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dail questions

'Who is NPHET ultimately accountable to?': Taoiseach questioned on governance of decision-making

‘Elected office cannot be subservient even in this crisis,’ said Labour leader Alan Kelly.

TAOISEACH LEO VARADKAR faced questions from opposition leaders today on the lack of transparency around decision-making during the Covid-19 crisis. 

Labour leader Alan Kelly questioned the make-up of the National Public Health Emergency Team (NPHET), how members were appointed and who ultimately makes decisions.

“Ultimate decision-making cannot be in the hands of the few. Elected office cannot be subservient even in this crisis,” he said.

Speaking in the Dáil today, Kelly raised issues with the governance of decision-making during the public health emergency. 

“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?” he asked.

He told the Taoiseach that the group has  grown substantially since it was convened in January with 11 sub-groups now operating. Kelly asked if the government had approved this.

What is discussed at meetings?

Kelly asked who appointed the new members of NPHET, and highlighted the lack of public transparency in relation to what is discussed at the meetings. 

He asked if the notes published are 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,” he told the Dáil.

Kelly also said that notes are no longer being published on the website.

“I would have expected that all minutes would be published continuously given the crisis we are facing. This isn’t acceptable surely,” said the Labour leader.

Disagreements on policy?

It is noteworthy that there are a lot of people on the committee yet there is no record of any disagreements on any decisions, he said.

He raised what he said was a lack of clear documentation surrounding decisions relating to nursing homes, and also stated that one note mentioned a discussion of a paper for childcare for health workers on 31 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?” said Kelly.

“What happens if the government or Secretary General of the Department of Health disagrees with a decision of NPHET?” asked Kelly, who went on to question who is in control of making decisions around new announcements and measures.

Hey questioned who signed off on the Chief Medical Officer Tony Holohan stating on the Late Late Show that 15,000 tests a day would be done, and 100,000 a week by 5 May.

“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 5 May – 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,” he said.

The Labour leader told the Taoiseach that democratic accountability and scrutiny of the Taoiseach is needed, stating that to date the Dail has “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”.

“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,” he said.

When the roadmap for the lifting of the restrictions is outlined, it must take in the view of the NPHET, he said.

“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,” he said, stating that the secondary effect will have negative health outcomes for many and the loss of life in other cases.

“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,” said Kelly.

“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,” he added.

Fianna Fáil Micheál Martin raised similar concerns, with Martin calling for proper debate about future steps.

He said there had been many occasions where parties or journalists had received negative responses or no answers when they had asked questions, “which had not allowed the issues to develop to the level of public disputes”.

The Taoiseach said he accepted the points on transparency raised by the two deputies, but asked people to understand that this is a fast-moving situation, where officials are “swamped” with emails and important documents. 

He said he wanted to be “frank and honest” about testing and possible future backlogs.

The criteria for testing will be widened, he said, but added that there is an inherent riskin widening the criteria as it may overwhelm the system again.

“We can only guess how much a change in criteria will impact on demand,” he said.

The Taoiseach said the “new enemy is complacency”. The easing of public health measures will be gradual, he said, stating it “will require continuous effort by all of us to suppress and control this virus”.

“The easing will not necessarily mirror the manner in which they were escalated,” said Varadkar, adding:

“We must have a period of time between taking each step so we can monitor the impact.”

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