“That Dáil Éireann:
— 4,000 student nurses and midwives have been working on the frontline in the midst of the Covid-19 pandemic;
— these students are carrying out essential work and are compensating for the long-term understaffing of our health service as well as covering for Covid-19-related absences of qualified staff;
— 11,369 health care workers have been infected with Covid-19, 16.6 per cent of all cases in Ireland, 59 of whom were admitted to Intensive Care Units;
— the chronic understaffing of our health service was a problem before the Covid-19 pandemic, and that the necessary measures to address this understaffing have not been addressed by successive Governments;
— these students were briefly paid the Health Care Assistant (HCA) rate in Spring in recognition of the essential nature of the work, but this payment has since ceased, and they now receive no payment for their work;
— the financial cost to the students of carrying out this essential work is sizeable, with many students paying well over and above their travel and accommodation allowances to simply be able to attend the workplace;
— the personal and mental health cost to student nurses and midwives working in such high stress and high-pressure jobs are enormous, as well as the obvious risks to their health and the health of their family and/or those they live with;
— even before the Covid-19 crisis, the role these students were playing in their placements was more essential work than training;
— these students are actually paying for the ‘privilege’ of doing unpaid work in their placements, with fees of between €3,000 and €7,500;
— the vast majority of these students are women and their exploitation is also a reflection of gender inequality;
— these students utterly refute the recent claim by the Minister for Health that his refusal to pay them for their placement work is in order to ‘protect their education’;
— student nurses and midwives assert their education has never been protected while on placement because of the burden of essential nursing and care work, alongside academic work, while simultaneously needing to do other jobs to survive financially;
— during the Covid-19 pandemic, the opportunity to work in other jobs to earn income and generally survive has been largely cut off because of the risk of bringing Covid-19 infection in or out of their hospital placement;
— the health services across the country have faced huge difficulties in recruiting and retaining staff for many years, due to the chaos and under-resourcing across the health service, the low pay and the long hours of work;
— many nurses, midwives and doctors emigrate to Australia and other countries, where the pay is higher, and conditions are more favourable; and
— a survey in 2018 showed that, 71 per cent of 4th year student nurses and midwives were considering leaving the country, 79 per cent of them identified increases in pay and improvements in staffing and working conditions as the required incentives to retain nurses and midwives in the public services, and 76 per cent of them found that staffing levels are not adequate to support the learning of student nurses and midwives in the clinical setting; and
calls on the Government to:
— immediately reinstate the payment of student nurses and midwives who are in placements during the Covid-19 pandemic at the HCA rate;
— urgently engage with student nurses and midwives and their union representatives to establish a bursary or payment system that will fully acknowledge the work they do in our health service and will cover the costs of travel and accommodation for the length of their placements;
— abolish all fees for students who are training to work on the frontline of the health service in order to stem the ‘brain drain’, and allow the Health Service Executive to recruit a sufficient number of staff to run our health service at safe and adequately staffed levels; and
— ensure parity of pay, conditions and esteem for nurses and midwives with all other paramedical graduates, including the 37-hour week.”
I will share time with Deputies Gino Kenny and Paul Murphy. I am moving this motion on behalf of Solidarity-People Before Profit, which has been campaigning on the issue to which it relates for quite some time now. We wanted to bring the motion before the Dáil this morning for a full debate. The purpose of the motion is to seek to end the non-payment of nurses and midwives for the work they perform in our hospitals. We appeal to all Deputies to support the motion and reject the Government's amendment.
What is the most dangerous job in Ireland in 2020? The most dangerous job is to be a healthcare worker. One in six Covid-19 cases relates to a healthcare worker. That is more than 11,000 individuals.
In June, the Oireachtas health committee heard that Ireland had the highest rate of infection among healthcare workers in the entire world. The Government amendment places a great deal of stress on the fact that the number of Covid-19 patients in the hospitals is less now than it was in the first wave in the springtime. It ignores, however, the fact that 50 nurses must still take sick leave every day because they have contracted the disease or because they are close contacts of someone else who has.
Student nurses and midwives know what it is like to be on the front line. More than 3,000 of them have been working in our hospitals in recent months alone. It is fair to say that without the effort and sacrifice of those people, our health system would have collapsed. It is also fair to say that for a student nurse or midwife, the issue of Covid-19 risk is very much an issue nowadays. Yet, these student nurses and midwives are paid precisely nothing. Think about that. Thousands of people without whose toil the health service would collapse are paid nothing. In the springtime, the Government appealed to people to come out of their houses and stand on their doorsteps to cheer and applaud our nurses. It described our healthcare workers as heroes, and yet thousands of those workers, student nurses and midwives are paid nothing. That is wrong, and Government Deputies know it is wrong.
Student nurses and midwives make big financial sacrifices just to come into the hospitals and work for nothing. Many held other jobs such as, for example, in nursing homes. They had to give up those jobs when the time came to go into the hospitals. For many, the income from those jobs they had to give up was the money that paid the rent. This is not to mention the fact that student nurse and midwives must pay fees, which are substantial and which range from €3,000 to €7,500 per year.
No doubt some Government Deputies will point to the issue of internship pay for fourth year nurses, but what about first, second and third year nurses? No doubt some of them will point to the allowance, but the allowance is modest at €50.79 per week. For many, it would not pay the parking costs in the hospitals in which they work, and only a minority of student nurses and midwives receive it.
In other countries, student nurses and midwives are paid. In Australia, student nurses and midwives are often paid more than €15 per hour. I Canada, they are paid more than €12 per hour. Here, however, a student nurse who received the allowance all year round would receive a little more than €2,500. A person would need to work for 140 years at that rate of compensation to make what the chief executive officer of the HSE makes in just one year. What does this say about our treatment of our young people? What does it say about our treatment of women? The majority of student nurses and midwives are young and the vast majority are women. Is their exploitation a reflection of gender inequality? Of course, it is; you bet your life it is.
The State has several tools at its disposal which could be used to tackle this injustice. For starters, it could immediately reinstate the payment of student nurses who are in placements during the pandemic at the healthcare assistant rate. This rate was paid to student nurses and midwives in the springtime. The arrangement has since been terminated. It can and should be reinstated. A second tool the State has at its disposal is to establish a student nurses and midwives bursary. In other words, a payment to students which would take full account of the contribution they make to our health services, and also the costs of their travel and allowance. A third tool would be to abolish student fees for those training to work on our health service's front line. There is no shortage of options.
The State will pay a price for treating student nurses and midwives in a mean fashion. Treating student nurses and midwives as skivvies might save the State some money in the short-term, but it is tremendously costly, both to our health service and our society, in the medium term or even the not-so-medium term.
In 2018, a survey was conducted which showed that 71% of all fourth year student nurses were considering leaving the country on completion of their courses and 79% identified increases in pay and improvements in staffing and conditions as required incentives for the retention of nurses and midwives within the public health services. The alienation of student midwives and nurses by the State, with its mean-minded policies, comes with a heavy price.
I understand that there are negotiations taking place between the Department and the Irish Nurses and Midwives Organisation, INMO, on the question of student nurse and midwife pay. I hope that those negotiations bear fruit soon. As I said, Solidarity-People Before Profit has been campaigning on this issue, as have student nurses. I think this is the first Dáil debate on the issue, but I stand to be corrected. If these issues are not addressed soon, I doubt very much that this will be the last debate on the matter.