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Dáil
‹ Ceisteanna ó Cheannairí - Leaders' Questions

Covid strategy metrics and HSE nurses

Summary

Alan Kelly welcomes the new strategy but asks for clear targets, enforcement and measurements for success. He then raises HSE staffing, questioning why full-time nurses have fallen while temporary nurses have increased; the Taoiseach says the key metric is driving R well below 1 and will check the staffing figures.

I welcome the fact that a strategy has been announced and that the Taoiseach took on board a number of the proposals the Labour Party put forward last week. We were very clear on where we thought the country needed to go, unlike some others. In regard to what was announced, we are not going to magically wake up on 1 December and see what has been delivered. We need metrics and measurements. We need the Taoiseach to say to the public what we need to achieve, what will happen if we achieve the specified measurements in regard to the R-nought rate, hospitalisations and everything else and what will take us to level 3 and level 2. It is about giving people hope, as the Taoiseach knows, in terms of Christmas and there on in. We cannot always be going between levels 2 and 5. I believe we are going to have to live with this virus and to move between one level up or one level down, but these massive changes cannot be sustained. What do we need to do to ensure we get to levels 2 and 3? Can the Government show metrics and measurements in this regard to the public?

It is appreciable that the Government has taken on Senator Moynihan's proposal on bubbles, which she has been working on for some time. However, I want clarity on the idea that we can allow individuals to come together. There are 400,000 people living alone and over 200,000 single parent families. The details on the Government's website are way too restrictive on visiting for children under 18, mental health, custody arrangements, dementia and carers. We have overcomplicated this. I know the Government has made a couple of changes to what it announced already such as for funerals, with which I agree. How can one measure whether somebody has a mental health challenge and that he or she should go into a bubble? It is not measurable. We need to make this very simple. What is the difference between somebody going into a bubble because he or she needs to do so due to a mental health challenge and somebody going into a bubble because he or she is partaking in chemotherapy? These people are both equally needy. The Government should take a line from the television show "The Cube" and simplify it. The Government is on the right track but it is a little bit too narrow and tight. This needs to be simplified. It is a very good concept, it has worked in New Zealand and Britain has adopted it as well. It deals with the issues we all know the lonely and vulnerable faced in the first lockdown. I ask the Government to look at simplifying this and allowing two people to come together for whatever reasons, rather than those reasons listed by the Government. I also ask the Taoiseach to give us some measurements and metrics on what we can achieve through yesterday's announcements by 1 December.

Comment on this

I thank the Deputy for his comments and support for the Government's decision. On the metrics, NPHET has been clear that we have to get consistently below R=1. Ideally NPHET would want us to get it to 0.5, although it would be very challenging to do so in six weeks. There are other measures that we need to get consistently going on a downward trajectory. Other factors would have to be considered as well, as is the situation within the plan. Those are the broad metrics, particularly getting the R number well below 1 and getting the trajectory going downwards. That depends on all of us working and adhering to the regulations and guidelines. It is extremely important that we do that because the reward for that is to get shops open on 1 December, get people out again and get back to level 3. That would be my objective. Level 3 is a controlling level, if properly enforced and adhered to. I am not holding up prospects beyond that. It depends on the progress we make against this virus over the next six weeks. Nonetheless, that is what is ahead of us.

I appreciate the proposal that Senator Moynihan put forward. The co-leader of the Social Democrats, Deputy Shortall, also raised this issue at our meeting last week, namely the concept of a support bubble and we have taken that on board. We have to be careful about this. Care exemptions are already available outside of the concept of the support bubble and they were always available in the context of the household rules and regulations. Beyond the care regulations, there is the situation of someone who is living alone. The overriding objective is to prevent social isolation and to enable people to have an exclusive bubble or connection with another household. I take the Deputy's point and I also want to keep it simple. I do not want to complicate it any more either. The public health officials are nervous that people may exploit this measure but that will not happen. It is a valuable addition and it is an example of learning from the first phase of the lockdown. It is an example of trying to take lessons and apply them to how we behave.

We will be dealing with the impact of this for the next 12 months, even if we get the vaccine before the end of the year.

Today the Government signed up for two more advance procurement deals with the EU and two other companies. This comes on top of the deal we signed up for with the University of Oxford and AstraZeneca, so the European Union has now signed up for three. The vaccine could come by the end of the year, but by the time it is manufactured in sufficient volumes and we have it distributed we will still be dealing with Covid-19.

Comment on this

I appreciate what the Taoiseach is saying. I believe the Government needs to simplify this, particularly if it is to bring in new regulations for An Garda Síochána, so I urge the Taoiseach to consider that.

I also wish to ask the Taoiseach a question about something I revealed yesterday. We have 200 fewer full-time nurses in the HSE than we did in December, which is incredible. How in the name of God did that happen? We have 1,800 temporary contract nurses more than we had. I am following what the Minister, Deputy Donnelly, is saying about the number of healthcare workers he will bring in, which is 1,600 by the end of next year. I remind the Taoiseach of the figures of 8,500 by the end of this year and 12,500 by the end of the winter plan in April. Nobody watching these proceedings and no one here believes that is achievable, given the track record I have just outlined, so what will the Taoiseach change to ensure we can get more permanent nurses, who are so badly needed, into the system? Will he once and for all ensure that the exploitation of student nurses ends now? It is utterly wrong. For his information, on the HSE website, as of an hour ago, there were 70 advertisements for nursing, three of them in the community care area and only two for more than one nurse in any setting, so it does not look in any way as if there is any hope of achieving those numbers.

Comment on this

I will engage with Deputy Kelly, the Minister for Health and others on Deputy Kelly's ideas about the bubble and with other Members of the House on how it can be, in the Deputy's words, simplified, particularly in respect of subsequent adherence and enforcement. However, it is not really a measure that one would enforce; rather, it is a measure one would want to make sure is useful for the correct purposes.

I will have to check those recruitment figures with the Deputy and I will talk to the HSE. There can be statistics, statistics and damned statistics, suffice to say-----

Comment on this

The figures came in an answer to a parliamentary question. They are HSE figures.

Comment on this

-----there is no shortage of resources being given to the health service and the HSE right now to expand numbers and deliver over 1,200 acute hospital beds for next year in community, rehabilitation, acute - right across the board. The recruitment will continue. Another challenge, as we recruit into the HSE system, is to make sure that nursing homes and so on do not come under pressure as a result of that recruitment effort. That is an important issue that we have to keep an eye on.

Comment on this