Media Release: 18 June 2020
Good morning Chairman and members. Thank you for the invitation to meet with the Special Committee on Covid-19.
I am joined by my colleagues:
- Dr Colm Henry, Chief Clinical Officer
- Mr David Walsh, National Director, Community Operations.
I wish to begin by taking the opportunity to again express my condolences to the families and relatives of those deceased as a result of Covid-19 and in particular those who were residents of nursing homes.
We have seen that the impact of Covid-19 was greatest in such settings. The experience of the outbreak across these facilities, and the immediate responses put in place by the HSE to support these services across public, private and voluntary was unprecedented.
I have submitted a detailed paper to the committee which captures the substantive ongoing level of engagement across the system between the HSE, HIQA, DOH and the private and voluntary nursing home representative group, Nursing Home Ireland (NHI).
Within this paper, I have set out the different mandates of the HSE and HIQA in relation to this sector. However, we are united in the singular mandate of safeguarding the health and well being of older persons living in long-term residential care. Indeed, a significant feature of the response to this pandemic has been the extent of the cooperation between HIQA, as the regulator, and the HSE. The knowledge of the sector, acquired by HIQA over many years through their inspectorate has been used on an ongoing basis to inform the actions and supports provided by the HSE.
The HSE Area Crisis Management Teams (ACMTs) which were formed with a specific purpose of implementing the COVID Response in turn set up COVID Response Teams. These enable the management of outbreaks of this insidious disease with absolute equity across public, private and voluntary operated services. These teams of clinical specialists provided a range of advice and support throughout the period, including onsite assessments of resident’s needs. The HSE also had to provide additional staffing, not only to its own facilities but also to private providers.
Public Health and other guidance were issued across a range of measures sometimes on a daily basis. A full nationwide PPE logistical distribution system was formulated and deployed to all providers within a very short timeframe and making, what was a scarce commodity both here and internationally, available in a fair and equitable way to support the demand in as far as possible.
Through the work of the ACMTs and the COVID Response Teams, it is fair to say that tremendous work was undertaken in conjunction with staff of these residential facilities preparing for and dealing with Covid-19 related issues. Over 80% of Long Stay Care Facilities registered with HIQA are operated by private and voluntary providers. However, the HSE’s local knowledge (supplemented by HIQA’s knowledge of the sector) and the support they provided through the Response Teams, was critical throughout the period concerned and has assisted greatly in ensuring that many of these facilities are now functioning normally once again.
The HSE did not have the opportunity of a ‘Dress Rehearsal’ to plan for and manage this crisis. COVID-19 is a Novel Virus. Information is constantly evolving on how it is transmitted and how it presents in different age groups and how it can be present in people without symptoms. As with any disease, decisions are made at a point in time based on the available evidence and knowledge.
We were receiving international advice and learnings from other countries simultaneously with our own experience of its spread across our population, and this knowledge was changing on an ongoing basis throughout.
This committee has enquired in relation to the learning from the events of the last six months so as to inform how we, as a nation, are prepared to address further outbreaks of this or other diseases. I have addressed this in my submission and it is clear that there is a requirement for very significant changes in relation to the models of care that are used in this country to care for our most vulnerable older people. These changes require a concerted effort across policymakers, regulators, providers and clinical experts to achieve a safe and sustainable model of care into the future.
Significant areas for development include:
- Assess the overall governance arrangements for Private Nursing Homes.
- Further development of HSE support structures (COVID Response Teams).
- The funding model for long term care and alternatives to longterm care.
In conclusion, I would like to pay tribute to all healthcare workers in residential care settings, the staff who volunteered to support these services at critical stages and the cooperation of the representative bodies who engaged positively with the HSE to support the flexible deployment of staff of all grades and professions. I also wish to pay tribute to the community and family volunteers who continue to provide a bedrock of support to older people both at home and in care during these difficult times.
While we currently have the virus under control it has not gone away and there is the risk of a second wave as the Country further opens the economy and society.
It is therefore vital that all of the public health advice and guidance is followed by us all so that we continue to do everything we possibly can to prevent the resurgence and spread of this deadly virus.
That concludes my statement and we are happy to take any questions.
Last updated on: 18 / 06 / 2020