the legislation expire or extending the sunset clause to 22 October and then letting it expire and if we need more ability to respond, we can re-legislate. While that is a reasonable position, there is no way we could have done that last December. There is no way that could occur between a Friday and Monday, in terms of seeing something serious, making the decisions and going through a legislative process. I hope it will never be used. On the current trajectory, it would not be used, but as we know from last December, things can move with this disease very quickly. The ask is to extend it for about 11 weeks past the end of October as a safety net that we hope we will not have to use.

I thank the Minister for that clear presentation and summary at the end.

I thank the Minister for his comprehensive and fully thought-through position on what he is asking us to do. It is a reasonable position. We know how dangerous this virus is. We have performed well but the threat has not gone and we need to be in a position to act rapidly. It is a limited power he is asking for regarding the hospitality industry. This concerns people's businesses, lives and livelihoods. They have been through a lot and enough. I hope we do not have to extend any more restrictions. I am glad to hear we are on the positive trajectory and I hope we stay on it. I have happy children in school and neighbours. Everyone is happy things are getting back to a better position but we want to make sure it stays there and that we are able to enjoy a much better Christmas this year.

I appreciate the Minister said that, given the way things emerge, he has to act rapidly. He cannot wait for us to reconvene and pass further legislation. That is the basis on which I am happy to offer our group's full support to the Minister in his attempts to keep us all safe. The Minister, Department and everybody in the HSE has done Trojan work over the past almost two years. We are at the top of the world league table in terms of vaccine roll-out. That is a great source of national pride. The solidarity the public showed to get to that position is needed for the final stretch. I hope everybody here sees the Minister's sincerity and caution and that he is acting in the best interests of the people of the country in his proposal today. I call on colleagues to offer full support to the Minister, his officials, the Department and this motion.

It is my pleasure to call on behalf of the Independent Group my county neighbour, Senator Keogan.

I thank the Leas-Chathaoirleach. The Minister is welcome to the House for the last hurrah of Covid measures, we hope. It seems like only yesterday that the legislation to which this motion refers was rushed through the House, all Stages in one sitting, with pre-legislative scrutiny having been waived. I opposed it then and oppose it now. I watched the motion being debated in the Lower House yesterday and was struck by the clear and candid summary of events by Deputy Connolly. We were told this legislation was essential to reopening. It was put through on a Government majority and, four months on, we have no clear picture of how it is operating and no numbers on compliance officers hired, emergency cessation orders handed out or compliance notices served. There has been no independent assessment of adherence to GDPR by businesses carrying out functions under the Act. However, we are again trotted into this Chamber to rubber stamp the extension of this outrageous Act because the Government wants it just in case.

On 5 October last year, there were 518 cases; this year, there were 1,124. On 5 October last year, not a single person in the world had been vaccinated; now, 7.4 million vaccines have been received in this country, with the 90% of the adult population mark passed in September. Aside from breakthrough cases which were expected in older persons and those with underlying conditions, the vaccines have largely succeeded in reducing the hospitalisation rate per thousand. This is reflected in the planned date of 22 October for the roll-back of Covid measures.

All of this begs the question of why we are here. The Act provides for an extension of any period up to three months. Why opt for the full three months? Why not match the sunset clause of the Act to the Government's chosen end date for the use of domestic vaccine certificates? Do we expect the Covid ghost of Christmas past to rear its ugly head again? If so, what modelling is that based on? Where was it published?

Is it NPHET's minimal change modelling from last summer which predicted 2,300 cases per day? For those who can remember, that modelling was undertaken to provide scenarios to inform the Government's reopening of society. Minimal change meant outdoor dining remained closed to all. The Minister will remember the modelling as it was sent to him. The most pessimistic scenario projected 681,900 cases by the end of September, while the most optimistic scenario projected 81,000 cases. There were in fact 35,700 cases. The most optimistic scenario projected 165 deaths between the end of June and September. The actual figure for that period was just over 60. The data were widely inaccurate. This is NPHET's best case scenario versus the reality. That was certainly not the one that got the headlines, "Grim" and "Sobering". The Minister warned us that the biggest hurricane that had ever hit Ireland was coming. It was not true. It did not happen. I do not for one second believe the Minister was being disingenuous; he was simply being cautious. We cannot afford to be so cautious for caution comes at a price. When caution is based on such inaccurate data or, as in the case of this Act, no data at all, it becomes an impossible pill to swallow.

Let us for once recognise the reality of the situation. We need to send out the clear message to the public that the blunt instrument of lockdown will be put away for good and that the insidious practice of dividing society based on vaccination status will be likewise put to rest. I oppose the use of domestic vaccine certificates and I oppose this motion before the House today.

