Paul Murphy: Demands Answers on Nursing Homes and PPE
Deputy Paul Murphy pressed the Taoiseach over a national emergency in nursing homes, asking about PPE provision, staffing regimes, staff accommodation and the role of private providers. He also challenged the government on the estimated cost of leasing private hospitals, the Apple tax appeal and the involvement of Ernst & Young.
Nursing homes emergency
Murphy asked whether the Taoiseach agreed with Dr Jack Lambert that nursing homes face a national emergency and that leaving private homes responsible for staffing, infection control and PPE was "a huge disaster." The Taoiseach agreed the coronavirus is a national emergency but said the emergency extends beyond nursing homes and that he had not seen evidence showing private homes perform worse or better than public ones.
PPE, staffing and HSE guidance
Murphy called for HSE guidelines to be augmented so staff are not living in overcrowded accommodation and are not rotating between different residential care facilities, and asked for a confidential reporting procedure to HICWA for breaches. The Taoiseach said he would need to check assertions about whether nursing homes were left to provide their own PPE, stated his understanding that the HSE has been supplying PPE, and noted that staffing regulations are HICWA rules.
Private hospital leasing costs
Murphy cited a report estimating the monthly cost of leasing private hospitals at €115 million and asked whether any profit margin was built into the deal. The Taoiseach and the deputy minister described that figure as an estimate and said the agreement with private hospitals was done on a not-for-profit basis to cover costs.
Public finance and Apple tax escrow
Murphy asked whether the government would drop its appeal of the Apple tax ruling and seek to access €14.3 billion in an escrow account to help fund the crisis. The Taoiseach answered no to dropping the appeal and called the question disingenuous.
Concerns about advisory roles
Murphy repeated a question about why Ernst & Young (EY) were being involved in drafting plans for a return to "business as usual," noting EY's former role as auditors of Anglo-Irish Bank. The exchange on EY's involvement is left unresolved in the provided transcript.
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I plan to ask a question, answer, question, answer and so on. Just to the point, Taoiseach, do you agree with Dr Jack Lambert that we have a national emergency in our nursing homes? Do you agree with him that leaving the individual private nursing homes to be responsible for staffing regimes, infection control and supply of PPE, as the HSE guidelines have done, was, quote, a huge disaster? Do you agree, Taoiseach, that that is part of a process of privatisation, of not having the nursing homes as part of a national health service and the agency staff underpaid, living in overcrowded accommodation, working in multiple homes is a factor in that? And finally, Taoiseach, will you agree that the government should provide a procedure for workers in residential care facilities to confidentially report breaches of HSE guidelines to HICWA? Do you agree that the HSE guidelines should be augmented so that staff are not living in overcrowded accommodation and are not rotating between different residential care facilities? Thank you, Taoiseach. Thank you very much. I just did not have time to jot down all the Deputy's questions, so please do repeat them if I miss them. Do I agree that the coronavirus is an emergency? Absolutely. It is a national emergency. The government declared the emergency some time ago, and that emergency exists not just in nursing homes and care homes. It exists in hospitals and exists in the community as well. It is a health emergency. It is an economic emergency. It could yet become a fiscal emergency. So, yes, I agree with that. I absolutely agree with that, but I do not think the emergency is confined just to nursing homes. I think it is a wider emergency than that. In relation to our nursing homes in Ireland, as is the case in most countries, as has been the case in Ireland always, we have a mix of nursing homes. Some are provided directly by the HSE, some are voluntary, some are private for profit nursing homes. I have yet to see any evidence that indicates that the proportion of cases in nursing homes that are private versus public is higher or vice versa, or that the number of deaths per population in private versus public is higher or lower. I know people have views on this, but I would like to base views and opinions on facts. I have yet to see any facts that show that the private or public ones are performing better or worse than each other in terms of the number of cases or the number of deaths. I think, again, I would ask people not to jump to those kind of conclusions if the facts are not there and also to be responsible in their commentary. As I said earlier, there are lots of people in nursing homes, in care homes who are terrified about getting the virus and lots of people who are relatives and friends who are worried for them. We should make sure what we do and say is entirely fact-faculate. The Dr. Downers said leaving the individual of private nursing homes responsible for staffing regimes, infection control and supply of PPE, as the HSE guidelines have done, was a huge disaster. Do you agree with that or not? Dr. Thanks, Deputy. Dr. Thanks, Deputy. I cannot give you a straight answer to that. I do not know if that is correct. I would have to check the HSE guidelines. I am not sure if it is actually correct that that assertion is factually true. It may be correct, but I would have to check whether it was left to nursing homes to provide their own PPE. My understanding is that the HSE has been providing PPE to private nursing homes. My understanding is that there are regulations around staffing schedules and they are HICWA regulations, not HSE ones, but I would honestly have to check whether those assertions are true or not before I could say whether I agree or not. To move on to the deal with the private hospitals, it is reported in a newspaper today that the estimated monthly cost of the leasing of private hospitals will be €115 million. Is that accurate? Again, a simple yes-no answer, not a kicking to something that is going to be published at some time. Is it accurate that €115 million will be given a month to private hospitals? If it is accurate, is there a profit margin built into that? In other words, are some people going to get rich off of dealing with this massive health emergency? Mr Deputy Minister, that is an estimate. It is as accurate as any estimate can be, if that answers your question. It may be right or wrong, but it is an accurate estimate. It is not necessarily what the accurate cost will be, because we will not know that until the end. That costs have to be calculated, but the agreement that was made between the HSC and the private hospital association was done that this would be done on a not-for-profit basis, so it is the covering of the costs of the hospitals. The Taoiseach himself on St Patrick's Day said that the bill will be enormous. That is a bill for the immediate health costs. It is also a bill for the economic consequences that flow from that. Obviously, a key question that is going to be posed is who is going to pay that bill. The attitude of the Government and what has happened so far is not particularly hopeful. When you look at the clear approval of the change by revenue of the rules in terms of tax exiles, so they are not discommoded by the coronavirus crisis, they are able to continue in that state. The question I will ask very simply is, will the Government drop its appeal about the Apple tax ruling? Will it instead seek to access some or all of the €14.3 billion in an escrow account and use it in terms of this crisis? Finally, I will repeat a question that Deputy Boyd Barrett asked earlier. Why on earth are Ernst & Young, now called EY, formerly Auditors of the Anglo-Irish Bank, why on earth are they being involved in the drafting of a plan about coming back to, quote, business as usual? Thanks Deputy. The Taoiseach. Thanks Deputy. Your answer in relation to Apple is no, and I think it is a very disingenuous question and solution. The truth is whether the state withdraws its appeal or not is irrelevant. Apple is appealing this judgment as well. This will continue to be a matter for the courts for many years, no matter what the Government does. Secondly, the money has been collected, but it is in an escrow account, an escrow account that is controlled by the Bank of New York Mellon. No Government of any colour, of any party, led by anyone, would have access to that escrow account which is controlled by the Bank of New York Mellon. Those who are claiming that there is some mechanism by which we could access those billions is just being entirely disingenuous, and the public deserves better than fake solutions from people. I will have to come back to you again on the details of that. My understanding is that somebody who works for Aston Young has been retained by the HSE as a project manager. The view that the CEO of the HSE took, Paul Reid, was that we were asking the scientists and the lab managers to do too much. We were asking the same person, Kilian de Gascoune, Professor de Gascoune, a great man who runs the NVRL, the National Virus Reference Lab, to at the same time project manage the ramping up of testing across the entire country. You can only ask one person to do so much, so an experienced project manager was brought in from the outside to do it, and that is how that came about. Thank you.
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