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Dáil Éireann debate -
Tuesday, 2 Mar 1999

Vol. 501 No. 3

Priority Questions. - Nursing Training.

Alan Shatter

Question:

46 Mr. Shatter asked the Minister for Health and Children if he will discharge the fees payable by student nurses undertaking a fourth year nursing undergraduate degree course and render them eligible for maintenance grants in view of the nursing shortages in hospitals and the proposal of the Commission on Nursing that a nationwide nursing degree programme be put in place to commence in 2002, to be funded in the same way as other undergraduate degree programmes in conjunction with the Department of Education and Science. [4766/99]

I presume the Deputy is referring to the one year full-time degree course which the National University of Ireland, Galway, is offering to students who have successfully completed the nursing registration-diploma programmes, the first of which was introduced in 1994.

Successful completion by a student of the three-year nursing registration-diploma programme leads to registration as a nurse with An Bord Altranais, at which point he or she will become eligible for employment as a nurse. Since a degree in nursing is not a requirement for registration as a nurse and subsequent employment, such a qualification would be an optional post-registration qualification. Members of the nursing profession wishing to undertake a nursing degree programme, therefore, are responsible for making their own arrangements, including the payment of course fees. I am not in a position to provide funding for these courses.

As the Deputy will be aware, the whole area of pre-registration nursing education and training was examined in depth by the Commission on Nursing. The commission recommended that the future framework for the pre-registration education of nurses should be based on a four-year degree programme in each of the disciplines of general, psychiatric and mental handicap nursing, approved by An Bord Altranais, which will encompass clinical placements, including 12 months continuous clinical placement as a paid employee of the health service. The commission envisaged that the start of the academic year in 2002 would be specified as the commencement date of the proposed new degree programme.

As a first step, the commission recommended that a representative nursing education forum be established to prepare a strategy for moving pre-registration nursing education and training to a four-year degree programme in time for the intake of nursing students in 2002. I have established this forum which is chaired by Dr. Laraine Joyce, deputy director of the Office for Health Management. It includes representatives of the schools of nursing, health service providers, third level institutions and An Bord Altranais. A majority of the members of the forum are members of the nursing profession. The forum held its first meeting on 10 February and is proceeding with its work.

The provision of funding for an undergraduate degree course in nursing, similar to that being provided at the National University of Ireland, Galway, would not improve the current situation vis-à-vis the shortage of nurses. In fact, it would have the opposite effect. As I stated earlier, successful completion by a student of the three-year nursing diploma programme leads to registration as a nurse with An Bord Altranais, at which point he or she will become eligible for employment as a nurse. A further year of studies would reduce the number of nurses available for employment and only serve to exacerbate the current problems the agencies have in relation to the recruitment of nurses.

The Commission on Nursing considered this difficulty when making its decision regarding the introduction of the four-year degree programme for nurses. It was for this reason it proposed that the third year of the degree course would be a 12 months continuous clinical placement as a paid employee of the health service. It should also be noted that the commission emphasised that the proposed new degree programme should not commence before the start of the academic year in 2002.

Will the Minister confirm that the proposed new degree programme will be an undergraduate programme and that the participating students will have their fees discharged by the State in the same manner as the fees of other third level undergraduate students are discharged at present?

Is the Deputy referring to the new programme?

As the Deputy is aware, financial supports were available for students undertaking diploma programmes. They received an annual maintenance grant and other financial supports. The value of the grant was £2,500 when first introduced in 1994. It remained at that level until 1998 when it was increased by 20 per cent to its current level of £3,000. I announced on 20 January a further increase, giving a total of £3,250 with effect from 1 April next. This maintenance grant is not subject to a means test and will have been increased by 30 per cent in the lifetime of the Government.

Since the abolition of third level fees does not extend to the nursing diploma programmes, the student nurses' fees continue to be paid by the relevant health agency on their behalf. The average annual fee is approximately £1,350. There is also a book allowance and other allowances which bring the average annual total value of these supports to approximately £6,000 per nursing student. This compares most favourably with the level of funding available to other third level students.

I presume I am correct in assuming that from 2002 the fees of students attending the undergraduate degree course will be met by the State. It is an even greater anomaly that the same privilege is not extended to the nurses who have completed the diploma course and who are now doing the one year undergraduate course. The additional year will result in their having an extra qualification which ultimately will be to the benefit of the health service.

The nursing education forum is meeting to decide the basis on which we will move to the degree programme from 2002. It may involve the abolition of fees or a continuation of the payment to health agencies. This will be decided by the forum.

I have received representations regarding the particular problem which has arisen in Galway involving the students there. The NUI, Galway, effectively extended the original three-year diploma programme to a four-year degree course in 1998. It did so before the independent external evaluation of the first diploma programme, introduced in Galway on a pilot basis in 1994, was completed. The commission made it clear in its report that no third level institute or discipline should commence the programme prior to the agreed date. In making this point, the commission was concerned that for a third level institute or discipline to do otherwise would result in a recurrence of many of the difficulties encountered in the transition to the registration-diploma programme.

This is why I have been unable to assist the students on the course the NUI, Galway, introduced before the evaluation was completed. I provided extra money totalling £7.5 million this year for nursing education, bringing the total to approximately £32 million. However, I cannot accommodate these students.

In the context of the Minister's implementation of the recommendations of the Commission on Nursing in the education area from 2002, it is particularly anomalous that these students, who are effectively doing a four-year nursing course, must meet their fees for the final undergraduate year in Galway. In three or four years, nurses undertaking the four-year course will not have that difficulty. Will the Minister reconsider his approach to the fee issue in the context of the lead in years to the four-year undergraduate nursing degree which will come on stream in 2002? It is to the benefit of the health service that a number of nurses are participating in this fourth undergraduate year and obtaining a degree. They will ultimately use the additional knowledge to the benefit of patients under their care.

I understand the Deputy's point. However, the anomaly was not created by the Department or An Bord Altranais. In 1997 NUI, Galway, indicated to the Department that it intended to introduce a one-year full-time degree course for nursing students who had successfully completed the three-year diploma programme. They are not required to undergo this extra year to qualify as nurses. They took on this optional extra year. Up to now nurses had to fund their own postgraduate education and we are trying to address this. On the basis that NUI, Galway, introduced the course—

It pre-empted the Department and the commission proved it right.

When the proposal was made in 1997, the Department made it clear to the college authorities that it would not be in a position to provide funding for such a course and that the approach favoured by it was the provision of part-time degree courses which would be open to graduates from the diploma programme as well as existing registered nurses. Dublin City University and Trinity College, Dublin, had already developed part-time nursing degree courses along these lines. However, NUI, Galway, proceeded to introduce the full-time degree course in January 1998 and it is offering it again this year. No other third level institution has followed NUI, Galway, in offering a full-time degree course. These types of difficulties were addressed in the commission's report. It is necessary to plan for the new graduate course from 2002 and to ensure there is no repeat of some of these anomalies, which arose because not everybody used the same starting date.

The time for Priority Questions has expired. Therefore, Questions Nos. 47 and 48 will be taken in ordinary time.

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