I welcome the Minister to the House. I seem to be meeting him a great deal today. I welcome this legislation. We have been successful in regard to Covid-19 precisely because we have been cautious, we have followed public health advice and, by and large, the public have bought into and supported politicians, the Department of Health, the Minister for Health and the Government in terms of the leadership that has been shown by abiding by restrictions and accepting the vaccines.

It is a fact that Ireland is a world leader when it comes to Covid-19 vaccinations in that over 90% of our adult population are vaccinated. We are the envy of many countries throughout the world that cannot get their vaccination rates over 50%. Some countries would consider themselves to be successful on achieving a vaccination rate of over 70%. We are in the situation where over 90% of our adult population are vaccinated. This is proof that when the Irish people roll up their sleeves and get stuck in, Ireland is a world leader, as it has been in so many areas down through the years. Ireland is now a world leader in terms of dealing with a pandemic and a world health emergency. It has led the way in terms of the leadership shown by the previous Government and this Government, the former Minister for Health, Deputy Harris, and the current Minister, Deputy Donnelly, in dealing with the pandemic. In fairness, throughout the country the public have been leaders as well in terms of how they have adapted to very difficult situations, including staying at home, working from home and through businesses closing their doors. Some businesses will never reopen. All of that was done because people wanted to save as many lives as possible.

We must always reflect on the lives lost. More than 5,000 people lost their lives to this disease and thousands more are sick as a result of it. Many thousands more might have died but for the coming together of various components in our battle to save lives and to reduce the risk as much as possible.

The Minister is aware of my concerns in regard to long Covid. I do not think we have dealt with it in the way we should. This is an evolving situation and a learning process in terms of the consequences of long Covid. I know the Minister has put together a high level group to address the issue, but I think it probably needs more attention and more resources. So many are suffering from long Covid. It is one of the legacies of the pandemic. We need to deploy the best possible medical resources and research to help those people to deal with long Covid and, it is hoped, if at all possible, to overcome it.

The ask in terms of the Act is very reasonable. I would have been happy to support a six-month extension. If it is necessary to extend it beyond 9 January, the Minister should not hesitate in coming to the House this side of Christmas to do that. It is important this legislative mechanism is in place in order that the Minister can act and move swiftly if necessary to do so. That he was in a position prior to last Christmas to act and move swiftly in terms of the reintroduction of restrictions saved many lives. It did not save all lives, but it did save many lives. The Minister needs to have that flexibility. He does not need to be looking over his shoulder in regard to the legislative framework and his powers to act when dealing with health in the public interest. As I said, if prior to Christmas this Act needs to be extended further, the Minister should by all means do it. We wish him well.

We are seeing much brighter days and we are all looking forward to 22 October, depending on what comes between now and then, but it is looking good. We can be reasonably positive and optimistic that, as we move towards Christmas, we will see a significant return to normality. I am sure the Leas-Chathaoirleach will agree it is great to be back in Leinster House, to meet people again and to see the self-service and Members' restaurants open and people somewhat returning to normality. That is reflected throughout the country. Those who are vaccinated have the confidence to return to work for a couple of days per week and many more will be returning on 22 October, all going well.

I hope the motion in respect of the legislation is agreed. There is no argument as far as I am concerned as to why it should not be. I wish the Minister well with it.

I echo the Senator's sentiments in regard to our being back together again. It is also great that we are back in our beautiful Chamber as a collective again. It is another important milestone for us.

It is nice to see the Minister. Before I get to the substance of Sinn Féin's position on this Act, it is important to reflect on what we have achieved nationally in regard to Covid. The current vaccination rate of approximately 87% - it may be slightly higher - is a huge achievement. The political consensus on the importance of science on vaccines has been crucial to that. At the Council of Europe last week I had an opportunity to chat to colleagues from countries that do not have that consensus. For example, in Armenia only 10% of the people are vaccinated but not because there is a shortage of vaccines. They have ambulances outside market squares inviting people to get vaccinated but there is a huge level of government distrust and, unfortunately, there is a far-right opposition in this country that is anti-vaccination and anti-science. Thank God we do not have that in this country. With the possible exception of the odd Tipperary Deputy we do not have that, thank God. It is important to reflect on that and on the progress that has been made. That is an important point.

While we are on the issue of vaccines with the Minister, I also raise the issue of the lack of Government support to date to a call for a waiver on intellectual property, IP, rights for vaccines. That is a significant disappointment to me. I am sure the Minister will accept the logic that no one is safe until everyone is safe and that we need to assist the developing world in a way that we just have not done to date. We need voices at European level. This was brought up at the Council of Europe again last week and it was very disappointing to hear the Commissioner not back the idea of dropping intellectual property rights. It is so depressing to see western governments aligning themselves with big pharma rather than with the world. We need to give the world the right to produce its own vaccines. I cannot for the life of me understand why this Government cannot make that simple and clear call. I ask the Minister to reflect on that and perhaps respond to this point.

