Kelly raises questions on Covid-19 democratic accountability
23 April 2020
Party Leader and Spokesperson on Health and Disability Services
Taoiseach, since this Dáil met this day last week 4,124 more people have been diagnosed with Covid-19 and a further 337 people have sadly passed away. Our thoughts are with the families and loved ones of those who passed away and we are wishing all of those who have been diagnosed with Covid-19 symptoms a speedy recovery. I’m thinking in particular of my friend and neighbour Kieran Maguire and his family at this time.
Taoiseach, we are in the biggest public health crisis that this state has ever faced, and I want to preface what I have to say by thanking everyone who is working so hard across Government, NPHET, the HSE in this crisis and across society all the way to the retail workers in our shops who I admire so much every day. There are so many heroes out there and we truly cherish them.
However, I am seriously concerned about transparency in decision making in this crisis and I wish to concentrate on this today. When this crisis broke, we in the Labour party stood alone in asking for an Oireachtas all party committee to ensure accountability and transparency. That was dismissed by most across the house. Now I hear correctly talk of the lack of democratic accountability and lack of transparency 7 weeks later and this process which we are going through again today does not negate that fact.
I want to ask you Taoiseach about governance across this crisis and how decisions are being made.
The National Public Health Emergency Team was convened by you on 27th January 2020 for COVID-19. It was previously convened in 2019 for dealing with CPE bacterial superbug. Interestingly, the terms of reference for the CPE NPHET was significantly longer and more detailed compared to COVID (2 pages versus half a page).
A cabinet sub committee has been set up to help manage this crisis. This is serviced by a Senior Officers Group and its sub-group the Communications Group which then leads into the National Public Health Emergency Team which includes an Expert Advisory Group and has 11 sub-groups ranging from Acute Hospitals Preparedness sub group to Behavioural Change sub group and so on.
I’d like to ask the following questions Taoiseach:
- I looked up the membership of the NPHET and it seems to have grown substantially since it was set up. Did the Government agree to all the new members who joined it and if so where is this documented?
- If not, who appoints the members of NPHET? Is it a case of the Chair or other members deciding what other public health officials need to be invited? What is the process for approving new members? For example, minutes of meeting 16 note ‘Expansion of NPHET Membership. It was agreed to expand the membership of the team to include a general practitioner, an intensive care specialist and an infectious diseases consultant and invites will issue to join the meeting on Tuesday next, 3rd April 2020.’
- Only Notes are recorded of meetings. Are these actual minutes and if not why not? There is a difference. Minutes reflect the record of the meeting and must be agreed at the beginning of the next meeting. Notes could be a subjective view of what happened? Were all these notes agreed by all the participants after each meeting? Future Generations will want to know where people stood on decisions.
- Why are notes or minutes no longer being published since the end of March? I would have expected that all minutes would be published continuously given the crisis we are facing. This isn’t acceptable surely?
- There is a huge volume of people on this Committee now and no disagreements of any decisions are documented which is noteworthy. It is something I believe each member should consider as obviously all decisions will have a historical review as some stage. The issues arising in the nursing home sector being an obvious example.
- For example, on the last published meeting note, under matters arising, it said they discussed a paper for childcare for health workers (31st March). It doesn’t say why the paper wasn’t agreed to. We cannot see transparently why? This is an issue that the Government are still grappling with almost a month later?
- How many subgroups are there now in existence under NPHET? 11 are listed in the National Action Plan. There are little, or no minutes published for any of them. What are they doing, and can we see these minutes?
- Will all the market research and survey data from the communications sub-group be published? Its referenced in some minutes but not published. What is this for?
- Why is the Dept of Health Sec Gen or HSE Director General not attending? I would have thought that they would be intrinsic members of this committee. What happens if either of them disagrees with a decision of NPHET?
- When the CMO made the decision on the Late Late show or thereabouts that we would have to get to 15,000 tests a day and 100,000 a week by May 5th, did he do so with the agreement of the HSE who ultimately would be responsible for making such a testing regime possible in such a short space of time? I agree with it but I’m not sure it can be delivered by May 5th – but what I really want to know is how the decision was made and why was it made and stated publicly if the HSE didn’t feel they could deliver it? If we had minutes of course we could see this, but they don’t exist.
- Has the HSE or its Board communicated in any way to the Government, Minister for Health and/or the Department regarding their concerns over governance of decision making in this crisis and if so, will you publish such communications?
- Who is NPHET ultimately accountable to? Who makes the final decisions? Do NPHET have to consult with you or the Minister for Health before making formal announcements that affect all the citizens of this country? I presume they do. But how does that happen?
I want to make sure we have democratic accountability and scrutiny Taoiseach and to date I and believe all of us here in this house have fully trusted everyone but the lack of information on processes and decision making as I have just outlined means I have to ask these questions on behalf of the public.
Ultimate decision making cannot be in the hands of the few. Elected office cannot be subservient even in this crisis.
We have to heed public health advice - that is absolute. However, we also need to make sure that the formulas for providing this critical public health advice are working, robust and most importantly are transparent. I trust your belief that they are working but they certainly aren’t transparent.
I say all this today also as we look to chart a roadmap out of this crisis. Taoiseach it must be a roadmap decided ultimately by you and your Government and shaped by this chamber. The kite flying and mixed messaging from you and the Minister for Health last weekend must end. Remember everyone is hanging on your every word.
The roadmap must take full cognisance of NPHET views regarding COVID. However, it critically also must take cognisance of wider health concerns where participation in normal health procedures is now substantially down and screening is non-existent. This will result in a secondary effect with some of the population having negative health outcomes and loss of life resulting. The roadmap must also consider wider public concerns, both social and economic that have a wider impact on the health of our people and the future of this country. It must be holistic and that may mean on occasion you and your Government may have to balance your decisions in a way that you have not had to up to this point. I wish you well.