THE DEPARTMENT OF Health has published the full governance structure of the National Public Health Emergency Team (NPHET) after concerns were raised around transparency and accountability. 

NPHET, chaired by Chief Medical Officer Dr Tony Holohan, was convened at the end of January this year to coordinate the country’s response to Covid-19. 

Members of that team are now front and centre, guiding the government in its actions and driving the public messaging around Covid-19. 

Questions were raised last week by Labour leader Alan Kelly and Fianna Fáil leader Micheál Martin around NPHET’s transparency and accountability given its input into Government decisions around restrictions and public health measures. 

Let’s take a look at who sits on NPHET and its various subgroups, and what each group’s function is. 

NPHET

According to the Department of Health, NPHET for Covid-19 was established on 27 January.

It takes its lead from the World Health Organisation (WHO) and is tasked with overseeing and providing “expert advice, guidance, support and direction for the overall national response” on both a regional and national level.

There have been previous NPHETs established in Ireland in response to public health threats such as swine flu. 

Membership, as previously reported by TheJournal.ie, comprises of representatives from across the health and social care service including the Department of Health (DOH), Health Service Executive (HSE), Health Protection Surveillance Centre (HPSC), Health Information and Quality Authority (HIQA) and Health Products Regulatory Authority (HPRA).

According to the Department of Health, NPHET’s Terms of Reference include overseeing and providing direction, directing the collection and analysis of required data, directing communications at local, regional and national level and evaluating the readiness of Ireland’s health service to manage Covid-19. 

Evaluating the health service’s capacity is done with a view to standing NPHET down eventually. That decision will be made by Dr Holohan in consultation with other members. 

NPHET currently meets twice per week and, according to the Department, actions, decisions and recommendations are made by consensus of all members. 

In terms of communication and transparency, NPHET’s recommendations are sent by letter to Minister for Health Simon Harris and to the HSE CEO Paul Reid after each meeting. 

It was raised earlier this week that NPHET’s meeting minutes had not been published since 11 April. 

In response to concerns raised around transparency, Dr Holohan said earlier this week that the delay in publishing minutes was down to a “workload issue”.

According to the Department, NPHET’s Secretariat “work diligently to finalise the minutes of the meetings as quickly as possible after the meetings, bearing in mind the pace of the current pandemic public health crisis.”

Here’s a full list of who sits on NPHET:

• Dr Tony Holohan (Chair) Chief Medical Officer, Department of Health (DOH
• Prof Colm Bergin – Consultant Infectious Diseases, St. James’s Hospital and Professor of Medicine, Trinity College Dublin
• Mr Paul Bolger – Director, Resources Division, DOH
• Dr Eibhlin Connolly – Deputy Chief Medical Officer, DOH
• Ms Tracey Conroy  – A/Sec, Acute Hospitals Division, DOH
• Dr John Cuddihy  – Interim Director, Health Protection Surveillance Centre (HPSC)
• Dr Cillian de Gascun -  Director, National Virus Reference Laboratory (NVRL), UCD, Consultant Virologist
• Mr Colm Desmond – A/Sec, Corporate Legislation, Mental Health, Drugs Policy and Food Safety Division, DOH
• Dr Lorraine Doherty – National Clinical Director for Health Protection, HPSC, HSE
• Dr Mary Favier – President Irish College of General Practitioners (ICGP)
• Dr Ronan Glynn  – Deputy Chief Medical Officer, DOH
• Mr Fergal Goodman – A/Sec, Primary Care Division, DOH
• Dr Colm Henry – Chief Clinical Officer, HSE
• Dr Kevin Kelleher – Asst. National Director, Public Health, HSE
• Ms Marita Kinsella – Director, National Patient Safety Office, DOH
• Mr David Leach – Deputy National Director of Communications, HSE
• Dr Kathleen Mac Lellan – A/Sec, Social Care Division, DOH
• Dr Jeanette Mc Callion – Medical Assessor, Health Products Regulatory Authority (HPRA)
• Mr Tom McGuinness – Asst. National Director, Office of Emergency Planning, HSE
• Dr Siobhán Ní Bhrian – Lead for Integrated Care, HSE Prof Philip Nolan President, National University of Ireland, Maynooth
• Ms Kate O’Flaherty  – Head of Health and Wellbeing, DOH
• Dr Darina O’Flanagan – Special Advisor to the NPHET, DOH
• Dr Siobhan O’Sullivan – Chief Bioethics Officer, DOH
• Dr Michael Power – National Clinical Lead, Critical Care Programme, HSE Consultant in Anaesthetics / Intensive Care Medicine, Beaumont Hospital
• Mr Phelim Quinn – Chief Executive Officer, HIQA
• Dr Máirín Ryan – Deputy Chief Executive and Director of Health Technology Assessment, HIQA
• Dr Alan Smith – Deputy Chief Medical Officer, DOH
• Dr Breda Smyth  – Director of Public Health Medicine, HSE
• Mr David Walsh – National Director, Community Operations, HSE
• Ms Deirdre Watters – Head of Communications, DOH
• Mr Liam Woods – National Director, Acute Operations, HSE 