Moving on to the issue of this debate and the powers, the Minister is correct in what he said in that there is a consensus that we should extend legislation until 22 October. Sinn Féin will certainly support that but we cannot support its extension beyond that date for the simple reason that the restrictions are being lifted, which we welcome and want to see happen. This Government has shown on several occasions in the past that we can move legislation very quickly, if needs be. It is important to recognise that we have to be very careful in regard to the extraordinary powers that were granted and to how they were granted and managed. I reflect that when the need arose, we signed up to a €64 billion bailout for banks overnight. The idea that we could not come in here, if necessary, to reintroduce this legislation just does not fly. Christmas this year is on a Saturday. Even accepting the Minister’s scenario, we could take the week coming up to Christmas and still come back and pass this legislation. Our view is that that would be preferable in terms of respect for human rights than the tack the Minister is taking. I stress that our party thinks that the approach has been broadly correct but on that one issue, we do not agree with the Government, so this is a respectful difference of opinion.

We need to reflect on the fact that even if these restrictions are dropped on 22 October, there will be partners who still cannot join their loved ones in maternity wards. For the life of me, I cannot understand that. They are marching in the rain as we are conducting this debate. I ask that the Minister respond to that point and say what else he can do. I have spoken to colleagues in Limerick on this issue and have stood with them. There seems to be a significant disconnect between what the Minister’s Department is saying and what is actually being implemented. Ultimately, I argue that the buck stops with the Minister on this issue. We have all spoken about this and it has come up almost every week in the Seanad since we have come back and yet it persists. I ask the Minister address this issue.

Gabhaim buíochas leis an Seanadóir féin. Our next speaker, as per the agreed rotation, is Senator Black on behalf of the Civil Engagement Group.

Gabhaim buíochas leis an Leas-Chathaoirleach.

I welcome the Minister to the Chamber. It is the first time we have been in the Chamber with him, so it is good to see him here. Thankfully, there appears to be a light at the end of what has been a very dark tunnel. I commend the Minister on the work he has done in taking on that role as Minister during a very difficult period in the history of the State. Not only did he have to deal with the pandemic but with all of the data issues as well. At times during the pandemic, it seemed as if normal life, or at least a version of it, might never resume. Thanks to the sacrifices and the sensible decisions made by the Irish people, we are back on track to seeing most of the remaining public health restrictions lifted on 22 October. Thanks to the impressive rate of vaccine uptake and the buy-in by the Irish people to the remaining public health restrictions, we have avoided the worst case scenario as modelled by NPHET, both in terms of case numbers and deaths attributable to the virus throughout the summer months. Additionally, we have had fewer deaths attributable to the virus throughout the summer that was modelled in NPHET's best case scenario.

Despite this relative success, we need to progress with caution from this point. Breakthrough cases persist in some people who have been fully vaccinated and the risk of infection remains high for those people in Ireland who remain unvaccinated. While our case numbers are stable, they remain stubbornly high. Our hospitals remain under pressure and we must ensure they have the capacity to deal with the seasonal surges in presentations this winter. I have full confidence in the Irish people to look after one another as they have done so well over the past 19 months.

Different industries and sectors of society have all made sacrifices throughout the pandemic but, as I have said here many times, our hospitality, entertainment, cultural and creative sectors have, potentially, shouldered a greater burden than many others. There is no doubt about it that 22 October is a beacon of hope for those employed in those sectors and those who take so much from them, socially and culturally.

While the Government is confident at present that it will not require the emergency powers as set out in the Health (Amendment) Act 2021, it has decided to extend the legislation which underpins these powers as a precautionary measure. I understand the rationale in doing so and the caution around it but I remain concerned that the continuation of this Act makes legal provisions for an Irish society in which people can be treated differently on account of their vaccination or health status. While the Government may not utilise the powers as set out in the Act past 22 October, there will remain provision for it to do so as it sees fit until the legislation expires on 9 January 2022. We must, therefore, have the conversation as to what will happen in the circumstances where the emergency powers are required. I invite my colleagues in the Chamber, in the Government and in the Cabinet to speak to those considerations.

If the Government chooses to invoke its powers as set out in this Act over the coming three months, it must ensure that expert public health modelling informs its decision-making while also actively consulting with experts in human rights and civil liberties. Additionally, those sectors which will be affected by this legislation must be consulted and communicated with regard to Government decision-making in a clear and transparent way.

While there is a specific endpoint to the legislation, it is vital that we ensure that it is adhered to. However, with this in mind, what does the Government suggest might happen if the public health landscape deteriorated to such an extent that it required the emergency powers to be extended past the date currently provided for in the Act? Expert groups on the protection of both data and civil liberties have expressed concern about the use of the Covid-19 tracker app as an e-wallet within which to store the digital Covid certificate. These concerns were raised with the Department of Health, the Department of Public Expenditure and Reform and the Data Protection Commission in the first iteration of this Act. These concerns, to my knowledge, have not been adequately addressed to date.

