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Coiste Speisialta Um Fhreagra Ar Covid-19

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Coiste Speisialta Um Fhreagra Ar Covid-19 DÁIL ÉIREANN COISTE SPEISIALTA UM FHREAGRA AR COVID-19 SPECIAL COMMITTEE ON COVID-19 RESPONSE Déardaoin, 18 Meitheamh 2020 Thursday, 18 June 2020 Tháinig an Coiste le chéile ag 11 a.m. The Committee met at 11 a.m. Comhaltaí a bhí i láthair / Members present: Teachtaí Dála / Deputies Colm Brophy, Colm Burke, Mary Butler, Holly Cairns,+ Jennifer Carroll MacNeill, Michael Collins, Catherine Connolly,+ David Cullinane, Stephen Donnelly, Mairéad Farrell,+ Aindrias Moynihan,* Fergus O’Dowd, Louise O’Reilly, Éamon Ó Cuív,+ Aengus Ó Snodaigh,+ Matt Shanahan, Róisín Shortall, Bríd Smith, Duncan Smith, Ossian Smyth. * In éagmais / In the absence of Deputy John McGuinness. + In éagmais le haghaidh cuid den choiste / In the absence for part of the meeting of Depu- ties Mary Butler, David Cullinane, Louise O’Reilly, Matt Shanahan and Róisín Shortall. Teachta / Deputy Michael McNamara sa Chathaoir / in the Chair. 1 SCR Minute’s Silence for a Member of An Garda Síochána Chairman: Before we get into the business of the committee, I invite members to stand for a minute’s silence in tribute to a member of An Garda Síochána who lost his life last night. Members rose. Business of Special Committee Chairman: We have been notified that Deputies Cairns, Ó Cuív and Aindrias Moynihan will substitute for their party colleagues today. Congregated Settings: Nursing Homes (Resumed) Chairman: I welcome our witnesses for our resumed hearing on Covid-19 outbreaks in congregated settings. We are joined by our witnesses from committee room 1 this morning. From the Department of Health we have Mr. Jim Breslin, Secretary General; Ms Kathleen Ma- cLellan, assistant secretary, social care division; and Mr. Niall Redmond, principal officer of the social care division. From the HSE we have Mr. Paul Reid, CEO; Dr. Colm Henry, chief clinical officer; and Mr. David Walsh, national director of community operations. I wish to advise the witnesses that by virtue of section 17(2)(l) of the Defamation Act 2009, witnesses are protected by absolute privilege in respect of their evidence to the committee. However, if they are directed by the committee to cease giving evidence on a particular matter and they continue to so do, they are entitled thereafter only to a qualified privilege in respect of their evidence. They are directed that only evidence connected with the subject matter of these proceedings is to be given and they are asked to respect the parliamentary practice to the effect that, where possible, they should not criticise or make charges against any person, persons or entity by name or in such a manner as to make him, her or it identifiable. Members are reminded of the provisions within Standing Order 186 that the committee shall refrain from enquiring into the merits of a policy or policies of the Government or a Minister of the Government or the merits of the objectives of such policies. We expect witnesses to an- swer questions asked by the committee clearly and with candour, but witnesses can and should expect to be treated fairly and with respect and consideration at all times in accordance with the witness protocol. I invite Mr. Breslin to make his opening statement and, as I have done previously, ask that he please limit it to five minutes as it has been circulated in advance. Mr. Jim Breslin: Since its emergence, Covid-19 has spread rapidly, presenting an unprec- edented global challenge. Of the more than eight million cases worldwide, some 25,000 have been in Ireland, where, very sadly, as of last night, 1,710 people had lost their lives. The deaths in our nursing homes are the most difficult aspect of our national experience, and each person who has died is deeply mourned by his or her family and all of us collectively. Nursing homes are what more than 30,000 of our citizens call home. Residents of nursing homes are vulner- able because of their age, underlying medical conditions and the extent of their requirement for 2 18 JUNE 2020 care involving close physical contact. The National Public Health Emergency Team, NPHET, the Department of Health, the HSE and HIQA placed a focus on supporting older people from the outset of the pandemic. Responding to Covid-19 involves an all-of-society, public health-led approach, with inter- ruption of virus transmission the main goal. Suppressing the virus in the general population is a key action to limit spread to nursing homes and other settings. In addition, specific protective measures for nursing homes were introduced, including general infection prevention, social distancing, visitor restrictions, cocooning, guidance, training, testing and enhanced HSE sup- ports for providers. The public health advice suggests that the key to protecting patients and staff in nursing