Newly published letters reveal tensions between the HSE and the National Public Health Emergency Team over the State coronavirus response.

In one of the letters published this afternoon, the HSE Chief Executive Paul Reid voices his anger at the NPHET decision to announce that COVID-19 testing would be expanded to 100,000 tests per week.

He notes that he was “very much taken by surprise” at the announcement and warned that the commitment did not take into account what the HSE was capable of achieving or by when.

He said the announcement was at odds with the plan agreed upon at Cabinet committee level and in meeting with the secretary general of the Department of the Taoiseach - which would have seen the HSE taking a week to confirm its testing and tracing capacity.

Dr Tony Holohan, Chief Medical Officer, at the daily COVID-19 briefing at the Department of Health, Dublin. Picture by: Sam Boal/Rollingnews.ie

He said he was “extremely disappointed that these understandings appear not to have been respected.”

"I’m at a loss as to why this direction from the NPHET to the HSE was given and publicly communicated without completing the jointly agreed processes and without regard to appropriate governance,” he wrote.

“The directions set out effectively attempted to commit the HSE to an intensity of implementation which bears absolutely no resemblance to that which we previously discussed and has taken no account of what can be achieved by when.”

Alan Kelly speaking at the Clayton Airport Hotel. Photo by: Leah Farrell/RollingNews.ie

On The Hard Shoulder this evening, Deputy Kelly said the letters show tensions at the highest level regarding NPHETs role in decision-making.

“The HSE knew they couldn’t deliver this – so from a governance point of view this for me is completely unacceptable,” he said.

“The HSE are there to do a role - the HSE board doesn’t become defunct in this situation. In fact, if anything, we need greater governance and greater analysis of decision-making.

“I think what these letters demonstrate is the tensions between the HSE and NPHET regarding decision making, which I believe now have extended to Government as well.”

Childcare

Deputy Kelly also criticised the Dr Holohan for yesterday dismissing the Taoiseach's comments on reopening schools and crechés.

Leo Varadkar said he had been informed by the World Health Organisation and HIQA that emerging evidence suggests reopening schools and childcare facilities was “among the safest things” the State can choose to do as it eases restrictions.

Just hours later however, Dr Holohan said there were only a small number of studies that had examined the virus transmission rate among children and said he did not anticipate any changes to the current plan for reopening schools.

Deputy Kelly said the decision is up to the Government and it is not right for Dr Holohan to dismiss comments from the Taoiseach.

Communication

Speaking in the Dáil, Deputy Kelly said the situation illustrates a clear lack of communication at the highest levels of the coronavirus response.

“The CEO of the HSE is basically writing to the Secretary General of the Department of Health saying that the process they had put in place through Cabinet sub-committee and the board of the HSE is not being respected by NPHET,” he said.

Transparency

He warned that the letters were only published after “three weeks of pressure in the Dáil” and said they demonstrate the “obvious tensions between NPHET and in particular the Chief Medical Officer and the HSE.”

“What the letters show is that denials by the Government and NPHET of tensions over governance, and the testing target that was publicly set on Friday 17th April, were false,” he said.

“We still don’t know why the testing target was made public when it was obvious a pathway was still to be put in place, and that the HSE had made clear it would not be able to get to that.

“Why did the Taoiseach, Minister for Health and CMO continuously deny that such tensions existed when they obviously did.

“There is now firm evidence of NPHET announcing policy without consulting key stakeholders – the most obvious and fundamental of all being the HSE.”

Restrictions

He said he was concerned that other state departments would face the same treatment as attention turns to reopening the economy.

“I am concerned that we will face the same issue with wider stakeholders now that NPHET advice has to be balanced against non-COVID mortality and the economic and social reopening of the country,” he said.

The Health Minister Simon Harris played down any rift, noting that a number of HSE officials are members of NPHET.