Specifically, I would welcome assurances that the use of special data in this way, medical data in this case, is not demonstrative of an instance of scope-creep by the Government. Further, I ask for assurances that the data protection impact assessment undertaken in designing this app and the EU digital Covid certificate, DCC, was thorough and considered the principles of necessity and proportionality, having adequately assessed risks and the safety and security measures necessary to mitigate it.

While people are not required to upload their digital Covid certificate to the Covid tracker app, this is the format in which many people are storing their certificates. We must ensure that the sensitive personal data that we are storing and processing to facilitate this is kept as safe and as secure as it can be.

I thank the Minister and commend the Irish people on the Trojan efforts made to keep people safe throughout this pandemic. I hope with all of my heart that this sense of unity and togetherness is something that we continue to hold on to long after the darkest days of this pandemic are well behind us.

I thank Senator Black for that contribution and I now call Senator Kyne to speak.

The Minister is welcome back to the House. I will start, as I did this morning at the meeting of the Joint Committee on Health, by acknowledging the success of the vaccination programme. I commend the Minister, his team within the HSE and the Department of Health and, most important, the Irish people, as well as, in some instances, the mothers and fathers who persuaded younger persons in particular of the importance of taking up the vaccine to protect themselves and others. The success of the vaccination programme has been acknowledged in worldwide league tables.

I have always acknowledged that the issue all along was the supply of vaccines. All present are aware of the current situation in New Zealand and Australia that has resulted from a mixture of hesitancy and the non-prioritisation or non-supply of vaccination. We are lucky to have had the power of the European Union behind us in that regard. Despite a slow start, it came through in terms of supply of the Covid vaccine, so well done to all involved in that.

I welcome the decisions relating to mandatory hotel quarantine. I do not think anybody, not even the Minister, was overly supportive of the initiative but it was a necessary measure at the time. The Delta variant has now spread worldwide and it was very much evident in Ireland. Most important, the success of the vaccination programme has negated the need for mandatory hotel quarantine. It is a chapter of this saga that has ended and I welcome that.

The legislation relates to the extension of emergency powers to January of next year. These are powers that I am sure the Minister hopes will not be needed and does not expect to use. However, it is important to have them in place in case they are required. As they say, "fail to prepare, prepare to fail". It is a precautionary measure as recommended by the team in NPHET, which has been proven to have given proper advice in all its various interventions in the past year. Although the advice was not always politically welcome or welcomed by the public, it was necessary and has proven to be correct, so we have to respect it. Out of an abundance of caution, we must ensure these measures are available and can be easily put in place if required. As I stated, we all hope they will not be required.

The flu vaccine is an issue related to that of vaccine uptake. Ireland has a strong record in the context of the flu vaccine, particularly among older people. One could argue that a lack of hand hygiene and cough etiquette, such as shaking hands and so on, was a vector for spreading infection pre Covid. That is important. I urged from the start that there be strong messaging on this issue. People have been in close contact, whether at funerals or various other events. I hope that does not stop, but the use of antibacterial and antimicrobial hand sanitisers and the like will be very important and should be continued. I would like those products to continue to be available in shops, supermarkets, churches and at funerals or wherever there are large crowds gathering. I encourage everyone to use them. It is particularly important that they be available for those who wish to do so. That should continue in an effort to combat the spread of infectious disease, particularly flu, which can be debilitating and life-threatening, particularly for older people. I ask the Minister to ensure the Department continues to look at messaging on that issue and to roll out guidelines or messaging relating to the flu season that are similar to those rolled out in the past 18 months in the context of Covid. That would have a very positive effect in the context of flu prevention. Members are aware of the number of people who appeared in accident and emergency departments pre Covid, particularly in January, suffering from flu. Prevention and messaging in the context of maintaining proper cough etiquette, hand hygiene and hand sanitisation are important aids in preventing the annual surge that takes place every January. They are probably as useful as many of the more expensive measures needed to treat flu. Prevention is more important.

I again acknowledge the work the Minister, his Department and the HSE have done. I wish him well on this measure.

To come into Cabinet and take on the gauntlet of the health ministry is a daunting challenge at any time, but it is particularly daunting to come into that role at the height of a pandemic. It has been no joke. I say "Well done" to the Minister. We are where we are largely due to courageous decisions that have been made.

The roll-out and uptake of the vaccine have been fantastic. I look forward to the next phase, encouraging the last section of the population to take it, and its possible extension to younger groups. On a personal level, I believe in taking on the responsibility of vaccine justice. My family has donated elsewhere the cost of vaccines as we have benefited from the wealth of this country and its being able to provide us with the vaccine. I encourage others to do likewise and I ask the Minister to be active at governmental level in ensuring that is given consideration. We are not safe until we are all safe. That is important.

