I welcome to the House my colleague, the Minister of State, Deputy Dillon. He is speaking on behalf of the Minister for Health, Deputy Carroll MacNeill. He will convey my sentiments to her, which I also propose to do in other forums.

It is never inappropriate to thank the healthcare workers of this country for their valiant, courageous and selfless service during the Covid-19 pandemic. It is never inappropriate and should be done on any occasion. Phil Ní Sheaghdha, the general secretary of the Irish Nurses and Midwives Organisation, INMO, and president of the Irish Congress of Trade Unions, ICTU, put it very well on the excellent "Prime Time" programme on 28 April when she said that we applauded the healthcare workers at the time of Covid and we should support into the future those who are unfortunate long-term victims.

To turn to the specific issue, long-term Covid manifests itself through fatigue, breathlessness, brain fog, persistent cough, chest pains, muscle and joint pains, loss of taste and smell, and cardiac conditions. It is not contingent on the gravity of the Covid in the first instance. In other words, somebody could have had mild Covid and still have long Covid.

Healthcare workers were at high risk during the pandemic. Studies show that close contact, inadequate protective equipment, particularly early on, and an inability to distance, because it was not possible to distance in their work situation, increased the risk. Indeed, the figures are startling. Some 10,000 healthcare personnel and social care workers contracted Covid at some point. Twenty-three healthcare workers lost their lives. More than 120, and up to 150, INMO members and social care workers remain affected with long Covid. I thank Ms Karen Eccles, who is the health and safety officer of the INMO, for supporting me with some data here. That many workers remain affected with long Covid. They want to but are unable to go back to work. Moving them to sick leave, which is proposed to happen on 1 June, will affect their mortgages, the education of their children and all the normal bills and expectations they have. It is a small number of people who are still affected at this point. A number of people with long Covid have recovered and gone back. The numbers now are quite low so the potential bill is not a big one.

Those people have financial needs. They need medical support. Without this recognition, their symptoms can be wrongly labelled and they can be considered malingerers, if people remember that term from our childhood, when, in fact, it is an unjustified tag. Recognition of their condition will result in the establishment of appropriate safety management systems for further assistance. If it could be recognised as an occupational injury, which it is, as is the case in France, Germany, Italy, Spain, South Korea and Taiwan, and we would like to think we are up there with those countries, then they could get the benefits therefrom. Those countries apply the presumption of occupational exposure leading to the injury for high-risk occupations, unless, of course, it is proven to be a bogus claim, or whatever.

Providing sick pay will allow a focus on recovery and can affect retention of healthcare workers and morale. Sick pay for healthcare workers is essential to maintaining a healthy workforce, ensuring public safety and the overall well-being of those who have been affected. Sick pay for victims of long Covid will provide financial security. The expectation of it will give job satisfaction for all because with the hantavirus recently, we do not know what is coming in the future and it is important that nurses and all healthcare workers feel they will be protected. It will affect morale. It will help to attract talent, which is an issue at the moment. There is a compelling case here. It is not a big bill. It is a moral issue. It is a responsibility of the State to deal with the issue.

I thank the Senator for raising this important Commencement matter, which provides an important opportunity to again acknowledge the very real and ongoing impact of long Covid on a small number of healthcare workers. I am, as the Senator said, taking this matter on behalf of the Minister for Health, Deputy Jennifer Carroll MacNeill, who is acutely aware that, while the acute phase of the pandemic has passed, its effects have not disappeared for everyone. Recent public discussion, including media reporting on the lived experience of people affected by long Covid, underlines the complex, unpredictable and at times debilitating nature of this condition.

We cannot forget the enormous contribution of our healthcare workers who became ill while caring for the needs of others in extraordinary circumstances that continue to be deeply challenging. From the outset of the pandemic, exceptional measures were put in place to recognise the risks faced by healthcare staff, particularly during the period before effective personal protective equipment, PPE, vaccination and widespread community transmission were established. In that context, a temporary special scheme for long Covid was introduced in July 2022 for eligible public health sector workers. That scheme was unique to the health sector and has provided sustained support at full pay for almost five years through special leave with pay initially and then the special scheme itself. While the scheme was extended on several occasions at the request of the Minister for Health, the Labour Court ultimately recommended a final extension and the scheme concluded on 31 December 2025.

It is important to be clear that the conclusion of that temporary scheme did not mean an end to supports. Staff who remained unfit to return to work moved seamlessly into the public service sick leave scheme, ensuring continuity of income protection and access to further supports. Since the conclusion of the scheme, a significant number of staff have returned to work, including on phased return arrangements, while others continue to be supported through the sick leave scheme and related provisions. Under the public service sick leave scheme, staff may access paid sick leave and, where appropriate, further supports, such as temporary rehabilitative remuneration and the critical illness protocol.

In parallel, the health service continues to focus on supporting recovery and return to work, where possible, including through reasonable workplace accommodations and adjusted duties. The Minister is very conscious, however, that for some individuals their recovery has been slower and more uncertain than initially anticipated. In light of this, the Taoiseach met with health unions on Thursday, 30 April. Following that engagement, the Taoiseach asked the HSE to ensure that management discretion under the critical illness protocol is actively and compassionately applied in cases involving long Covid so that staff continue to be supported while the Government considers what further long-term measures may be appropriate.

This matter remains under consideration across the Government, including by the Department of Health, the HSE and the Department of Social Protection, with the Minister for Health and the Minister for Social Protection having met in recent weeks to discuss ongoing supports. They welcomed the progress to date, noting that a significant number of staff have been supported in returning to work, with others continuing to receive support through the public service sick leave scheme.

It is important to note that we need to keep those who are feeling longer effects in our thoughts in this time and to acknowledge the enormous contribution and service they have given to the State.

I appreciate the Minister of State’s last remarks. I am a natural optimist and believe in a half-full glass rather than one that is half empty so I will interpret some of the coded language as suggesting that something may be done about this. In case I am wrongly interpreting it, it would be shocking if it is not. I want to make that clear. I have no ambiguity about this. It is our duty as public representatives to say what should be said. The truth is that anyone still genuinely suffering long Covid should not be stopped on 1 June from receiving full sick pay as was. I accept good supports were there but the supports for that relatively small number of people, all of them great professionals and all sending out signals to others, should continue and there should be no change in their position until they recover.

Again, I wish to assure the Senator and the House that this issue continues to receive very careful and compassionate attention at the highest level of the Government. I welcome the Taoiseach’s engagement with the nursing unions. From discussions with the Minister for Health, Deputy Carroll MacNeill, I know she is working closely with the Taoiseach’s office, the HSE and with staff representatives to monitor the position to ensure existing supports make an impact as extended but also to consider the further long-term responses that may be possible for those who are affected and that those who remain unable to return to work continue to have access to the full range of entitlements available to them and not just the public service sick leave scheme including paid sick leave, the temporary rehabilitation remuneration and, where criteria are met, the critical illness protocol. Discretion does need to be given to the HSE. I welcome the Taoiseach’s intervention in that regard.