Thu, Mar 2, 2023
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Neasa raising ongoing issues around supports for healthcare workers affected by Long Covid.
Neasa Hourigan TD: In some ways, the matter I want to talk about - the ongoing issue of long Covid and how it affects healthcare workers - is related to the pressure that we see in emergency departments and hospitals because it speaks to the staffing issue we are experiencing in the health service. By “healthcare workers”, I do not just mean nurses and doctors. I also mean healthcare assistants, cleaners, housekeeping staff, catering staff, porters and every person who was expected to go to work when we were all told to stay at home, mind ourselves and cut down on our contacts. They did not just “go to work” during the middle of a global pandemic - they went into the epicentre of that pandemic. They went into places where we knew people had Covid and sometimes did so in the knowledge that the protective equipment we had given them was not adequate.
When we talk about long Covid, we are not talking about people who experience Covid and then take six, eight or 12 weeks to recover. We are talking about people who are still experiencing very severe symptoms after two or three years. We do not have a particularly good track record in this country of dealing with post-viral illness. Even though it can be nebulous to diagnose, it is very real for many people. People experience things like debilitating fatigue, difficulty getting out of bed or getting through the day, brain fog, joint pain, muscle pain, insomnia, which seems to be an issue I hear about repeatedly, and vertigo. Those are probably symptoms that all of us have experienced to some degree at some stage in our lives. However, if a person is experiencing that all day, every day, it impairs his or her ability to work.
We know that a disproportionate number of healthcare workers are experiencing long Covid. Certainly, their unions would be well able to speak around how many people are experiencing it. These people have acquired long Covid in conducting their duties as healthcare workers. In minding and looking after us, they have contracted a long-term illness that is affecting their ability to live their lives and do their work. On top of that, it is now affecting their financial security, the security of their long-term employment and their general well-being.
We recognise in this country that when you contract an illness or a condition through your work, the State should support you. We have a system of recognising prescribed diseases or illnesses, as set out in the Social Welfare Consolidation Act 2005. In section 87, it sets out two criteria. The first criterion is that the illness has been contracted as a risk during their occupation, not as a risk that is common to all.
We all accept that those who were working in emergency departments, in wards, in hospitals or in primary care, and were dealing with people who were suffering from Covid-19, were at more risk than the rest of us who got to stay at home.
The second criterion is that the illness can be reasonably attributed to their occupation. I do not think we can argue with that. People who looked after us during Covid got Covid themselves. We know that other countries have an occupational injury scheme for healthcare workers who are disproportionately affected by long Covid. France, Italy, Denmark and Sweden are doing it. It is being introduced in countries throughout Europe. The EU Strategic Framework on Health and Safety at Work 2021-2027 highlights long Covid and states that it is something we should be looking at. It does affect healthcare workers. It is a real thing. It is very easy to dismiss and it is hard to diagnose, but that does not mean that people should be put at financial risk and insecurity and employment risk in the long term for minding the rest of us.
Minister of State, Burke: I wish to respond on behalf of the Minister for Health, Deputy Stephen Donnelly. I thank Deputy Hourigan for raising this issue.
The Department of Public Expenditure and Reform introduced special Covid leave with pay for all Civil Service and public sector employees at the start of the pandemic to assist in preventing the onward spread of Covid in work premises. Currently, special Covid leave with pay applies for all cases for the duration of the self-isolation period only. Any periods of Covid-related illness which extend beyond the isolation period are treated as ordinary sick leave. A temporary 12-month scheme, specific to the public health service, was introduced to provide for paid leave for certain public health service employees who were unfit for work following a Covid infection. Employees who met the eligibility criteria for the scheme will have transferred to the scheme in July 2022. This temporary scheme, specific only to the public health sector, was introduced in recognition of the higher risk faced by certain public health service staff who were required to work on-site through the most challenging phases of the pandemic in clinically exposed Covid-19 environments.
