Madam, – Your recent coverage of H1N1 has rightly pointed to the significant progress made by Ireland in the area of pandemic preparedness since the advent of Sars and concerns about avian influenza. It has also pointed to the commitment of Irish public health doctors to provide their services around the clock despite a failure of the Government to provide rostered “out of hours” public health cover. However, one area which your coverage has not addressed, and which the Government has abjectly failed to tackle, is the area of public health legal preparedness. Despite the 2002 Irish pandemic preparedness plan’s identification of an urgent need to review Irish public health law there has been no evidence of meaningful progress in this area.
Legal preparedness is the means by which we ensure that our public health services can act with confidence and security that what they are doing has a sound legal basis. It is also the means by which we protect the rights of those who may be subject to significant public health powers.
I was surprised to read a report of the HSE impounding an aircraft at an Irish airport (World News, April 30th). The Infectious Diseases (Aircraft) Regulations 1948 provide sweeping powers to directors of public health to deal with infection risks on aircraft. However, due to an oversight on the part of Government, those regulations have not been updated since 1948 and so the powers they provide are not available in cases either of suspected flu or Sars.
The pattern of spread of swine flu recently demonstrates what was already well known, that air travel would be a major source of global spread for any new pandemic, yet in 2008 the Government updated the Infectious Disease (Shipping) Regulations and left their aircraft equivalent untouched. With passenger numbers through Dublin Airport alone being 10 times the total number of passengers by sea, the decision to prioritise reform of the Shipping Regulations is baffling.
Mr Justice Edwards' recent High Court judgment in the case of S v HSE and Anotherdoes not make for reassuring reading either. That case concerned the power to detain and isolate a probable source of infection under section 38 of the Health Act 1947. The court held that although presently in lawful detention, the patient's original detention had been effected unlawfully. He pointed to the lamentable failure of the legislation to provide the type of safeguards expected in modern legislation.
Having come into existence at the dawn of the antibiotic era, and before Aer Lingus began trans-atlantic flights, it should not come as any surprise that Irish infectious disease law is no longer fit for purpose. As the Government’s own pandemic preparedness plan urged in 2002, it is in need of review as a matter of urgency. It is to be hoped that this current wave of H1N1 will dissipate without a significant increase in the death toll. However, even if that is the case, we will hopefully have learnt that we cannot afford to be complacent about pandemic preparedness, and we will proceed to reform our infectious disease law as a matter of urgency. – Yours, etc,