Peadar Tóibín
Ceist:8. Deputy Peadar Tóibín asked the Taoiseach when the terms of reference for the inquiry into Covid-19 in Ireland will be produced. [55131/23]
Amharc ar fhreagraTuesday, 23 January 2024
Ceisteanna (8, 9, 10)
Mary Lou McDonald
Ceist:9. Deputy Mary Lou McDonald asked the Taoiseach when the terms of reference for the inquiry into Covid-19 in Ireland will be produced. [56544/23]
Amharc ar fhreagraPeadar Tóibín
Ceist:10. Deputy Peadar Tóibín asked the Taoiseach his views on the need for an inquiry into the handling of the Covid-19 pandemic in Ireland. [2773/24]
Amharc ar fhreagraFreagraí ó Béal (16 píosaí cainte)
I propose to take Questions Nos. 8 to 10, inclusive, together.
A comprehensive evaluation of how the country managed Covid-19 will provide an opportunity to learn lessons from our experiences in dealing with the pandemic. It will include a review of the whole-of-government response to the pandemic and how we might do better and be in a stronger position if another pandemic or other similar event were to occur. It will include a consideration of the health service response, covering hospitals, the community and nursing homes, along with the wider economic and social response.
It is intended to have a public element to hear the lived experiences of all of society. The review should be undertaken by those independent of the national response and with relevant expertise. A consultation with Opposition parties has been scheduled for this week and I intend to bring the terms of reference to Government shortly thereafter.
I have received some incredible answers from different Ministers to parliamentary questions in respect of what happened during Covid. The Minister for Health confirmed to me that there were 10% fewer cancers diagnosed in 2020 than would have been expected for that year by the National Cancer Registry Ireland. That is an alarming revelation. In 2020, 60,000 fewer women were screened by CervicalCheck than were screened in the previous year. This is because the Government in part shut down cancer screening. There were 30% fewer women diagnosed with cancer of the cervix in 2020 compared with 2019.
Aontú was the only political party in the Dáil at the time pushing back against the policy of the Government to reduce cancer services. During that time, Ireland was the only country in the whole of Europe to shut down the building of homes. In terms of child experiences in this country, there has been an enormous spike in the number of children who have been referred to the likes of Tusla and to State care in the past couple of years. People within that sector have told me there is absolutely no doubt that the actions taken by the Government in the context of how children were treated during Covid have left children in a very precarious situation.
Any time the Government refers to its review or investigation into the Covid time, the first thing it talks about is the need to avoid a blame game. It sounds like the Government is using language of trying to prevent accountability in that regard. We need a proper open public investigation into the decisions that were made and the outcomes they had on people. People suffered significantly from many of the decisions, some of which were not based on science relating to protection of people.
The Covid-19 pandemic was a worldwide catastrophe that no one could have anticipated. It brought worry, isolation and loss that will stay with us for some time to come. Some families will never recover. Some lost their loved ones who lay stranded in a nursing home and had to say goodbye through a window or over the phone. It was a cruel and hard time. Most of us rallied and it brought out the best of us. Front-line workers rose to the challenge in a magnificent way. Teachers pivoted to online classrooms and neighbours minded each other. Now we need to take the learning from what was a desperately dark time.
Nearly 12 months ago, Mary Lou McDonald and David Cullinane wrote to the Taoiseach asking for the terms of reference of a Covid inquiry. They heard nothing in response. A meeting with Opposition leaders in December was cancelled. Finally, a meeting is to happen later this week. The Taoiseach has committed to engaging not only with political leaders but also with those who showed bravery, steadfastness and creativity through the Covid crisis. Did he speak to Care Champions, which has been such a strong voice for those who lost family members? Did he speak to the Irish Association of Social Workers, Safeguarding Ireland and representatives of the healthcare trade unions? They must have their say in shaping this inquiry. I have spoken before on the need for a mechanism for families who lost loved ones in places such as Dealgan House.
