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Dáil
‹ Ceisteanna ó Cheannairí - Leaders' Questions

Zero Covid strategy

Summary

Deputy Boyd Barrett criticises the Government’s rejection of public health advice and argues for an elimination strategy. The Taoiseach rejects zero Covid as unworkable given EU membership, the Border, and the situation in Northern Ireland, and says Ireland has performed well in the second wave.

People Before Profit has been unique, clear and consistent in arguing that to deal with Covid-19 we need a strategy to eliminate community transmission, so we can avoid a constant cycle of going in and out of one lockdown after another, which is what we believe the Government's strategy is inevitably going to result in. We think the Government is wrong to ignore critical parts of the advice given by the public health experts in their letter of 26 November. In rejecting some of their key advice, in particular around the reopening of the hospitality sector, the Government in fact is endangering Christmas itself and risking the family gatherings, which is what most people want to protect.

If we disagree on these matters, and we do, I hope we are wrong about where the Government's strategy will lead us. One thing is absolutely clear from the public health advice and the letter of 26 November, namely, that its caution about the strategy being pursued and some of the decisions being made by the Government is related to the ability and capacity of our health service to cope with further outbreaks and waves and particularly the resourcing and staffing of our public health teams. It seems there is absolutely no dispute about that.

In this regard, the Government is singularly failing. It is not just that we believe it is wrong in the strategy being pursued but it is failing to provide the resourcing, support and staffing that is necessary for our public health teams and health services generally to be able to deal with further waves of infections and outbreaks.

The public health teams that we praised and applauded are going on strike in January. These are the people on the front line. If we are to deliver an immunisation programme, we will do so with public health teams at one third of the recommended level of staffing and where we have treated them as second class citizens in term of their status as medical specialists. We have recruited contact tracers and testers, who we need to deal with outbreaks, on the worst temporary agency contracts, where they do not even get sick pay and they are essentially in a "hire 'em and fire 'em" position. It is not exactly the way to implement what the public health experts are saying is the much greater capacity, integration and cohesion that is required in public health teams in order to deal with Covid-19.

Finally, there is the utterly disgraceful treatment of thousands of student nurses and midwives. NPHET has also expressed concern about the high level of infections in our hospitals but the Government has removed payment for these student nurses and midwives. They are working on the front line with no payment whatever.

At the very least, will the Taoiseach accede to the demands of public health doctors? Will the Government put contact tracers and testers on decent contracts, pay and conditions? Will the Government pay the student nurses and midwives something instead of exploiting them and paying them nothing when they are working on the front line for all of us?

Comment on this

The Deputy is wrong in his various assertions. In the first instance, I do not believe in the Deputy's zero Covid approach. It is not viable in terms of our membership of the European Union, our relationship with the United Kingdom and the seamless interaction of people. We also have the Border between North and South and the fact we are not in charge of the jurisdiction public health wise in Northern Ireland. We have seen the overlap and impact there in terms of Covid-19.

The bottom line is that in tackling the second wave, we are one of the best-performing countries in Europe. The strategy that has been pursued has worked so far. It is not a matter of being in and out of lockdown. There have been two phases of very severe restrictions since the Covid-19 outbreak. The very first, as the Deputy knows, was in spring and it was very severe. The second, which ended recently, was less severe because we kept schools open. Contrary to the Deputy's comments, we also kept health services open unlike in the first phase. In the second phase, the non-Covid health services were kept open.

The second phase did not have anywhere near the same impact on hospitalisation, mortality or intensive care unit occupancy rates as the first phase. The evidence from a variety of sources, including the Central Statistics Office, NPHET and others confirms all of this. The second wave has been different. We have had the best performance globally in relation to mortality in the second wave through the various measures we introduced. That said, there can be no room for complacency.

In respect of public health, for example, in September the Minister committed to doubling the workforce in public health. There were about 254 people working in public health pre-Covid, and the Government has provided resources to double that number, and hiring has already started in relation to that. In terms of the consultant status, the Crowe Horwath report is there and the Government is acting on it. There are ongoing discussions between the Departments of Public Expenditure and Reform, and Health, but consultant posts will be created. The manner and framework through which all of that will happen is an important issue and there is much detail involved in that, which has to be worked out, but the resources are there. More than €4 billion has been put into the health service this year, which is a record figure - €2 billion for Covid, and €2 billion non-Covid - and quite extensive and significant.

On the issue of student nurses, again, it is not the same as the first phase. It is not the same at all. When the nursing degree programme was brought in in 2002 - I brought it in as Minister for Health - it was seen as a radical transformation of nurse education at the time, to put student nurses on the same par with other university students in terms of their degree and so forth and investment in facilities in all of our universities and institutes of technology. All of that happened. Negotiations and work are ongoing between the Minister for Health and the Irish Nurses and Midwives Organisation, INMO, on a variety of issues in terms of trying to support student nurses in the current climate within the hospitals, particularly, for example, the application of the pandemic unemployment payment, PUP, to student nurses who understandably have lost the jobs that they would have had at weekends because of Covid restrictions. That has now been made available to student nurses, but crucially their clinical placements in fourth year and their internships must also be protected from an education perspective. That is something that is uppermost in terms of the HSE's objective in this situation.

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