Nphet is the beast Government created, but can it be tamed?

Ministers know they need public health team’s expertise as Omicron variant emerges

The words coming out of Dr Tony Holohan's mouth could not have been clearer: do not leak this information at all, and absolutely do not breathe a word before the Minister for Health, Stephen Donnelly has been told.

It was last Thursday afternoon and Nphet was wrapping up a meeting in which it agreed to recommend a series of additional restrictions in the lead-up to Christmas.

Going to “great pains”, Holohan declared: “This cannot leak before Stephen Donnelly sees it, and Stephen Donnelly can’t see it until late because he is in the Dáil. He almost said I beg you, he said I am pleading with you, do not.”

Total doses distributed to Ireland Total doses administered in Ireland
10,232,590 9,107,139

Extra safeguards were put in place.

READ MORE

By the time that official stepped out into the rain, however, most of the details were already being reported by major news outlets

This time the official letter which is sent from the Chief Medical Officer's office to Donnelly would not even be sent digitally by email. Instead, in the gloom of the winter night, an official was dispatched from the Department of Health to hand-deliver it to Donnelly, who had been on his feet in the Dáil all evening.

By the time that official stepped out into the rain, however, most of the details were already being reported by major news outlets. The information was out before the letter had even been put to paper.

There was “absolutely huge annoyance about this,” a Government source said. The thinking was, “this is not the way to do business.”

What followed the next day was a showdown between public health and Government, the likes of which had not been seen since the infamous Level 5 bombshell that dropped in October 2020.

As people and businesses the length and breadth of the country fretted over the clearly imminent restrictions, the Minister for Justice, Helen McEntee, appeared on the country's biggest radio show, RTÉ's Morning Ireland, to discuss a scheme for undocumented migrants. She was tackled on the letter and asked what the Government's plan would be.

“It is not helpful that I am talking to you and I haven’t seen the letter,” she said twice.

Even McEntee, a mild-mannered and level-headed politician, could not hide her evident frustration. Political insiders knew there was something brewing because, as one person put it, “that would not be Helen’s style”. She wasn’t alone.

A meeting of the Cabinet Covid-19 subcommittee was hastily convened on Friday.

‘Showdown’

The point of the meeting was to discuss the advice with Holohan, but it descended into what multiple sources have described as a “showdown” in which politicians either “read them the riot act” or “exchanged angry words”, depending on who you talk to.

Tánaiste Leo Varadkar was said to have been "clinically brutal" in his criticisms. The Minister for Finance, Paschal Donohoe, was angry too, along with McEntee and Minister for Arts Catherine Martin.

Ministers wanted to know why they were effectively the last to hear these matters of huge significance and they wanted to know why this kept happening.

There were other gripes festering: the previous evening Dr Cillian De Gascun appeared on RTÉ's Drivetime programme. He was asked about whether schools might reopen in January. He answered haltingly at first but then said he would be hopeful it could happen.

The upshot of the confrontation was that Nphet members were to be asked to route their planned interviews through the Government press office

Added to the mix was a letter addressed by Holohan to parents around the country where he wrote about a “very high incidence in the as-yet-unvaccinated 5-11 year old age group” which was “a cause for some concern”.

Ministers have often complained about feeling bounced into situations in a very public way by Nphet before they have had a chance to consider the implications, and this was the major bone of contention again.

The upshot of the confrontation was that Nphet members were to be asked to route their planned interviews through the Government press office. All week, a narrative has been allowed to form that members of the public health team would need to get their permission slip signed before they could go on the radio or TV, raising the spectre of the team being silenced.

But that is not how they see it.

Free to talk

Sources on the team say they don’t believe they have been silenced and that they feel free to talk on radio whenever they please. They say it is the Government’s fault if it mishandled the communications of what its actual plan was – to provide Nphet members with the Government position before they go on air and to have clarity on who will be appearing where.

“It is all a little bit of a manufactured storm. The Government are creating a problem that does not exist.”

Sources say that if the Government wanted to make the overall message more coherent and ensure conflicting messages aren’t going out in public then they should have “built a change over time” instead of “having a hissy fit.”

Some people on Nphet are undeterred; others are confused; most just plan on getting on with their jobs as they were.

Pragmatically, many people on the team can understand why the issue came to a head.