A Covid inquiry should not be a witch-hunt. It should acknowledge the hard decisions that had to be taken. It should be conscious and respectful of the efforts of all front-line workers and, most important, should acknowledge the trauma still felt by some.
My question is simple. Will long Covid be included in the terms of reference of the Covid inquiry? It is clearly important that if we are to come to a balanced assessment of mistakes that were made and so on, we do not look just at the short term but also at the long-term implications for hundreds of thousands of people, such as illness, isolation and inability to work. In that regard, the economic impacts alone are severe.
According to the World Health Organization, one in ten Covid infections results in long Covid. There are 350,000 people in Ireland suffering from long Covid. The Government has utterly failed to organise proper healthcare services for long Covid, such as basic training for GPs to properly diagnose and manage it. It is not recognised as a disability for the purposes of social welfare.
The Government continues to fail to warn the public about the ongoing dangers of contracting Covid through a public information campaign. Again, Taoiseach, it is a very simple question. Will long Covid be included in the terms of reference of the inquiry?
Some 24 residents died in a 51-bed nursing home at Ballynoe in Cork during the Covid emergency. They were just some of the more than 1,500 people who died in nursing homes during those times. Families and loved ones have many questions they want answered about the care that was and, in some cases, was not given in the homes. Ireland's Covid inquiry is due to be set up in the near future. Majella Beattie of Care Champions told Shannonside radio that older people and people in care were often seen through a medical lens rather than being seen as human beings with thoughts and being able to make choice and having human rights. They were never given that. Where rights were given in other countries, we continued with extreme restrictions on older people. Care Champions are calling for a human rights expert to be on the panel that looks at what happened in our nursing homes and how we go forward from here. Will the Taoiseach agree to this request?
There are a lot of issues that will have to be dealt with in the Covid inquiry but certain things are beyond question. The Irish health service is operating at near 100% capacity. Most countries in Europe operate at about 80% to 85%. If we are hit with further public health emergencies or major accidents, unless we have a buffer within our health system, which means additional capacity so we are not tipping over the edge of the ability of our system to cope on a day-to-day basis, we will be in very serious trouble. All the hardships we saw during Covid could be seen again. What is the Government going to do to ensure that we get ICU capacity at the same levels as the rest of the European Union when it is well below? Is it not time to recognise that having a fragmented, half privatised system is not the way to maximise the capacity that we have in our health service? We need an integrated national, publicly owned and run health service rather than the partially privatised and fragmented system that we have. Considering that staff are the key to increasing capacity, is it not very counter-productive that the Government is holding out on giving public service workers, including nurses and other health workers, a decent pay increase to entice them to stay and work in this country and in our health service? Many of them are leaving because their pay, their income, as the Taoiseach referred to earlier, is insufficient to give them a decent standard of life or for them to be able to afford accommodation in this country.
On Deputy Tóibín's questions, look, I was there in government both as Taoiseach and Tánaiste for that very dark period which was the pandemic. These were very difficult decisions to make. Everyone can be an expert in hindsight. We can only make decisions based on the information available and the advice that was put to us by experts. I have no doubt that the lockdowns saved lives. I am absolutely certain that the vaccine programme saved a lot of lives. We see that from the most recent OECD report, which shows that Ireland is one of only a handful of countries in which there were no excess deaths during that period, with only New Zealand, Iceland and Norway outperforming us. Of course the lockdowns had negative effects. I was among many people in government who were very clear about my concerns about the negative effects of lockdowns, not just on people's jobs and businesses but also delayed and deferred diagnoses, which the Deputy raised, which did happen. In housing construction we lost thousands of houses because of the housing construction lockdown.
The only country in Europe.
Even for something like Garda numbers, if we had not closed Templemore there would be 1,000 more gardaí today. These things have real consequences but they were difficult decisions. It was never a case of choosing between the right option and the wrong option. It was choosing between options A, B and C, all of which had pros and cons.
