Alan Kelly
Question:1. Deputy Alan Kelly asked the Taoiseach if he will report on the work of the Cabinet committee on Government co-ordination. [36605/20]
View answerTuesday, 1 December 2020
Questions (1, 2, 3)
Richard Boyd Barrett
Question:2. Deputy Richard Boyd Barrett asked the Taoiseach if he will report on the work of the Cabinet committee on Government co-ordination. [38635/20]
View answer
Mary Lou McDonald
Question:3. Deputy Mary Lou McDonald asked the Taoiseach if he will report on the work of the Cabinet committee on Government co-ordination. [39895/20]
View answerOral answers (7 contributions)
I propose to take Questions Nos. 1 to 3, inclusive, together.
The Government co-ordination committee was established by the Government to review the activity of Cabinet committees, review the agenda for that week's Government meeting, discuss political priorities and review implementation of a specified element of the programme for Government. The committee meets in advance of Government meetings. I am a member of the committee, which I chair, along with the Tánaiste, Deputy Varadkar, and the leader of the Green Party, Deputy Eamon Ryan. The Secretary General to the Government, my chief of staff and the chiefs of staff for the Tánaiste and the leader of the Green Party also sit in on meetings.
On Leaders' Questions, I raised with the Taoiseach the issue of what we will do regarding vaccines. I raised it in a non-political way and I hope the Taoiseach appreciates that. I think the people the Taoiseach referenced earlier are very eminent people, all of whom will make a significant contribution. However, I have a serious concern about co-ordination. I have a serious concern about leaving it to the current structures of the agencies we have and their capacity for the most important thing facing us as a country.
When it comes to the Cabinet committee on Government co-ordination, we now have a task force and a Cabinet subcommittee. The reality is that somebody needs to be in charge of vaccine roll-out. Somebody needs to be in charge of rules by which each and every agency and organisation act. It is not a case of whether Martin Shanahan of the IDA, who is an excellent chief executive, is responsible to his parent Department or to a task force. That cannot be the issue. They cannot be second-guessed. They have to know that they are putting aside whatever they are doing or their priorities in order to deal with this issue and that accountability is linear up to the Government. I genuinely do not mean that in a political sense. The Taoiseach does not have time to do this as well dealing with all the rest of us in here. We need one person to be responsible for this and to sit at the Cabinet table. It will probably only be for a year. I really urge the Taoiseach to reconsider this. In fact, that is not right. I am just asking him to consider it because, in fairness, he cannot reconsider it until it has been considered.
I am asking the Taoiseach to take up my suggestion because logistics will be a massive issue. The rules around who will get what and when will be a massive issue. I refer to the whole issue about mandatory versus non-mandatory. For instance, if vaccination is not mandatory, will people who do not get vaccinated be allowed into public events or public spaces as we open up the country? How would one have rules around that? I cannot even imagine it. I refer to the whole issue relating to ICT. What is going to be done about passports? I have had a number of Covid tests. I have seen passport technology and how it goes on one's phone. There will be a need for rules around how long that lasts.
The actual work of this committee is not just going to be for the roll-out and then everyone gets vaccinated and we are all happy. There are legacy issues that will have to be politically managed. We need somebody at Cabinet who will say "I am in charge. This is my job. This is my role." That person will be doing the State a serious service and will report to the Taoiseach and at Cabinet.
I know what is going on in other jurisdictions. I think the UK has been miles behind anything we have done on this issue since last February or March, but it has done this. I think it is right on this singular issue. I appreciate all the work that is going on with regard to vaccines, the number of vaccines coming through, all the work liaising with the Taoiseach's European colleagues and everything that is going to be done there. I understand all of it. I take an intense interest in detail on this.
I come from an IT background. There is a significant amount of logistics in terms of dealing with this issue. A significant amount of analysis will have to be done through a health passport. That will have to be done using PPS numbers and will have to take in a whole load of various other aspects and nominate by field with regard to people with various vulnerabilities. There is a range of other information.
This issue needs co-ordination. There is a co-ordination group in place. Its chairman is an eminent person. I have dealt with him in the past, both in government and in opposition, and he is well capable of this. However, there needs to be somebody who is politically over all this and all the agencies and groups and who will not be second-guessing in the context of their other work which obviously they have to do as well. I actually plead with the Taoiseach to do this.
To be helpful to Deputy Kelly, I think one answer to how we deal with the vaccination roll-out is to have our public health teams at a level such that they are capable-----
I agree with that.
They are the people who deliver immunisation programmes. As I mentioned to the Taoiseach on Leaders' Questions, they are taking industrial action. At a time when they have never proven their value to society more, they are being forced to take industrial action because the Government has shown them zero respect in terms of their status and giving them status as consultant specialists, but also in the fact that we have one third of the recommended public health staffing complement. How on earth are they supposed to deliver a vaccination programme as well as the contact tracing and testing that is necessary? To my mind, that is sort of indicative of the wider need for co-ordination in order that the left hand knows what the right hand is doing and they have joined-up priorities.
Last week, I raised with the Taoiseach the issue of graduate entry medical students at a time when we desperately need more doctors, such as for our public health teams. I met them last week. They are paying €15,000 in fees. They cannot manage it and are all saying they may have to drop out and so on. They are experiencing major financial difficulties at a time when the State should be assisting them to qualify so that we have more doctors.