“I can see their issue. It is not okay to be on Morning Ireland not having seen the letter,” one figure said.

On the other side of the fence, there is still aggravation. Government figures say that while Nphet meetings have been “leaky” for quite some time, they believe it has gone “to a whole new level” in recent weeks.

There has been much chatter about uncovering the leak. On the Nphet side, members say that if anyone in Government has a suspicion about a serial leaker then they need to take that person aside and confront them because other members of the team feel their reputations are being affected by what is happening.

It is clear there is paranoia in all quarters and a tug-of-war to re-establish where the power lies.

Nphet has been referred to on more than one occasion as being the most powerful group of people in the country. Although it existed in different forms before 2020, it rose from relative obscurity to become one of the biggest beasts in the political jungle.

Passenger seat

The question has been asked: how did Nphet become so dominant? And why is it that the Government always seems to be in the passenger seat when it comes to the big decisions?

The answer is: because the Government made it so.

In the very early days of the pandemic, on March 3rd, 2020, as the caretaker administration grappled with a decision on whether the St Patrick's Day parade needed to be cancelled or not, the then minister for health, Simon Harris, said that any decisions made by the Government would be guided by public health and by science – "not by politics".

It became apparent within days exactly how serious the situation was and by March 19th the first major piece of legislation allowing for sweeping restrictions was brought before the Dáil. During that debate, Harris said that the requisite steps would not be taken “on the basis of a whim I or any of the other members may have”, but on the basis of “the best medical advice from the Chief Medical Officer so that we can do that and do it quickly. If the Department of Health and the Chief Medical Officer believe these powers are necessary in the time of a public health emergency, then I am with them all day long.”

He added that “every decision that has been made by the National Public Health Emergency Team, which is chaired by the Chief Medical Officer, has been implemented in full.”

At the end of April, five weeks into lockdown, Harris was asked about an imminent plan for the reopening of society.

“We will follow public health advice first, second and third,” he said.

From the very beginning of the pandemic, the power and centrality of Nphet was endorsed, emphasised and encouraged by Government.

It is easy to blame the Government for allowing Nphet to take on a directive role but so did the Opposition. They were both in on it

From a cursory reading of the minutes of the very first Nphet meetings, it is clear that its members did not see themselves as being the primary decision-makers. They talked about being a forum for advising on strategy and about how everything was deliberative until the Government made the final decisions.

“No one knew what they were doing, the only people who had some semblance what they were doing was public health,” a source familiar with the situation said.

“Even that was on a wing and a prayer. The Opposition were also part of the collective effort too. It is easy to blame the Government for allowing Nphet to take on a directive role but so did the Opposition. They were both in on it.

“The Government didn’t have a choice because they didn’t have the knowledge, but it suited them as well politically to hide behind it and blame Nphet.”

Simon Harris was regarded as having a close and effective relationship with both Tony Holohan and those in his office.

The arrival of Stephen Donnelly as the new Minister for Health appears to have changed that dynamic.

Problematic

His critics inside the department paint him in a problematic light as someone who has struggled to maintain proper communication with the CMO and his team. They say there used to be clear lines of communication but now it has “triangulated”, with the Department of Taoiseach stepping in to take charge on occasion. Others say he went into the role ready to “interrogate” Nphet advice, “to question it, and to say no” when it was warranted.

Regardless of any personal views, it is clear the new Government brought about a change in the relationship with Nphet at a time when we had learned a lot about the pandemic – and a lot about the cost politically, economically as well as socially.

The relationship between Government and Nphet existed in two different worlds: the early and dark days of the pandemic when no one knew what was happening; and the later days when the country had to find a way to live with Covid-19.

This is still the world we are still living in and, despite plans to disband Nphet in October (which was apparently news to Holohan and his team), rising case numbers and the threat of the new Omicron variant mean we will be hearing from the public health team for some time to come.

Ministers clearly have no Plan B for how to grapple with the coming weeks in relation to taking advice, and no alternative to Nphet. Some insiders believe that if the plan was to get the team to quieten down then this will backfire.

This is because Nphet is the beast that the Government created and its expertise will be needed in the coming weeks if a more transmissible variant is about to take off. The Government knows it, and Nphet knows it too.

Jennifer Bray

Jennifer Bray

Jennifer Bray is a Political Correspondent with The Irish Times