I welcome that the extension of the powers is a restricted extension. It is good to have that caution in respect of the necessity for an extension of these restrictions and powers. I trust and believe that the Government and the Minister will be responsible in their administration. However - there is always a "however" - I refer to the issues being experienced by certain women, men and families. I know the Minister has done everything he can in that regard, but I ask him to consider whether more can be done to hear their experiences. We have met them in virtual meetings in recent weeks. To hear their stories is horrific. It is hard to believe that in 2021 women are going through pregnancy loss, and then the whole experience of birth, alone. In the context of pregnancy loss, I refer to those moments where a woman is going in to a scan that may reveal bad news. There is nothing like the moment when one is told there is no heartbeat. It would be just horrific not to have a partner with one for anything like that.

I refer to couples who were due to go for IVF treatment in time-critical circumstances. The availability of IVF treatment in Ireland is based on the age of the mother. As a result of Covid, in some instances, women seeking IVF treatment have gone past the required age through no fault of their own without being able to access the treatment. We need to look at that as a hangover from, and a consequence of, Covid. It means that some couples will be denied their opportunity of parenthood through IVF as a consequence of Covid. Something needs to be done. We need flexibility such that the availability of treatment is based on ability to conceive or receive an embryo, rather than the age of the mother, because some women get pregnant at older ages. We need to consider that.

The Minister cannot come to the House without me raising my next issue. He knows the drum I am going to beat, which is that we need progress on the legislation relating to surrogacy and assisted human reproduction. At present, international surrogacy is excluded. There is a need for it to be included and for issues relating to dealing with children who are born here and Irish citizens and growing up to be dealt with retrospectively. The lack of legislation has caused real delays and problems. I know the Minister is meeting groups and there is action afoot, but I ask him to really put his influence behind this. We are mammies. We are the only mammies our children have ever known. We have the right for them to have a lifelong legal relationship with us, rather than one that expires when they reach the age of 18. It is horrific to think that in order for my child to inherit from me, I am reliant on a barrister giving a legal opinion that I was in loco parentis for all of her life. I should have the right to be named as her mother legally.

I was there before she was born and all the way through it. That is a very important thing for us to do. When we look outside, we see mothers being judged in the consequence of the their age, IVF and surrogacy. It is said that this is no country for old men. There appears to be no country for women. Very strong action needs to be taken in that regard.

I welcome the Minister to the House. He has had a busy morning. I watched him attending the meeting of the Joint Committee on Health. It is important we continue to pioneer reform. I commend him on the appointment of the two new chairs of Sláintecare. His presentation this morning to the committee is one we should reflect upon as opposed to some of the populist commentary we have heard from some on other benches who do not care about the outcome other than what they can get in the newspapers and the headlines in the media.

I wish to acknowledge the response of, first, the people and, second, Government, in terms of the roll-out of the vaccination programme. We can reflect upon the rocky days at the beginning of the roll-out of the vaccination programme, when we were all inundated with reports that people had not received dates for appointments. We were all getting flummoxed and worried. Look where we are today. We are No. 1 in the Bloomberg Covid resilience rankings, with 92% of people vaccinated. Look at America, where 50% plus of the population is vaccinated. Rational, sane people are refusing to get vaccinated for reasons of political ideology, putting themselves and their colleagues at risk. That is why I am proud of our country, that we did the due diligence and listened to the science. Yes, there are people who hold different views. Senator Keogan gave a very spirited response to the debate today, much of which I did not agree, but that is okay; we can agree to disagree. The job of Government and public health is to lead, and the people responded and we saved lives.

The backdrop of our debate today, as Senator Conway rightly said, is the 5,000 people, citizens of our Republic, who have died: people we knew, grew up with, lived next to in our communities and estates, and in some cases they were part of our families. They were people of all ages and genders, with immunity and none. Our debate today takes place in the context of the deaths of those people.

As I have said many times, none of us would be making decisions to vote to curb civil liberties under normal circumstances. We are being asked to agree to a continuation of the legislation for three months. The Government is asking for extraordinary powers, which they certainly are. However, as the framework states, it is based on an evolving understanding and response to the virus. I can tell Members of the House there are friends of mine in many parts of the world who are envious of us because we have a vaccination programme that has worked.

I am a small bit concerned about two issues. One concerns the booster shot requirement. I appeal to the Minister, those in NPHET and in government to have an information campaign on why such booster shots are needed, if they are needed and who will get them. It should be clear and concise, as was the case with the vaccination programme. I heard the Minister's response in the context of the optimistic outcome, but I was struck by Professor Nolan's remarks yesterday when he said the situation is stable but it is a complex picture. I am small bit worried in two respects. First, on the issue of mask wearing, we say indoor retail and on public transport as two examples where it is to be continued. I believe we need to have a further debate on mask wearing to make it mandatory in all indoor settings. I was away two weekends ago and I travelled through Dublin Airport. It was a wonderful experience.

