Face to face with Minister Simon Harris
Simon Harris’s popularity soared, but the handling of Covid-19 in our nursing homes has drawn criticism, writes Hugh O’Connell
TWO months ago, Simon Harris was one of the most unpopular health ministers in living memory. Now children write to him telling him they miss school, while his growing Instagram following swoons over his every word in daily video updates on the Government’s response to an unprecedented pandemic.
As hundreds are dying from what he calls a “deadly, disgusting virus”, the Health Minister has never been more popular. Asked if he is uncomfortable with this, he told the Sunday Independent: “I’m probably engaged in, jeez I certainly hope, the biggest challenge of my life and probably the lives of everyone in this country, and I just want to do it as best I can.”
But goodwill towards Mr Harris and the Government was diluted last week by the escalating crisis in nursing homes. An uncoordinated and delayed response has had deadly consequences for hundreds of our most vulnerable citizens.
Sitting in the same Department of Health room where Dr Tony Holohan, the Chief Medical Officer, delivers the grim nightly updates on new cases and new deaths, it is a good place to start a wide-ranging interview.
Hugh O’Connell: Were mistakes made in the Government’s response to nursing homes?
Simon Harris: I’m sure when we look back we will say, ‘God, I wish I had done that, or I wish I had have done this’. But what I do know is every single day in this building, people are working 24/7 following public health advice, making the best possible decisions.
HOC: But were mistakes made?
SH: I don’t believe so.
HOC: You don’t have any regrets or believe any mistakes were made in relation to nursing homes?
SH: I’m sure there will be things that we could have [done better]. But I also know that the World Health Organisation says ‘speed trumps perfection’. When you’re in a pandemic, you don’t get to sit down and plan in great detail and at great length what must we do now. You act and every day you come into work, you take more actions, and that’s what we’re doing. So every single day, you’re taking more public health actions. The day you stop is the day you lose the battle in relation to the virus.
So I know how painful this is for families right across the country. These are not statistics, they are our mums, our dads, our grannies or grandads, they’re our loved ones. But I also know that 70pc of nursing homes in Ireland today are Covid-free. So we do need to get the narrative, in terms of assuring the public, correct. We do need to actually remind people that most nursing homes today are very safe places.
But in some nursing homes, just like in some homes, just like in some communities, just like in some workplaces, we have seen the outbreak of this virus. I am going to unapologetically, as Health Minister, shine a spotlight on that, test everybody we possibly can, test them quickly, test staff, provide the PPE, do things that sadly not every other country is doing because when we get through this pandemic, we’re not going to have left anybody behind. That doesn’t mean we’re going to be able to save every life. People are dying of this pandemic in Ireland, people are dying of this virus.
HOC: Do you think anyone has died because the response to nursing homes was too slow?
SH: I don’t. I think people are dying of a pandemic that particularly preys on vulnerable older people.
But what I also know again, in this room, and there has to be a context to this discussion.
HOC: But there was conflicting advice. Private homes implemented visitor bans and then people showed up with the advice of Tony Holohan — who said initially there should be no bans — asking to be let in.
SH: They weren’t turning up for the craic. They were turning up to visit their mum or their dad and I don’t know where the public health evidence is in any figure to show that that led to the transmission of the coronavirus in nursing homes. I haven’t seen that at all. I know that Tony Holohan has to make decisions every day of the week, really tough decisions in real time that rightly will be scrutinised and he has to make those decisions on what’s in the interest of people’s overall health.
HOC: Do you think he got anything wrong?
SH: Tony Holohan is an incredible person but nobody’s absolutely perfect and I’m sure when we look back, he will look back on things, and I will look back on things, but we’re making these decisions in real time.
I think the point we need to remember is you’re talking about vulnerable people here who haven’t got a chance to see their son, their daughters, their grandkids in many weeks.
If it’s a choice you’re presenting me between taking the view of a trade body [Nursing Homes Ireland] or a public health doctor on a global pandemic, I’m going to take the side of the public health doctor every single time… Nursing Homes Ireland is an excellent organisation that represents private and voluntary nursing homes. I’ve a great relationship with them. I am having a teleconference with them twice weekly, but they’re not the public health experts... They’re the people that I’m going to be guided by.
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Mr Harris is reluctant to criticise the private nursing home sector but the criticism of his handling of the crisis has caused tension.
“I will have lots to say at the end of this pandemic, about the future of how we care for older people in this country,” he said.
He accepts the views of Mater Hospital infectious disease consultant Dr Jack Lambert — who has heavily criticised the failure to stem the spread by deploying more medical staff in homes — but said pointedly: “What he says matters, but it doesn’t mean he’s infallible.”
He said the HSE response to the disease spreading in private nursing homes was complicated by the fact it does not control these facilities and he believes greater State involvement in healthcare will eventually render the nursing home model “out of date”.
He said: “There’ll always be a place for it but positive ageing and respecting the dignity of older people will involve much more in the community rather than in any kind of building.”
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HOC: Do you accept expectations were set too high by promising 15,000 tests per day?
SH: Yeah I do … though we’re getting very close to it. I do take that criticism, but I don’t apologise for being overly ambitious.
HOC: Did you not create an expectation that ultimately you haven’t delivered on and like many things you talk about, you actually don’t deliver them?