It is our understanding that an epidemiological survey is planned by the HSE and will provide much needed insight into long Covid, which is not yet fully understood from a clinical perspective. The HSE has also commissioned a review by the Health Information and Quality Authority to assess the latest international evidence on long Covid. The EU Advisory Committee on Safety and Health at Work has recommended the recognition of Covid as an occupational illness in health and social care. However, member states vary in respect of their treatment of Covid in this regard. Officials from the Department of Health have met with officials from the Department of Social Protection who operate the national occupational injuries benefit scheme. The Department has indicated that Covid does not currently constitute a prescribed disease or illness as set out in the Social Welfare Consolidation Act 2005. I understand that the Department of Social Protection has committed to reviewing the EU committee recommendation in respect of the occupational recognition of Covid and to reporting back to the Select Committee on Social Protection, Community and Rural Development and the Islands on the matter.
As part of the Department’s review, the Minister, Deputy Humphreys, has sought input from the Minister for Health in respect of the matter. The Minister, Deputy Stephen Donnelly, has asked officials from the Department of Health to examine the options in respect of the recognition of Covid as an occupational illness in the public health service, with the intention of replying to the Minister for Social Protection on the matter without delay. The matter is currently under consideration.
Deputy Neasa Hourigan: As the Minister of State can see, the State has already recognised that healthcare workers were at higher risk through the creation of the temporary 12-month scheme and that therefore they must be treated in a certain way.
I am sure the Minister of State is aware that when people are put on standard sick pay, it essentially means they are on a pathway to medical retirement. We are talking about people who are in their 30s, 40s and 50s. Not only do they have financial burdens such as kids in school and all the rest of it, but they are also very young to be put on medical retirement. It might be that we could manage the process in a better way.
I am pleased to hear the Department of Social Protection is doing a review. I will follow up on that. I hope the Departments of Social Protection and Health are engaging with the unions on this issue because I am aware that in certain community healthcare organisations, occupational health departments are putting pressure on workers to trial a return on reduced hours and then they move off the 12-month scheme. The scheme is about to run out. While we are dilly-dallying over whether it is an occupational injury, those people are experiencing great insecurity about what the future looks like for them. It is not fair to people who have given their all in supporting us and minding us.
There are two further points that the Minister of State, Deputy Peter Burke, could pass on to the Minister, Deputy Stephen Donnelly. The first is that there seems to be a disconnect in terms of recognising long Covid. We could communicate very quickly with GPs by means of a one-page circular outlining the symptoms of long Covid and what it looks like. We know it is difficult to diagnose. It is a nebulous series of symptoms, but it is a very real thing. We could support GPs to be able to recognise it sooner and give people the security that their illness is being taken seriously. Second, we could do a number of things to provide support, such as making melatonin available without a prescription. That is the case in many European countries but not in Ireland.
Minister of State, Burke: I thank Deputy Hourigan for the very important points she has raised. I will pass them on to the Minister for Health. The Government recognises the significant role of public healthcare workers throughout the pandemic. They have gone beyond the call of duty, working at the front line, in clinically exposed environments treating Covid-positive patients in extremely difficult circumstances. Their efforts continue to be very much appreciated by the Government. Unfortunately, many front-line public health workers contracted Covid in the workplace and, as Deputy Hourigan has pointed out, some still suffer from the symptoms of long Covid. While the temporary scheme of paid leave for certain eligible health sector staff suffering with long Covid remains in place, the Minister, Deputy Stephen Donnelly, is acutely aware that this scheme concludes in three months' time. He is also mindful that the criteria for the temporary scheme meant that not all staff who contracted Covid while working in clinically exposed environments were able to access the scheme. It is noted that many of our EU member state counterparts have adopted the EU Advisory Committee on Safety and Health at Work recommendation that recognises Covid as being occupational in nature in the health sector in their respective countries and have introduced the recognition of same. However, the recognition of same varies in the approach. The Minister for Health has asked his officials to consider the matter further in light of the treatment of the issue by his EU counterparts. He has also committed to providing support to impacted staff, as appropriate, in this regard.