Second, I am still not impressed with our response to antigen testing. The Minister for Tourism, Culture, Arts, Gaeltacht, Sport and Media, Deputy Martin, made some remarks on the issue yesterday. I do not know why we have not proceeded with antigen testing as quickly as we did with other testing.

We have been listening to public health advice. I share similar concerns around the extension of the powers as those raised in the remarks of Senator Gavan and others, while understanding the reasons we need to be where we are and where we are going to. Finally, there will be no requirement for social distancing from 22 October. We are going back to serving customers at the bar. There are still issues with maternity hospitals that have not been addressed. However, I commend the Minister on his work.

I welcome the Minister to the House today. I support the idea of giving the Minister the option of extending the restrictions if necessary when the time comes. Certainly, we have all been through a very turbulent time. On the Order of Business earlier today, I made the point that in Limerick, as part of mental health week, they are floating white roses on the River Shannon on Friday to mark the lives of the 289 people who died from Covid in Limerick city alone. The fact is it is the job of the Minister and the Government to act in a responsible manner and to provide guidelines to help people along and to protect their lives and health. Therefore, I fully support the extension of the powers. When people go into a restaurant or any enclosed setting, they want to feel safe. The fact the restrictions were brought in was very welcome at the time. Certainly, they should be kept in place for as long as necessary.

I know there is a protest outside Leinster House today in respect of maternity services. I wish to raise that issue. Access should be granted to partners of women using maternity services. I know the Minister is committed to looking at the issue and dealing with it as it comes along. I wish to put that on the record.

I must say that I believe the Government has done a very good job in terms of vaccinations and protecting people as much as possible. I support the Minister's proposal that restrictions may be extended down the line.

Cuirim fáilte roimh an Aire freisin ar an ábhar an-tábhachtach ar fad seo. I start by saying "Congratulations". The achievement of the Government and the Minister's Department in the roll-out of the vaccination programme has not just been exceptional but has been a watershed in terms of dealing with this virus. The Minister deserves great credit for it. We can rightly be proud of the work that was done by staff in the HSE, pharmacies and GP practices throughout country to ensure every citizen who wanted a vaccine could get one. I very much welcome that.

I know there are certain people who do not want the vaccine, and I agree with the right they have not to take it. I do not agree with some of the emails I have received recently to say this is the beginning of a fracturing of Irish society. While acknowledging that people have the right to choose not to take the vaccine, they also have the right to make that choice in circumstances where it gives rise to certain other consequences. When we make choices, there are consequences one way or the other. However, while part of the vaccination programme and part of this legislation does create, by some arguments, a divide, more importantly it facilitates those who wish to engage in particular activities to do so in a safe way. My colleague, Senator Byrne, just mentioned how important it is for people who go into restaurants to feel safe. That is exactly the purpose of this legislation, to allow businesses to re-establish themselves, get back to work, allow their employees to get back to work, and allow us as members of society to re-engage in the kind of activities we have all missed so much.

The Minister will be aware of the enormous demonstration that is taking place on Molesworth Street outside today relating to maternity services, which has been mentioned by other colleagues. I have been out there this afternoon listening to what are genuinely harrowing stories from not just women but their partners, who have been denied an opportunity to be together at wonderfully joyful moments and at tragic and sad moments when perhaps the news was not good in terms of a pregnancy.

I understand that the Minister has listened to what they have to say and that he agrees with them - at least on one level - but the time has come for the foot to be put down in the Department and for very clear messages to be sent to our maternity hospitals that the guidelines are to be followed and that it is no longer acceptable to exclude partners from the maternity process, be it an early scan, birth or postnatal care. The reality is that this is part and parcel of the care that is provided.

Covid has not yet left us. I recognise that by bringing this motion, the Minister recognises that and sees a need for the continuation of certain powers that we passed into law through this House and the Dáil. At the same time, we know that with the vaccination programme and the progress we have made on this, there is a safe way to facilitate people who must go into maternity hospitals and for people to be present at the birth of their children, at scans or, God forbid, when bad news is delivered. It is incumbent on the Department and by extension, the Minister to make it clear to maternity hospitals that this is the case. There are discrepancies around the country in terms of how hospitals deal with this, which is neither fair nor reasonable. The Minister has been here for the debate on this motion so he has not had an opportunity to go outside to talk to the people who are out there, but I can assure him there is a lot of deep feeling based on reality and reasonableness. It is not something they are saying on the hoof. These are people who have experienced the difficulty caused by those restrictions.