home settings is to follow the whole package of infection control. Compliance with infection control standards forms part of the legal responsibilities of persons in charge of nursing homes. Whereas Ireland recorded its first case of Covid-19 on 29 February, it was not until 16 March that the first case in a nursing home was notified by the Health Protection Surveillance Centre, HPSC. Cases peaked in the general population on 28 March but, around this time, cases in nursing homes commenced their increase in numbers. The peak in nursing homes occurred almost four weeks later on 22 April. Since then, the number of new cases has steadily declined and, today, 50% of all nursing home clusters are closed, meaning they have been Covid free for 28 days or longer. This has been a very challenging time for the residents, staff and families. Some 18% of the 30,000 residents of nursing homes have had a confirmed diagnosis of Co- vid-19. I want to recognise the enormous efforts of staff in nursing homes throughout the period and others who have supported them. Owing to their efforts, 56% of all nursing homes have remained virus free and the great majority of residents never contracted the virus. This is in the context of a highly infectious virus, much more infectious than influenza, smallpox or measles. On 29 and 30 March, the Department convened a series of meetings to examine the disease trends in nursing homes, strategies adopted to date and further measures available. The Depart- ment, HIQA, the HPSC and the HSE participated. HIQA’s regulatory programmes provide it with a unique knowledge of the nursing home sector. In response to a specific request from the Department, on 30 March HIQA provided details of nursing homes considered potentially at risk, having been found in previous inspections not to have fully met regulations in areas such as infection control and risk management. On the next day, NPHET requested HIQA to risk assess all nursing homes and liaise with nursing homes and the HSE nationally and regionally as necessary. On 3 April, HIQA established an infection prevention and control hub and com- menced a Covid-19 daily escalation pathway to the HSE, which has informed the HSE’s target- ing of supports to private nursing homes. Ireland is one of the few countries that have undertaken mass testing in nursing homes. More than 95,900 tests have been completed in long-term care settings. In addition, our com- mitment to recording all deaths associated with Covid-19 means our figures are more accurate than in many other countries. This was highlighted by Dr. David Nabarro, the WHO’s special envoy who appeared before this committee last week, who stated Ireland’s data were more “honest” than those of many other countries. Guidance, personal protective equipment, PPE, staffing, accommodation and financial sup- port issues have been addressed as speedily as possible. On 9 March, availability of PPE was provided by the HSE through local teams to private nursing homes. Up-to-date figures show that over the course of the pandemic, PPE of a value of €27 million has been provided. Fur- thermore, a €72 million temporary support package is in place. In the earliest period, the HSE 3 SCR experienced difficulties in securing supplies and scaling up testing and PPE operations. Such difficulties were experienced in many other health systems, sometimes with less success in overcoming them than the HSE achieved. Ireland will continue to manage the impact of Covid-19. It has taken the efforts of the entire country to suppress the virus in recent months, and it will take great vigilance on all our parts to prevent a further surge in the future. The priority now is to maintain high-quality prevention measures in all healthcare settings. The recommendations of the Covid-19 nursing home expert panel established by the Minister will be available in the coming weeks to provide further guid- ance in respect of nursing homes. The social care sector in many jurisdictions has been hit hard by Covid-19. There is a need for greater integration between health and social care. Hospitals tend to be better endowed with expertise and resources, while the continuum of care for older people is not sufficiently integrated. The HSE’s mobilisation of 23 Covid-19 multidisciplinary response teams demonstrates the type of integrated approach needed. Integration of services and structures at the population level is key to the Sláintecare reform programme. It will be extremely beneficial in addressing the growing needs of our ageing population into the future. Chairman: I thank Mr. Breslin for his opening statement. I invite Mr. Paul Reid, chief ex- ecutive officer, HSE, to make his opening statement. Again, I ask that he limit it to five minutes. Mr. Paul Reid: I thank the Chairman and members for the invitation to meet the Special Committee on Covid-19 Response.
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