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The extent of the tensions at the heart of the Government’s response to the coronavirus crisis is revealed in letters between HSE and the Department of Health.
Chief physician Hony Dr. Tony Holohan and his team were directly criticized by the HSE against Health Minister Simon Harris and his officials.
The Government has repeatedly denied that there are tensions with the almighty National Public Health Emergency Team (NPHET). But the letters released today show HSE’s anger at NPHET’s actions.
The HSE board expressed “concern” and called for “changes in the nature of the relationship between NPHET and its stakeholders, including HSE.”
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Paul Reid. Image: Photocall
In an explosive correspondence, HSE Executive Director Paul Reid said “unfortunately, I was very surprised by Dr. Holohan’s letter” about the expansion of Covid-19 testing.
The row focused on the NPHET announcement in mid-April that Covid-19 tests would be expanded to 100,000 tests per week, seven days a week for a minimum of six months. The move was announced without authorization from HSE, which is conducting the tests.
After a phone conversation that afternoon on Friday, April 17, Reid writes to the head of the Health Department that Sunday.
“I wanted to voice my concerns regarding the instructions from the National Public Health Emergency Team (NPHET) as of the previous date regarding HSE and their communications.”
Reid said he is “used to this stage” to receiving regular correspondence from NPHET through Dr. Holohan, its president.
“Generally speaking, I have a good sense of overall direction of travel before formally receiving NPHET actions which are then progressively monitored and closely monitored by the HSE National Crisis Management Team (NCMT) that I chair.
“Unfortunately, I was very surprised by Dr. Holohan’s letter of April 17, 2020 (received at 8:50 pm) and also by the NPHET press conference that preceded the letter.”
Mr. Reid says the actions are “at odds” with the process taking place at the cabinet committee level and in meetings with the country’s top official, the Taoiseach Department’s secretary general, Martin Fraser.
“They also disagree with the process established with the HSE Board,” he writes.
Reid said he attended a meeting, chaired by Fraser, on Friday, April 17, where it was agreed that the Health Department would confirm his testing and tracking capabilities a week later, on Friday, April 24.
“There was no mention in this meeting of the instructions the NPHET was to issue that night.”
A Cabinet Committee meeting is scheduled for Monday, April 20 to discuss testing and tracing capabilities. And the HSE had agreed, at the request of Dr. Holohan, to develop a document for consideration and approval at the NPHET meeting on Tuesday, April 21.
Mr. Reid said this was “not a small task” and that his staff had been “working hard” to ensure that the Department receives a response that is complete and capable of rapid implementation.
“Since all of this was agreed, I am extremely disappointed that these understandings appear to have been disregarded. I do not know why this NPHET address to HSE was given and communicated publicly without completing the jointly agreed processes and without taking proper governance into account, “he wrote.
“The established instructions effectively attempted to engage HSE at an intensity of implementation that bears absolutely no resemblance to what we discussed above and has not taken into account what can be accomplished by when.”
Mr. Reid also gave details on the challenges that HSE has been working on and continues to face in relation to increased testing and tracing capabilities.
“Overall, I think this points to the need for much greater cooperation and collaboration in NPHET decisions to work best in our collective capacities to protect the health of the population, our staff, and especially those who are most vulnerable.”
“My President, Ciarán Devane, will write separately to the Minister to express his and the Board’s concerns and request changes in the nature of the relationship between NPHET and its stakeholders, including HSE. I would like to discuss the issues raised in this letter as a matter of urgency. “
Following Mr. Reid’s letter, Mr. Devane wrote to Health Minister Simon Harris on the following Monday, April 21. He complained that NPHET did not consider HSE’s capabilities.
“For a time, it has become clear to me and to the HSE Board that operational requirements have sometimes not been adequately considered at the core of NPHET decision making.
Labor Party leader Alan Kelly, who forced the government to publish the letters, said the correspondence “demonstrates the obvious tensions between NPHET and also the CMO and HSE.”
“In particular, the April 17 decision to announce the ability to screen 15,000 people a day or 100,000 a week that HSE clearly knew they could not comply with and had led the government through a plan on what they could and would do. ” Kelly said.
“Why did the Taoiseach, the Minister of Health and the CMO continually deny that such tensions existed when they obviously existed?
“There is now strong evidence that NPHET announces the policy without consulting key stakeholders, with HSE being the most obvious and fundamental of all.
“I am concerned that we will face the same problem with broader stakeholders now that NPHET’s advice must be balanced with non-COVID mortality and the country’s economic and social reopening,” he added.
More to follow …
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