All of the restrictions create problems and I know the Minister and other Members acknowledge it. Every restriction will create a different level of difficulty for different people but I also think we recognise that they are necessary. I recognise the need for the continuation of the Covid passports or the digital certificate that allows people to enter restaurants but I also recognise that later this month, we will remove a lot of the restrictions about which we have been talking. I wonder whether the date until which the Minister is seeking to continue the restrictions is the right one. Could the Minister comment on whether an earlier date would be more appropriate?

I congratulate the Minister. I ask him to recognise the difficulties that restrictions cause. I ask him also to recognise that there is a fundamental inconsistency between the notion that we will lift those restrictions later this month and this proposal to continue the power of the Government to impose restrictions. Perhaps we should examine the possibility of an earlier closure of the powers the Government was given by the Houses of the Oireachtas.

I echo the comments regarding maternity services. It is hugely important that this is addressed because it is one of the most harrowing impacts on expectant mothers and their partners on what should be a very joyous occasion.

I thank colleagues for their comments, feedback and acknowledgement of what has been done in healthcare in the past year and a half. We all know that the healthcare system in Ireland, and I have been involved in healthcare systems abroad, is under constant attack and criticism. We all know that when things go wrong in healthcare, it is the most serious situation we can have. I know from my current role and my previous jobs that it can be very demoralising for those working in healthcare - in a department of health, the HSE or the NHS - to be criticised again and again. If we were to look at the public narrative around the world - it is not unique to Ireland - we would be forgiven for thinking nothing good happens in healthcare systems. I really welcome the comments from colleagues acknowledging our healthcare workers; not just front-line workers but also managers including directors of nursing, directors of medicine, managers of hospitals and civil servants. My view, which I think is shared by everyone else, is that over the past year and a half, those working across the healthcare family have demonstrated the very best of our nation. It has been really tough for them. They have had a brutal year and a half. Many of them are traumatised by it and it is great to hear an acknowledgement from the Oireachtas of what they have managed to do in the middle of the biggest health crisis in 100 years.

Regarding the motion, they are extraordinary powers but they are being extended by just 11 weeks. In answer to the question "why 11 weeks?", that was the public health advice. That was the recommendation I got from the chief medical officer. While we hope not to use these powers, we are mindful of what happened the week before Christmas when we found out about the Alpha variant and how quickly we had to move. We simply cannot legislate and implement policy in that period of time. We could not have done it last time. The ask of the House is that it would agree to that. I thank colleagues for their input, debate and support.

Regarding global justice for vaccines, it is essential that we have a global and just solution to this. I think the waiving of IP rights has merit. The analysis I have seen, which looks solid, makes the point that waiving IP rights on its own will not answer the question. These are highly sophisticated compounds that require highly sophisticated manufacturing, cold chain storage, containment and distribution and one must get it all in place. I am very happy to be able to report that Ireland recently donated a large number of vaccines to Uganda. We will be doing more and through the international mechanisms of COVAX, we will donate millions of vaccines. We should be proud European citizens on this. The EU stands out as the region that has exported out of its region way more vaccines than any other region in the world. Some parts of the world that should know better have put restrictions on exports of vaccines and the raw materials for them. I want Europe to continue to play a leading role and I want Ireland to be a leading voice in the EU on this. It is essential.

I know the next issue is not part of today's debate but as most colleagues and the Acting Chairperson have raised the question of maternity visits, I might have some leniency to discuss it. Covid has resulted in awful restrictions across the healthcare system. They have affected mums and their partners, nursing homes, hospital visits to people on bed wards and ICU. I have spoken with seasoned experienced ICU nurses who over decades have seen many people get very sick and die in intensive care and they tell me that they have been traumatised by Covid - both the viciousness of the disease and how it kills people, and the isolation of those people when they are so sick and trying to communicate with their families on phones and iPads. It is vicious. It has been brutal for mums and partners, patients and people in nursing homes and it has been brutal in intensive care. Covid caused a horrible situation for patients and our healthcare professionals supporting those patients. That is true in maternity services and across healthcare. I acknowledge the men and women who have come to Leinster House today to have their voices heard and I acknowledge their passion, frustration and anger.

No woman in this country should be asked to deal with pregnancy loss alone. The brutal reality is that women have been asked to do that because of Covid. The question is what are we doing about it. I have worked very closely with the HSE and Department of Health on this. We established four criteria that had to be met. As we pushed successfully back against Covid and the vaccine programme took hold, we moved from four to eight criteria. We then moved from those eight criteria to much more comprehensive guidelines.

The HPSC guidelines were updated at the start of September. The guidance facilitates access for support partners when women are attending for antenatal care, during the period of labour and childbirth and during postnatal care. It includes, critically, antenatal appointments for 12-week scans and 20-week scans and unscheduled attendances. It also includes a minimum of two hours access for partners per day where the woman is in a multi-bed room. If she is in a single occupancy room, the HPSC guidelines say that there is no time restriction. They are the guidelines, and more detail on the guidelines is available online on the HSE website.

