We note from the number of clusters and deaths from Covid-19 in the nursing home sector just how exposed that sector was and the tragic consequences that followed from that exposure.

At the height of the crisis, the sector's lack of preparedness was raised in the House on numerous occasions. We heard concerns raised by Nursing Home Ireland as early as the beginning of March, including concerns about safe and appropriate discharges from acute hospitals to nursing homes, about staff being recruited into the health service at the expense of the nursing home sector raising the risk that it would endanger older people, concerns about PPE, testing and so on. More information came into the public domain yesterday in The Irish Times as a result of a freedom of information request. We learned that senior HSE officials privately raised major concern about coronavirus hitting nursing homes in March with one flagging their “totally inadequate preparation” and another saying it could be “the biggest live risk” facing the health service. We learned that agency staff were being supplied to nursing homes at double cost, where they were available. Safe Ireland has raised serious concerns about the care of the late Mr. Ultan Meehan, a nursing home resident from County Meath, after he was admitted to Connolly Hospital. The care home was unable to manage his care for a facial wound which became badly infected.

Will the Taoiseach commit to ensure that Mr. Meehan's wife, Mary, is given a full report? This could be undertaken by the Health Information and Quality Authority, HIQA, or the expert panel. The previous Minister for Health, Deputy Harris, established a Covid committee - an expert panel - to investigate the nursing home sector on 23 May. This expert panel was supposed to report by the end of June. Has it reported and, if not, when is this likely to happen? The temporary assistance payment scheme to nursing homes was amended by the Minister for Health last week. It reduces the overall amount. Is that because of an income-related reason? Is it funding or was there another rationale? If there is a rationale, will the Taoiseach provide it to the Dáil? Does he believe that clinical governance should remain the responsibility of the nursing home sector? If not, who should have responsibility and how quickly can it be put in place?

In Opposition, the Taoiseach was one of those who raised concerns about the nursing home sector. How concerned is he now about what is emerging in the public domain about the sector and how exposed it was? How satisfied is he that on his watch, the sector is fully prepared should there be another outbreak?

I empathise with much of the Deputy's comments about the challenges that faced the nursing home sector at the outset of Covid-19. I do not believe it was adequately prepared at that time to cope with the pandemic. Much has been learned since. The expert panel has been set up by the previous Minister and I understand it should report within the next fortnight. It will be an important basis on which to evaluate policy in the next number of months. There is comprehensive testing in nursing homes now. In one nursing home, five people have the virus who are asymptomatic. That illustrates how even now, with the suppression of the virus, the challenges clearly still there in the sector.

On clinical governance, I will be guided by the report of the expert panel, however we have learned enough from the experience during the pandemic to accept that changes must take place around governance in the nursing home sector, particularly on the clinical side. Stronger clinical oversight will be required.

That is my view on that.

I am also very concerned about the case that has been raised of Mary Bartley Meehan. HIQA is the regulating authority for the nursing home sector and Ms Bartley Meehan is entitled, at the very least, to a report, and from what I have read of the case, it should be reviewed. I have sought from the Department of Health a further update on this particular case. It is very worrying indeed as to Ms Bartley Meehan’s own experiences when she visited, where she lost both her son, Adrian, and her husband. It is a very traumatic and shocking situation which deserves a comprehensive and full response for Mary Bartley Meehan herself and her family, and that should be done.

As to future preparation and preparedness for any resurgence in the virus, the testing exercise that is under way is something I take solace from in the sense that we desire the HSE and the public health authorities to be on top of this in the nursing home sector to ensure that it is not caught off guard as perhaps it was at the outset of the Covid-19 virus outbreak, which was an unprecedented global pandemic. At the beginning all concern was around the acute hospital side and the nursing home side received attention somewhat later.

I take it then that the Taoiseach will be talking to HIQA to ensure that that report is done and will be produced for that tragic case.

The Taoiseach did not address the issue of the reduction of funding. Will he address that in his response, and if there is a report or evaluation, that that will be provided to the Dáil?

Is the Taoiseach surprised about the kind of warnings that were coming from senior officials in the HSE who had a responsibility? Very serious concerns were raised. Is he concerned that they did not come into play earlier, because they were being raised at the beginning of March? Some of these concerns, including those from Nursing Home Ireland, were being raised at the same time that NPHET was saying that there was not a requirement to isolate nursing homes from visitors. It was at a very early stage. Does that surprise the Taoiseach? This has been raised. We all felt that we were a bit dismissed when we raised the issue about what we were seeing in nursing homes. Will those concerns in particular be looked at by the expert committee?

On the specific response to the issue of the temporary assistance payment and the funding issue, we have to accept that when a global pandemic of this scale emerges, which is once in a hundred years, lessons have to be learned from it. There should be comprehensive reviews of everything that took place, but with a view to learning lessons and not trying to damn people or apportion particular blame. The exercise has to be about learning lessons, because if it happens again, we need to be able to respond better and more effectively. We do not want future public health officials or public servants hamstrung by the fact that there may be another inquiry conducted into what they are doing in the middle of a crisis.

All international responses to crises have this is a basic standard, that we look back to evaluate and learn and ensure that those lessons are applied to future pandemics and crises. That is the general philosophy and one that I would have. That said, the fact that senior people raised those concerns is a worry, although the system did respond. The biggest issue early on was personal protective equipment, PPE. Public health officials will still say that it may not necessarily have been visitors coming into the nursing homes that was the primary conduit or cause of the transmission of the virus and that there were other factors as well. The current testing is beginning to throw some light on that also at the moment.