We were an outlier.
Often those decisions were finely balanced. The public health advice more often than not was for deeper, longer, stricter lockdowns. That was often the view of the Opposition, too, indeed some even flirted with the bizarre zero Covid policy which has proven to be among the worst options when we see the effects that occurred, or certainly not a sustainable option as it was abandoned by all the countries that attempted it.
In respect of Deputy Ó Murchú's questions about the terms of reference of the Covid inquiry, I am going to consult with Opposition leaders this week. I had hoped to do so in December but my diary just was not able to do it because of the amount of other obligations I have, particularly in relation to foreign travel. I hope that can go ahead this week. We will share the draft terms of reference with Opposition parties and discuss their views on the composition of them. Unfortunately I am not going to be in a position to engage personally with all of the different individual groups and stakeholders. We would never get this commission up and running. If it was possible to schedule that many meetings I would but I just cannot. We will find a mechanism to consult interested groups and stakeholders.
On health service capacity, I agree that our health service needs more capacity, not least because of our rising population, our aging population and the development of new treatments. What Deputy Boyd Barrett did not acknowledge is that this is exactly what this Government has been doing since 2020, in the three or four years since we have been in office. We have 20,000 more staff in our health service now than we had in 2020. Yes, there are people leaving but there are way more people joining, 20,000 more in fact. We have 1,000 more consultants than we had in 2020. We have 1,000 more hospital beds than we had in 2020. We have more ICU beds and the Deputy is right that we are going to need a lot more. In terms of nurses we are now in the top five in the western world when it comes to practising nurses per head, even higher when it is practising nurses per bed. For the first time that I can remember, in the most recent statistics we are now around average in terms of the number of doctors that we have. We had been below average previously. There have been pay increases and we are in negotiations with public service unions about further pay increases. We would have liked to have that agreed back in October or November but it has not been possible. I do think that the utopian system, or perhaps the ideal system, to be fair, that Deputy Boyd Barrett describes sounds very like the NHS. It might have been a model that would have worked 50 or 100 years ago but it does not work in the modern world. What do we see in the NHS? We see longer waiting lists and waiting times for patients, lower life expectancy, worse outcomes when it comes to stroke and heart attack and lower pay for the staff.
That is because they ripped it apart.
That is definitely not a model that we will be following. In the election we will be encouraging people not to vote for Sinn Féin or for left wing parties precisely because that is what they want to do in Ireland. It is not a good thing.
On long Covid, early in the pandemic the HSE identified a need for a national service for long Covid and to set up a multidisciplinary team to develop a model of care under the auspices of the chief clinical officer. The model of care is now being implemented building on existing service provision in addition to establishing new services across GP and community services and acute hospitals, to ensure a national service is in place for those who need it. Funding for the model of care has been increased to €6.6 million this year. At present there are six long Covid clinics and seven post-acute Covid clinics that are operating nationally. The clinics currently operate at St. Vincent's and Beaumont and the post-acute Covid clinics operating under the new model of care will be in the Mater and Connolly Hospital in Blanchardstown. In addition, Tallaght, St. James's Hospital, CUH, UHG and Limerick hospitals are operating combined post-acute and long Covid clinics. The HSE is working with Letterkenny to have a more definitive timeline around their anticipated launch date. Recruitment, which includes consultants in the areas of infectious disease, respiratory medicine, psychiatry, neurology and allied health professionals, clinical psychologists and administrators, is under way. To date 66 WTE primary notification numbers have been issued across all of the post-acute and long Covid clinics. As of 8 September last year, 46 whole-time equivalent posts had been followed. Deputies will appreciate that long Covid is an emerging area of medicine and expertise. There is still so much that we do not know about it.
And the human rights expert?
I will be consulting with the Opposition parties on Thursday and am happy to go through it all then.
I would have thought you might have a view on it, but anyway.