There is a point on which we have to be very clear, namely that the safety concerns being raised by our clinicians are real and very present in maternity care today. I would like to share with colleagues one piece of data that emphasises how important it is that we are careful around maternity care. Pregnant women reflect 1% of the population. Believe it or not, pregnant women represent 8% to 10% of those with Covid in ICU. Let us think about the implications of that. Our clinicians have acted to try to protect mums and babies. We have to find a way to make access as full and complete as possible while protecting mums and babies.

I sought an update on this. As of yesterday, the HSE has advised that hospitals are broadly compliant with the current guidelines. We must always keep pushing on those guidelines to make them more and more open. Seventeen of the 19 units are being reported to the Department as being fully compliant. Two hospitals - St. Luke's in Kilkenny and Mullingar - are non-compliant. St. Luke's is non-compliant for high-risk emergency presentations. Mullingar is non-compliant for high-risk emergency presentations as well, but it is noted that following a clinical assessment on a case-by-case basis attendance is facilitated where it can be determined by the clinical team.

I wrote to the board and chief executive of the HSE yesterday and today to state that we must have full compliance and ongoing and very clear monitoring of that compliance, and where there is non-compliance we must understand exactly what the local reason for that is and do everything we can to support the maternity hospital or unit in addressing that issue. However, I have gone further. I believe that the women and men outside have experienced very real and traumatic experiences.

It is very easy for people to say that there are guidelines in place and compliance is being monitored. That is not enough. This morning I wrote to the chief executive of the HSE and board of the HSE to ask for a mechanism to be put in place immediately that would facilitate mums and partners who find themselves denied the access that is contained in the guidelines to contact the HSE to ask why access is being refused and to ask that it be followed up on. I want reassurance that if there is non-compliance, it is for a legitimate local clinical reason. If there is not a legitimate local clinical reason, we need to know about that so we can intervene.

I can assure the House and, more importantly, the men and women who have come to Leinster House today that we are taking this seriously and will always put safety of mums and babies first. Obviously, in a global pandemic that is priority number one. Once that is addressed to the satisfaction of the clinical experts, all other restrictions need to be removed.

A lot of the restrictions that are causing real frustration have nothing to do with Covid. They have to do with historical underinvestment in women's healthcare and maternity care in this country. A really good maternity strategy was introduced by the previous Government in 2016, the national maternity strategy. It puts choice for women right at the centre. If they want specialist obstetric care, they can choose that. If they want midwifery-led care, they can choose that. If they want a hybrid between the two, they can choose that.

This year, for the first time, that maternity strategy has been fully funded. I have been in maternity units and have spoken to caregivers who have talked to me about the benefits and increased choice that is beginning to happen for women. I cannot commit to next year yet because the budget has not been agreed and signed off on, but I am again looking for considerable funding to continue the roll-out of maternity care. That is not enough because the facilities are not fit for purpose.

I do not believe it is a coincidence that some of the oldest hospitals are maternity hospitals. I honestly believe that if men had babies, all of these hospitals would look like the Blackrock Clinic, the Hermitage or some very fancy place. They do not. The Rotunda is 250 years old. Stand-alone maternity hospitals and maternity units need a level of investment they have never had, and that is something I, as Minister, am determined that we are going to see. I am determined that we are going to build a state-of-the-art national maternity hospital that can provide the care and experience that mums deserve and that our clinicians deserve to work in. Ultimately, that capital investment and increase in facilities is what will allow things like single-room occupancy and unrestricted visiting for partners.

I thank the Minister for addressing the broader issues raised during the debate.

Question put:
The Seanad divided: Tá, 25; Níl, 5.

  • Ahearn, Garret.
  • Blaney, Niall.
  • Buttimer, Jerry.
  • Byrne, Malcolm.
  • Byrne, Maria.
  • Carrigy, Micheál.
  • Casey, Pat.
  • Cassells, Shane.
  • Conway, Martin.
  • Crowe, Ollie.
  • Cummins, John.
  • Currie, Emer.
  • Daly, Paul.
  • Davitt, Aidan.
  • Dolan, Aisling.
  • Gallagher, Robbie.
  • Garvey, Róisín.
  • Kyne, Seán.
  • Lombard, Tim.
  • Martin, Vincent P.
  • McGahon, John.
  • O'Loughlin, Fiona.
  • O'Reilly, Pauline.
  • Sherlock, Marie.
  • Ward, Barry.

Níl

  • Black, Frances.
  • Boylan, Lynn.
  • Gavan, Paul.
  • Keogan, Sharon.
  • Ó Donnghaile, Niall.
Tellers: Tá, Senators Robbie Gallagher and Seán Kyne; Níl, Senators Niall Ó Donnghaile and Paul Gavan.
Question declared carried.
Sitting suspended at 2.33 p.m. and resumed at 3.34 p.m.