Ceisteanna ó Cheannairí - Leaders' Questions

Yesterday I raised with the Taoiseach the refusal of his Government to pay student nurses and midwives who have been working on the front line during this awful pandemic. I told the Taoiseach of the real anger and frustration felt by these students over the outrageous claim that they do not get paid because they do not do real work. I conveyed to the Taoiseach, in their own words, the very real work that student nurses and midwives do. The testimonies I read yesterday show that not only do student nurses and midwives do real work, they do the hardest work. They treat the sick and injured, often in the most difficult circumstances in understaffed and overcrowded hospitals. They are often on their feet for 13-hour days, rushing around performing their tasks with professionalism and compassion.

Over the last eight months, student nurses and midwives have worked incredibly hard in the battle against Covid-19 and the Taoiseach should remember that these students have stepped into the breach and it was the Government that asked them to do so. They have put their health and safety at risk, given up paid work which would pay their bills due to the risk of cross-infection. They have literally held the hands of dying Covid patients as they took their last breath, when their own family members could not be with them. Not alone is this real work and hard work, this is heroic work. Student nurses and midwives have plugged the gaps created by decades of bad health policy from Fianna Fáil and Fine Gael. They have been the glue that has held our already strained health service together during the greatest public health emergency in a century. Their dedication and work have saved lives that might have been lost. The public knows this and doctors and nurses working with these students know it; the only people who do not seem to get it is the Government.

I put their personal testimonies to the Taoiseach yesterday in the hope he would finally acknowledge their work and, more importantly, commit to paying them and paying them properly. The Taoiseach refused to do that and gave me some bogus rationale as to why it could not be done. The truth is that these students are on the roster, they are working and they should be paid. Surely the Taoiseach can accept that. As he was refusing to pay these student nurses and midwives, we hear he has delivered pay increases for already well-paid super junior Ministers and judges, along with pension increases for very well-paid former taoisigh. There is no complexity and no review on that front. It seems it is always very straightforward to cough up when it comes to those at the top. Big money for Ministers, judges and the people who once did the Taoiseach's job, but nothing for student nurses and midwives who have given their blood, sweat and tears for the health and safety of our people. This is shameful and it demonstrates once again whose side Fianna Fáil and Fine Gael are on. However, the people know who was there for them when it counted and I do not believe they will stand for this awful treatment of student nurses and midwives. The Taoiseach has a decision to make now. Will he finally tell these student nurses and midwives that they will be paid?

First, we need the truth here. The Deputy and her party campaigned for the reversal of financial emergency measures in the public interest, FEMPI, for years, from 2013 onwards. FEMPI involved payments to the people the Deputy just outlined. She knows that, of course, but it suits her to twist and distort the truth about the reversal of FEMPI cuts. Legally, in terms of those cuts, one cannot discriminate between one group and another. However, one can delay as far as legally possible, which is what the Government has done. In 2017, legislation passed by this House, which the Deputy participated in, meant that by the end of December, the remaining FEMPI cuts had to be reversed in respect of the small group left. At the time, if it had been done in 2016, it would have meant the same thing that is happening today would have happened four or five years earlier. It was delayed deliberately because they were on the higher end of the scale.

On student nurses, I never said they are not doing real work. I never used that phrase yet the Deputy comes in here and says I did. In terms of the testimonies the Deputy and other Deputies have brought forward, they should be forwarded to me and the HSE because, in some instances, they represent an abuse and exploitation of student nurses. What I said yesterday in the Dáil was not bogus. The Deputy has deliberately avoided the question of whether we want a degree programme or an apprentice model. Her line seems to be it is okay to go back to the era when nurses did menial tasks and were on the bottom rung of the ladder in our hospitals and in the medical hierarchy, deferring to consultants and so on. The idea of the introduction of a degree programme was to end that era, professionalise nursing and give opportunities in nurse education so nurses could take their rightful place in the overall structures within our health services. That was the objective and the idea behind that was that first year students would have clinical placements of six weeks at a time. They were never meant to be working during those six weeks. If nurses are rostered for a 13- or ten-hour shift, they should be paid. Nursing directors in hospitals are disputing that and the Minister for Health is investigating that.

There is a core question here. In my view, nurse education is vital for the progression and advancement of the profession so that nurses can take their rightful place in the overall framework within our hospitals. The cases referenced yesterday should be sent in and there should be an investigation because no first year student should be treating a Covid patient, which I have said repeatedly. If the Deputy has evidence that they are treating dying Covid patients, in my view, that is wrong. That is an abuse. No hospital and no director of nursing should enable that to take place, particularly in the second wave of Covid, which did not have the same impact as the first wave on hospitalisations or ICU occupancy.

We are not refusing to pay anybody. We have initiated a review of the allowances, which will be finished by the end of this month and will result in higher allowances for student nurses. We have applied the pandemic unemployment payment to student nurses who cannot work part time in other workplaces because of the fear of cross-contamination. We have also provided other financial supports to meet additional costs as a result of working in a Covid environment. That is our commitment but we also want to ring-fence student nurses from having to work in the first place. Does the Deputy accept that principle in relation to the nursing degree programme? I would like a clear statement from her in relation to that principle and its implementation with regard to the degree programme.

Here are the truths. The truth is that student nurses and midwives are working hard. The truth is that our system and the services patients rely on would grind to a halt, in some cases, without their effort. The truth is the Taoiseach has chosen to disregard and disrespect the fact that these students work extremely hard. The only abuse at play here is the abuse of not paying these student nurses and midwives for their honest effort and work. The Taoiseach says he is not refusing to pay them. The only logical conclusion, then, is that he will pay them but to pay them he must recognise their work and effort. I will state clearly that professionalisation of nursing should not be used as an alibi or a cover for pauperising these workers.