EAG

In addition to NPHET, which currently has 32 members from across the health sector, there are a number of sub-groups working alongside it. 

This includes the Expert Advisory Group (EAG) to NPHET, chaired by Dr Cillian de Gascun, director of the National Virus Reference Laboratory at UCD, who provides an update every Tuesday on lab testing numbers and capacity.

There are 27 members of the EAG, the function of which is to monitor and review evidence as well as “identify gaps, and update and provide clear, evidence-based expert advice on preparedness and response,” according to the Department. 

There’s also the EAG Research Subgroup chaired by Professor Colm Bergin, Consultant Infectious Diseases, St. James’s Hospital and Professor of Medicine at Trinity College Dublin.

Comprised of 11 members, its role is to hone in on priority research topics, explore potential collaborative possibilities to advance Covid-19 research and to monitor and to monitor and track development at a European level. 

Subgroups 

Then there’s the Acute Hospital Preparedness Subgroup of NPHET, chaired by Tracey Conroy, Assistant Secretary, Acute Hospitals Policy Division at the Department of Health.

It was established on 3 March and its 12 members are tasked with oversight and ensuring the preparedness of the acute hospital system to deal with a significant increase in hospital admissions due to Covid-19. 

Another subgroup of NPHET is the Behavioural Change Subgroup which was established on 18 March and is made up of nine members.

Chaired by Kate O’Flaherty, Head of Health and Wellbeing at the Department of Health, this group is charged with providing advice and researching population behaviours and drivers. 

It advises the Communications Group on how best to communicate public health advice like washing hands, respiratory hygiene and social distancing. 

Next up, the Guidance and Evidence Synthesis Subgroup of NPHET, chaired by Dr Máirín Ryan, Deputy Chief Executive and Director of Health Technology Assessment at HIQA. 

This subgroup is made up of 18 members and its role is to report to NPHET on the public health and clinical guidance relating to Covid-19, currently in development and to be developed in Ireland.

Modelling Group 

To an extent, there’s some crossover on who sits on which subgroup and the heads of each subgroup also sit on NPHET. 

For instance, Professor Philip Nolan, president of the National University of Ireland in Maynooth, who also heads up the Irish Epidemiological Modelling Advisory Group.

This group comprises 25 members from across universities, HSE, Department of Health and HIQA. 

This group’s function is to capture how Covid-19 has spread throughout the Irish population and to develop the capacity to enable real-time modelling of Covid-19 in Ireland which in turn will inform NPHET’s decision-making. 

The group itself is made up of three subgroups; Epidemiology Modelling, Demand/Supply Modelling and Geospatial Mapping Modelling. 

In addition to this Modelling Group, there a further five subgroups. 

These include the Health Legislation Subgroup of NPHET (19 members), the Medicines Criticality Assessment Group (27 members), Medical Devices Criticality Assessment Group (13 members), Pandemic Ethics Advisory Group (9 members), Vulnerable People Subgroup (30 members), Health Sector Workforce Subgroup (20 members). 

As can be seen, Ireland’s response to Covid-19 is a considerable, multidisciplinary operation. 

As well as the above-mentioned groups there’s also the Special Cabinet Committee at Government, the Crisis Communications Group and the HSE National Crisis Management Team feeding into NPHET’s response and acting on its recommendations. 

To see the full details of functions and membership of each Covid-19 group, click here.