Tuesday, 13 July 2021

Ceisteanna (36)

Mattie McGrath


36. Deputy Mattie McGrath asked the Minister for Health if he will initiate an immediate public enquiry into the handling of Covid-19 by the Government and NPHET, including an immediate investigation into the nursing home deaths; if there will be an independent external audit of the advice from NPHET and its modelling by an external team of auditors who are not otherwise engaged by the State; the rationale for Ireland’s position as an outlier in Europe in the context of the level of restrictions on hospitality and antigen testing here; and if he will make a statement on the matter. [38064/21]

Amharc ar fhreagra

Freagraí ó Béal (8 píosaí cainte) (Ceist ar Health)

I ask the Minister for Health if he will initiate an immediate public inquiry into the handling by the Government and NPHET of Covid-19, including an immediate investigation into nursing home deaths. Will he commit to an independent external audit of NPHET's advice and modelling by auditors not otherwise engaged with the State? Will he explain and justify Ireland's position as an outlier in Europe regarding the level of restrictions on hospitality and in the use of antigen testing?

I thank the Deputy for the question. It is fair to say that Covid-19 has had a devastating effect and caused huge difficulty for everyone in Ireland. That is especially true for people in nursing homes and their families, who have suffered huge hardship, as well as staff. The Department of Health is exploring ways to ensure their voices are heard.

It must be recognised that the pandemic has not concluded and at this time the priority focus of the Government remains on the ongoing management of the Covid-19 response to ensure the gains we have seen are preserved and that those most vulnerable to the virus continue to be protected. NPHET and its modelling team have served us well, performing essential roles. I pay tribute to the chairs of both groups, Dr. Tony Holohan and Professor Philip Nolan, for their leadership and expertise.

Ireland's response has been robust, as is evident when one considers some of the outcomes here relative to those in many other countries.

Ireland currently has one of the lowest number of cases per capita within the EU and UK and thankfully, when this is over and if things continue as is, Ireland will have one of the lowest levels of excess mortality also.

Our vaccination programme is also performing extremely well. By the end of the week the vaccination programme is expected to have administered 5 million doses, with more than 2 million adults fully vaccinated and more than 70% of the adult population having received their first dose. I am delighted to be able to share that when one considers the target population, Ireland has either the highest or one of the highest participation rates right across the board.

The Deputy raises the very important point of antigen testing. In January I established the rapid testing group chaired by Professor Mark Ferguson. More recently I have established an expert advisory group on rapid testing, chaired by Professor Mary Horgan, to support the roll-out of rapid testing right across sectors in the country.

I commend and thank the front-line staff, the nursing staff and their attendants.

The independent investigation I seek should include a cost-benefit analysis of the Government-imposed lockdowns to date. For instance, the overall costs of the lockdowns must include delayed diagnoses and missed diagnoses, the effects on mental health and other health-related services, together with the economic and community impact versus the benefits derived from the longest-ever lockdown in Ireland.

Ireland has had the longest lockdown in the world and the second highest rate of nursing home deaths, which is so sad. Aon death amháin is one too many in any situation, but these were in nursing homes. Of these deaths, we know that 50% of the people who died were infected in 575 nursing home buildings and 15% of the deaths were due to people being infected in 86 hospital buildings. This is what I am coming at. I put it to the Minister that people go to those trusted institutions for care and protection and to the hospitals to get better, not to pick up an infection. We need a thorough external and independent investigation to find out where the mistakes were made and if we can be ready in the future to avoid something like this.

It sounds like the Deputy and I agree that everything that can be done to protect people in the nursing homes and right across the residential care sector must be done.

The Deputy will be aware that an expert nursing home group was brought together. They did a huge amount of work and produced a comprehensive report. Critically, an implementation group was put together because the Minister of State, Deputy Butler, and I wanted to make sure that this was not just a report that sat on a shelf. An awful lot of work has been done. HIQA and the HSE have been involved. As the Deputy is aware, the Defence Forces were at times brought in to help out as well. The Minister of State, Deputy Butler, and I will shortly bring forward quite ground-breaking legislation on the regulation of the nursing home sector and home care more generally. I share the Deputy's view that everything that can be done must be done for people in the nursing home sector and in home care.

I put it to the Minister that of the approximately 5,000 Covid deaths in Ireland, 40% of them occurred in nursing homes. Internationally, the Republic of Ireland has the second worst rate of nursing home deaths in the world after Canada. As society returns to normal, this issue must be addressed to bring release for the many families who have lost loved ones in the most tragic and traumatic of circumstances over the past 15 months. They must get answers. I am aware that a number of court case challenges are coming up in this regard. I have spoken with and met nursing home staff and I have visited one or two homes by invitation. They allege that they were literally left without personal protective equipment and in some cases were left without oxygen, which they allege was taken away by the HSE. This is shocking. We must examine this fully. I do not want an internal investigation. We must have an external, inward-looking investigation that has no commitments to any sectors in Ireland. It must be open, honest and transparent to find out if we can learn from the huge mistakes and the lack of readiness and preparedness for any kind of a pandemic. We must learn from the mistakes.

We absolutely have to learn from what happened. Some things were done well but undoubtedly there will have been mistakes made. I assure the Deputy that a constant review has been ongoing for a long time. The Minister of State, Deputy Butler, and I have had numerous meetings with the Department, with the HSE and with HIQA to be able to go through it, nursing home by nursing home, around the country, identifying those nursing homes that are most at risk.

Who will do it?

HIQA in the first instance. As for how it works, HIQA does a very thorough examination right across the sector and then identifies specific challenges that individual nursing homes may have. They engage with the HSE and the Department to make sure that the supports are put in place. While I hear clearly what the Deputy is asking, I wish to assure him, as well as those people in the nursing home sector and their families, that this is not something new. We have constantly been reviewing, revising and learning and putting in place more and more safeguards right the way through this pandemic.