I raised a similar issue with regard to student nurses and midwives. The Taoiseach did not really respond on this issue. When I met several hundred of them in an online meeting last week, one after another, the student nurses and midwives who we need and have been holding together the front line said they would not work for the HSE in a blue fit once they are qualified because it is treating them so badly. They said they will be leaving as soon as they are qualified.
The State is haemorrhaging the nurses, midwives and doctors it needs because it is treating them so badly. When will there be a moment of enlightenment, as we face a pandemic, when it becomes obvious we need more health professionals, including more doctors, nurses and midwives? When will there be joined-up thinking and a realisation that we should stop putting obstacles in the way of these people actually training, completing their education and then wanting to work in our public health services? That is the sort of co-ordination that I think is very sadly missing at a time when we need it most.
As the Taoiseach is aware, responsibilities for domestic violence supports and services are spread across multiple Departments and State agencies. Safe Ireland has called for the urgent roll-out of a funded national service development plan as the start of a comprehensive and long-term response to the enormous everyday problem of domestic violence. Domestic and gender-based violence services are to be commended for developing a structure within which they work together to share experience and develop policy, but it is clear that the disjointed provision of these services is failing victims and their children. I previously raised with the Taoiseach the issue of the lack of refuge places.
I have called for a Government strategy to deliver additional refuge places with trauma-informed wrap-around supports and services. Ireland is currently failing to meet its legal obligations under the Istanbul Convention regarding the provision of domestic violence refuge places, and no additional funding has been providing in next year's budget to remedy the situation. Worse still, the Minister has confirmed that no single Department or agency is responsible for ensuring Ireland meets its legal obligations in this regard. It is my strong view that this perennial challenge to front-line service provision will not be addressed until such time as the Government commits to a national service development plan, as called for by Safe Ireland. Implementation of this plan should be overseen by the Department of An Taoiseach, working with the coalition partners to ensure there is a cohesive and comprehensive policy and service delivery response for victims and their children.
Regarding Deputy Kelly's question, I said to him earlier that I appreciate the constructive way in which the question was put. I established a task force and asked my Department to co-ordinate its work in order to give a sense of the national priority that attaches to what will be a very significant logistical undertaking in regard to the procurement, storage and distribution of the vaccine, and IT infrastructure to back that up, and proper protocols around the administering of the vaccine, including deciding, in the first instance, who will administer it - it could very well necessitate additional personnel, over and above GPs, given the scale of the undertaking - and also the prioritisation of who receives the vaccines and the sequence of that. To be fair, there are structures already in place in the Department of Health around immunisation and we already have people with considerable experience in this area, including the national immunisation advisory committee. The HSE will be the operational delivery arm of all of this. Already, four significant streams of work have been established, covering the areas I have identified. A key additional piece would be on communications around the vaccination programme itself and the value and importance of vaccines in dealing with viruses of this nature.
That said, I will reflect on what the Deputy said. Those on the task force are well aware that it was established by the Taoiseach, will have to report back to the Taoiseach and we want to keep it at that level in terms of making sure it gets prioritisation across Government and across the different agencies. The Department of Health and the HSE will play a key role in the health dimension of this but will draw upon expertise in other Departments and from the private sector in terms of the logistics side and ensuring we can get the vaccines rolled out as safely and efficiently as we possibly can as they come on stream, if they get authorisation from the various authorising bodies. The Deputy's suggestion is that a Minister or Minister of State be put in charge of delivery of all of that. As I have outlined, it is being co-ordinated by my Department and that will continue. However, I will give consideration to what the Deputy said.
Regarding Deputy Boyd Barrett's point, I already said that the Minister for Health, Deputy Stephen Donnelly, who is in office some five months, has secured significant resources to transform public health. That is known and the funding has been secured. The Minister announced plans in September to double the workforce in public health. It is currently at approximately 254 people and the plan is to double that. The hiring process has already begun. The Minister, the Department and the Government have been very clear in their support for the creation of consultant posts in public health medicine. I do not agree that now is the time for strike action, in the middle of a global pandemic. I believe the issue can be resolved through ongoing talks and engagement with the Irish Medical Organisation, IMO, under the public service stability agreement. That is the forum for resolving these issues.
The creation of consultant-level posts and roles in public health medicine is a priority for the Government and we are fully committed to delivering on it. Obviously, much detailed work goes into that, as everybody knows. The HSE has put a substantial amount of work into it and the Department of Health has developed a detailed framework for the future public health model that includes consultant-level roles. The business plan seeking consultant status was submitted last week to the Department of Public Expenditure and Reform for consideration. That will be the basis for the engagement with the IMO on the matter. People in the public health arena are aware that this kind of progress has been made. There is a process that has to be followed. We believe in a consultant role but how that all works out and how people apply for the roles and posts that will be created is the type of detail that needs to be worked out with all concerned.
Regarding Deputy McDonald's questions, we dealt with this issue last week. I agree with her on the need to provide additional resources for more refuge places and to deal with domestic violence on a co-ordinated basis. The Minister for Justice, Deputy McEntee, has been proactive, and remains proactive, in this regard. She is committed to expanding services and dealing with issues that have arisen and have been brought to her attention.