Transparency of decision making essential
30 April 2020
Party Leader and Spokesperson on Health and Disability Services
Remarks by Labour Party Leader Alan Kelly in Dáil Éireann during Leader Statements on Thursday 30th April
"I want to pay my respects to all the people who have lost their lives and their families. May those who have died rest in peace. I also again thank all the workers making such sacrifices for us all. Coming up to May Day, I hope that will be acknowledged in some significant way this year above all years.
"There are four areas I will speak to today. The first relates to the transparency of the Government's actions and the second relates to testing and Government contributions around that. The third area relates to how we all use language and the fourth area relates to the Taoiseach's proposed roadmap.
"Last week I asked a number of questions regarding transparency of decision making. I again restate my support for the National Public Health Emergency Team, NPHET. Last night the Taoiseach wrote to me in reply to some of my questions except he did not answer them. I will write to him again. I still do not know why minutes are not recorded from the beginning of every meeting and signed off afterwards. I still do not know how people are appointed to NPHET. The letters from the Chief Executive and Chairperson of the Health Service Executive, HSE, to the Minister for Health and his Department regarding concerns around governance have still not been published. Please publish these letters. On behalf of the people of Ireland I ask for this to be done in a transparent way. What is there to hide?
"Since last week I have been inundated by people asking about the transparency of decision making. People are concerned about this now more than ever. Transparency is not a luxury in our democracy. There must also be rebalancing in democratic accountability; it is fantastic that so many members of NPHET appear in the media but the odd time they need to appear before some formation of these Houses. We have received unpublished legal advice given to the Business Committee on how we can meet but what the Labour Party raised at the beginning of this matter on setting up a committee on Covid-19 must be realised. The laws allow this to happen and it should happen imminently. It happens in New Zealand and it even happens in the United Kingdom.
"In a letter to the President of the European Commission, the European Ombudsman, Ms Emily O'Reilly, has stated that maintaining high standards of good administration may seem particularly challenging in these times but it is exactly during such times that high standards across all areas of public life are needed more than ever. She is not wrong. We must be able to speak clearly and honestly with citizens in order to maintain democratic processes and we must show everything transparently.
"I believe the Minister for Health and NPHET have overstepped the mark, legally speaking, on decision making related to testing, and this led to those letters being written. Under section 70 of the Health Act 1970, it is the function of the HSE to "make arrangements for carrying out tests on persons without charge, for the purpose of ascertaining the presence of a particular disease, defect or condition that may be prescribed". Under the 2014 Act, the Minister must lay before the Houses any general written directions regarding its statutory functions but in this case, that did not happen. The Minister prescribes the disease for which tests will occur and the HSE is responsible for making the arrangements to test for that disease. The Minister and some members of NPHET have been demanding a quantum of tests beyond the HSE's capacity without first consulting the executive.
"I have gone back to log where this requirement to meet 15,000 tests per day appeared first and it seems to have been on 18 March or 19 March, following the visit to the National Virus Reference Laboratory by the Taoiseach and the Minister for Health, Deputy Simon Harris. The Taoiseach referenced this visit a number of times. The Minister, Deputy Harris, said on the following day that the 15,000 tests target would be reached in "the next few days". Following the Chief Medical Officer's appearance on "The Late Late Show" on 17 April, the number suddenly changed to 100,000 tests per week. It was mooted that this target would need to be achieved within ten days, and the following day NPHET indicated this needed to happen urgently. We understood that the lifting of restrictions on 5 May was conditional on this happening but that now seems to have changed. It is not now conditional on that number being reached.
"During all this, bizarrely, nobody asked the HSE if it could deliver this level of testing and the answer was clearly "No". It is why those letters were written. The executive did not have control over all the labs or the other levers, and this is why it could not deliver that level of testing. Government actions throughout all this must have a basis in law and the actions with respect to the instructions to the HSE did not have that basis.
"I also raise the use of language, which is critical these days. The poet Eavan Boland passed away this week; through her poems she often indicated that the language we use is the making of us. She said that language has the power to redeem the damages that have been made. As we remember her life that quote is very apt for how we communicate in these days. At times in the past couple of weeks the kite-flying and tone from Government has simply been unacceptable. The Government, including the Taoiseach and in particular the Minister for Health, and indeed some members of NPHET have been creating a narrative that the citizens of Ireland who are doing their best to stick to the rules that are in place are in some way to blame for these restrictions not being lifted when the real reason is nothing of the sort.
"The Taoiseach cannot dangle citizens' freedom in front of them and say, "If you adhere to the rules then we'll give you your freedom." The relationship the people have with the State during this pandemic is not a transactional one; it is one that needs to be built on trust and respect. On Monday Paul Reid, the CEO of the HSE, tweeted about this in a very direct and timely way in saying, "One of the best lessons I learned in life is the difference between committment and compliance. Committment has to win hearts and minds." This is what we need to do now and not just talk about compliance." I believe we need to listen to Paul Reid much more.
"The Irish people have been very patient since 13 March when schools and crèches closed. We all know that and we thank them. What they need now is honesty and clear communication. People need hope and not to feel shamed.
"The whole pandemic, as we all know, is having an extraordinary impact on the well-being of our nation. The over-70s feel that more than most. I think of my own parents. This weekend the Government needs to give them hope more than anyone else. These people in the later years of their lives have been the most disciplined in this crisis and have contributed more than anyone else to creating this great country. Many of them now feel patronised over how they have been treated. I, for one, urge the Government to give them some hope this weekend, however small.
"On Friday when the Taoiseach updates people on restrictions and sets out a roadmap, he needs to remember that these need to be his decisions and his Government's roadmap - not NFID's or the CMO's. I do not believe we can continue with the CMO making pronouncements all the time before they are considered by the Taoiseach or the Government. I think the Taoiseach agrees with me on that. The Taoiseach needs to be holistic and assess where we are at. What will the impact of further restrictions be on the rest of our health services?
"The Taoiseach has spoken about secondary morbidity. I know of a consultant in Limerick who diagnoses cancer eight times a week but has not done so for the last four weeks. These people are walking around not knowing they have cancer. We have a lack of screening for bowel and cervical cancer. BreastCheck is not operating. We also know we have elevated mental health risks. On top of that are the socioeconomic impacts of maintaining restrictions. All of this needs to be considered and that is the Government's role.
"We need to start a conversation about what Irish society living with Covid-19 looks like, one that brings citizens with us, not making them feel like they are in the bold corner. Citizens need to see a coherent staged exit strategy from these restrictions. Businesses need to plan for the new world. Their instructions on what they need to do need to happen this weekend - not when they need to do it, but what they need to do to prepare.
"Nobody expects the Taoiseach to get everything absolutely right in the coming weeks - I certainly do not. However, we expect to see a vision from him and action from him - actions he will stand over. They are his actions and his Government's actions. We cannot allow perfection to get in the way of progress because we will not in these unusual times be in any way able to perform such an act. We need to remember that collectively we are all here to serve the citizens. This weekend those citizens need to see political direction. They need to see a plan and they deserve to be given hope. I wish the Taoiseach well."