In an interview in last Sunday's The Sunday Times, the Taoiseach said that, "The government will introduce retrospective contact tracing of Covid cases for the first time once daily case numbers fall to manageable numbers". He went on to say that he believed that, "a robust approach to tracking the infection pathways of each case of Covid-19 backwards from the point of diagnosis [...] will help to suppress the [virus]". It is quite extraordinary that it is only talking about that approach at this point. Some 12 months into the Covid-19 pandemic, the Taoiseach is talking about tracking down where the virus is being transmitted. Some of us have been asking for that to be done for a very long time.

Retrospective tracking and tracing, of course, goes back 14 days, it establishes where the virus was picked up, whether it has come from abroad and if the transmission occurred in restaurants, family gatherings or workplaces, for example.

It is absolutely essential information for the management of a pandemic. NPHET called for that last August. Who does the Taoiseach think is going to do that work? It is essential work, but who is going to do it? Public health doctors are the people who have the expertise to carry out this work. We should, of course, have a properly resourced public health doctor service but unfortunately we do not have that at the moment. Properly resourced public health doctors are an important part of any health service but in a pandemic they are absolutely essential. Yet this service has been starved of funding for many years.

Public health is the only discipline in our health service that does not have the grade of consultant, in spite of having exactly the same qualifications. If the virus numbers are to be brought down and brought under control, a fully staffed, consultant-led regional public health team service is absolutely essential. Will the Taoiseach explain what is the delay in addressing this issue? Three major reports have recommended an upgrading of that service: the Scally report from nearly three years back; the Crowe Horwath report in December 2018; and last year's nursing home expert panel recommendation. Everybody is saying it is essential that a properly resourced public health service is put in place. Is it any wonder that doctors will not come back to work in that service here? Is it any wonder that other countries are recruiting our public health doctors? What will the Taoiseach do to resource this essential service properly? The Taoiseach has been making promises for a very long time and yet no action has been taken. Can the Taoiseach tell us when he is going to do this?

I thank Deputy Shortall for raising the issue. When the pandemic began, testing and tracing capacity within the country was virtually non-existent, in terms of the requirements to combat a pandemic. It was literally built from scratch. The Deputy is correct that for quite a number of years there has been a lack of resourcing of public health medicine in general. The Deputy will know that from her own time in government as well. I support what she has just said. In my view, very rapid progress has been made in developing a testing and tracing capacity, and particularly from the summer onwards, so much so that our testing and tracing capacity more generally is up there in the top tier of the European Union member states. It is a more independent workforce now than at the start of the pandemic when a lot of people were redeployed, of necessity, to engage in testing and tracing.

In relation to public health, the resources have now been provided in the budget. Resourcing has been provided to the HSE to recruit personnel and to double overall the staffing within the public health domain.

I agree with the Deputy on the need for a consultant-led approach to public health. A consultant-led public health model is a priority of the Government. There have been ongoing discussions between the Department of Public Expenditure and Reform and the Department of Health, and also involving the unions and the partners. I hope that those would be brought to a conclusion quickly and that the process would conclude in terms of the consultant issue in particular. The plan is to double the current workforce in public health, including an additional 255 permanent staff at an annual cost of more than €17 million. This was included in the €4 billion allocated to health for 2021 - €2 billion for Covid and €2 billion for non-Covid - which allows for the embedding of a permanent workforce in a number of areas into the future. It is not just a pandemic era investment in public health; it is for the long haul. Engagement has commenced with the Irish Medical Organisation. There are issues, while doing this, so that we also reform the public health model in line with Sláintecare. A lot of work has been undertaken by the Department and the HSE in terms of a detailed framework for the future public health model. That, of course, includes consultant level roles. That engagement has begun between the IMO, the Department and the HSE going back to January. I have asked that this would be brought to a timely conclusion. The Government is committed to doing this.

It is disappointing for the Taoiseach to portray this as engagement that began in January. This has been recommended for 15 years. Three major reports have recommended it. Since last summer, various Government spokespersons have been saying that we are nearly there and nearly reaching a conclusion. The Taoiseach drove public health doctors to the point of threatening strike action in January because of his failure to respond to this need and to actually take action on it. That strike action was called off at the last minute on the understanding that the Government would actually deliver on its promises. It still has not happened. Is the Taoiseach going to force those doctors to the point of strike action again? How long do they have to wait for action from the Government? People are fed up with these promises. This is an essential service. It should, of course, be properly resourced. It is critical that it is properly resourced when we are trying to respond adequately to a pandemic. Will the Taoiseach give us a timescale on when agreement will be reached and when funding will be made available to upgrade those doctors? They have the same qualifications as every consultant in every other discipline of medicine. Why will the Taoiseach not do this? Let us not have public health doctors going on strike in the midst of a pandemic. It would be unforgivable.

The Deputy is correct that this has been going on for 15 years, but this is the first Government that has allocated the necessary funding required to action it and to give concrete reality to all of the reports and aspirations. This Government has decided to do that and this Government has allocated the funding. The issue now is structure, framework and how it is done for the future. It must be done properly with a view to making sure not only that we have a heavily resourced service, but also that we have a very well worked out and high-quality public health service into the future that is expanded significantly on what we have today. Yes, the public health doctors are working under significant pressures and constraints right now. Of that there is no doubt. I thank them for the work they have been doing. There is engagement with the unions and their representatives. This will have to intensify. From our perspective, and from my perspective as Taoiseach, this needs to be brought to a timely conclusion.