SH: Well that’s a very broad conversation which we can get into if you want but in relation to this pandemic and in relation to our leadership in regard all of the comments that I’ve made and all of the decisions that I’ve made have been guided by public health experts. We are — again not an often commented upon fact — testing amongst the most people in the world per head population. We are consistently in the top quartile… and consistently in the top five and often the top three in the European Union. Paul Reid, the HSE CEO, said we now have the capacity to do 10,000 tests but I do need to say this to people as well: we don’t have the demand for that currently.
So, on average, about 1,200 people a day are being referred by their GP for tests and about 1,500 in our hospitals, so in and around 2,500 to 3,000 people a day. We now have the capacity to do 10,000 and next week the national public health emergency team will expand that again. But the 15,000 wasn’t plucked from the air, [it] was the figure that our doctors, our public health experts, our medical scientists wanted to be able to do. We then saw a situation where a global battle for reagent really came to the fore. So we’ve been dealing with a situation where we’ve been trying to set up systems, testing that normally would take a year in real time in the space of literally weeks and Ireland has done very well in that regard. You don’t have to take my word for it, you can look at any international league table.
HOC: Where is the contact tracing app that was announced weeks ago?
SH: I think it’s a peculiar criticism. Lots of things are being announced and lots of things are being worked on and lots of things are being delivered. It’s being delivered by the HSE and I expect it to be ready towards the end of this month or the start of May.
HOC: When it was first announced [it was said] that it would be introduced within a couple of weeks (The HSE said on March 29 it could be introduced “in the next 10 days or so”).
SH: I’m not sure. [That was] certainly not a target given by me, but I mean, the HSE are doing a really good job developing this app. It will be a potential game-changer in terms of contact tracing and public health in general.
Look at what has been delivered for a virus that we didn’t know about four months ago, no one knew of its existence. We had a general election on
February 8. I don’t ever remember being asked a question about a ventilator, or test because you didn’t know about the virus and neither did I.
Within that window of time, we’ve had a situation whereby we have built up lab capacity, we have built up community hubs, we’ve employed more people in the HSE, we’ve effectively secured 19 private hospitals for the next three months, and we have ensured universal access, whether you’re public or private, we’re treating everybody equally.
We’ve saved lives, we’ve saved loads of lives together as a people in this country, we’ve come together in a way like we’ve never ever had before.
HOC: You said that all your decisions are guided by public health advice. Are you not concerned that you are so reliant on these unelected officials who are not currently accountable to Oireachtas committees?
SH: The buck stops with me and the buck stops with the Government … So I mean, I take advice, I’m choosing to accept their advice.
HOC: Can you give me an example of any recommendation they’ve made that you haven’t implemented?
SH: Absolutely not and not only can I not give you…
HOC: A lot of people might feel uneasy with that.
SH: I think a lot of people will be really reassured by that. I think a lot of people will be really reassured that this 33-year-old from Wicklow — Health Minister — is not making the medical decisions.
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The much-anticipated lifting of restrictions will, as ever, be guided by the public health experts, Mr Harris said. While cautious about outlining a definitive roadmap or timeline, the minister has a clear idea of what could be allowed to happen in the coming weeks — and what we won’t see for the foreseeable future.
“I’d like to see a situation whereby our schools could come back or at least could come partially back. Now I can’t guarantee the timeline for this, but in terms of you’re asking me the hierarchy of things, I’d like to see comeback that would be one of them,” he said.
“That would be one of them because I think, for the mental health and wellbeing of students and parents, imagine if children could go into school, even one day a week [to] get the books, meet the teacher, get the homework for the week.
“From a socially distanced, safe point of view, meet their friends, and then go home. That would provide breathing space for families and information and I think that would help.
“I’d like to see a situation where you could expand somewhat the areas in which people can go beyond their home. I’m conscious of the fact that cocooning may well remain a reality for quite a period of time because we know people, once they reach a certain age, are vulnerable. But is there a safe way that they can get out every now and again and take a walk?”
Mr Harris said social or physical distancing will be a reality until there is a vaccine or an effective treatment — and that’s likely to be next year.
“What’s not going to come back quickly are scenarios in which we can’t safely socially distance. So I can’t see how people can be in packed pubs again as long as this virus is still with us and we don’t have a vaccine or an effective treatment,” he said.
He said it is “highly unlikely we’re going to be seeing very large mass gatherings this year”.
Mr Harris was supposed to be a groomsman at his best friend’s wedding at the start of this month.
“He was due to have his stag in Eindhoven and the first thing I had to tell him was: ‘I can’t come’.” As the restrictions came in he had to deliver the grim news that the wedding could not go ahead at all.
“It’s deferred to later this year. But normal life is on hold for everybody and they’re really difficult sacrifices for people and I don’t like to trivialise them because I know people are finding this time tough, really tough. But I do always say to people, and I do passionately believe, that the alternative is so much worse.”
Mr Harris confirmed he has not been tested for Covid-19 and is relaxed about his own political prospects. He would like to remain Minister for Health in a new government. “I believe it’s a worthwhile job and I’d love to continue doing it,” he said.
‘I can’t see people in packed pubs again as long as this virus is still with us’ ‘All of the comments I’ve made, all the decisions I’ve made, have been guided by public health experts...’