It is lost on no one that student nurses and midwives get reviews, delays and denials-----

Thank you, Deputy, but you are over time.

-----but for the great and the good, for the hoi polloi, there is no delay. They get their money. They get their increases. The sheer unfairness-----

Deputy McDonald, you are over time.

-----of that is manifest to one and all.

The Deputy is deliberately dishonest in her presentation of the story and the narrative. There was a delay for the great and the good. It was a long delay. If the Deputy had had her way, there would have been less of a delay, given her desire to reverse FEMPI a long time ago. She knows that, but she chooses not to say it. She also has refused and ignored my central point. She says that we cannot have an alibi, but it is not an alibi. She has to make up her mind about how we can create a learning environment for nursing in the modern era. I do not believe it is right that nursing degree students should have to do menial tasks left, right and centre outside their clinical placements and I do not believe the health service has to depend on a six-week clinical placement for first year students or second year students to support the service. Personnel nurse managers are employed and specifically paid to ring-fence students from having to work and ensure that they are learning while in the hospitals. Fourth year nursing students get paid. That is also being reviewed in terms of looking at an upward increase. The Deputy knows and should say that no first year student should be treating a Covid patient. No second year student should either. Nor should they be rostered for night duty.

Thank you, Taoiseach, but we are over time.

That is an exploitation and abuse of the students, but the Deputy will not call that out because it does not suit her political story.

Please, could we have a little co-operation with the time limits?

We can all agree that 2020 has been a long and strange year. This time last year, we were facing into a general election where we knew that health and housing would be significant issues, and they were. Health has been front and centre all year and there is greater public understanding of the need for a functioning health service, a proper number of ICU beds, proper bed capacity, etc. However, the housing crisis has not received the same attention this year. One of the most important things for society is citizens having secure roofs over their heads. While a substantial housing budget has been approved for 2021, how it will be spent is critical.

I am increasingly seeing new builds being long leased. Instead of the State acquiring housing under Part V agreements, it is in some cases accepting 25-year leases on a 90% of market rent, four-year review basis. At the end of the 25 years, the properties revert to their developers. This appears to be the most expensive way of delivering social housing with no asset at the end. Essentially, the State is paying the mortgage on a new house for the mortgage's duration after which ownership will revert to the developer. What happens then?

This is not only happening in respect of Part V housing. New estates are being long leased. In some parts of the country, they are being acquired by housing associations and local authorities. According to information I received in response to a recent parliamentary question, there were 2,600 leases last year and the average cost was €13,000 per annum. Assuming that cost remains the same over 25 years, it equates to €845 million, which is not too far short of €1 billion, with no assets at the end.

A spending review published by the Department of Public Expenditure and Reform last month showed that it could be up to 30% more cost efficient for a local authority to build its own housing instead of buying ready-built turnkey units. When the housing assistance payment, HAP, was introduced more than six years ago, some of us warned that if it was not accompanied by a large public housing building programme, it would become unsustainable. HAP was introduced as a short-term measure, but there is no timeline for phasing it out. Realistically, that will only happen when there is sufficient housing stock.

Large sums are being spent on homelessness. For years, many functioning families and individuals have experienced homelessness, with significant evidence of developmental delays for children and high stress levels for all involved. Dublin City Council's spending on homelessness has grown as the problem has grown, but the issue is not confined to Dublin. This spending represents approximately 20% of the council's budget for next year.

Will the spending review by the Department help to change the policy on direct builds? Will the Government undertake a review of the 25-year lease policy as a matter of urgency?

I thank the Deputy for raising the issue. The lack of housing supply across the board remains a major crisis in our society. As a result of that, I have chaired a number of housing Cabinet subcommittees, all designed to try to break up the bottlenecks and move things on as fast as we possibly can both legislatively and in terms of various projects. From the July stimulus onwards, for example, we have moved very quickly to get up to 2,500 voids back into a habitable condition prior to the end of this year. That has gone very well.

Overall, as the Deputy knows, budget 2021 provided for an unprecedented level of funding to housing problems next year, with approximately €3.3 billion available for housing delivery in 2021. That will deliver 12,750 new social homes next year. Of that, a record 9,500 will be new build homes. A total of 2,450 homes will be delivered through a range of lease schemes, including repair and lease, mortgage-to-rent and enhanced leasing while a further 15,800 households will be supported through HAP and the rental accommodation scheme, RAS.

Regarding the specific leasing scheme that the Deputy has identified, I will check that out. We have asked the Department of Housing, Local Government and Heritage, and I have asked the Minister - he is doing this - to look at every available option in the short term to acquire housing but, predominantly, to build. This is being done to get homelessness down first of all. In the context of Covid, with properties becoming available in different ways, there is an opportunity to, for example, acquire properties in the short term for single people who are homeless. That will help us to eat into the waiting list for homeless people. The Minister has gone all out with the various agencies and his Department's unit to do that. There is also social housing.

Then there is affordable housing. Significant funding has been allocated for affordable housing measures, including the shared equity scheme, the cost-rental equity loan facility, the serviced sites initiative and so forth.

One of the biggest challenges we have is capacity to deliver. That goes right through planning, right through development. I must honestly say that there will be many different schemes and many different approaches. It will not be one-size-fits-all. There is no silver bullet in terms of one particular model that will solve all of our housing problems. In my view, what is required is a multifaceted approach and different models of providing housing. I was at a Co-operative Housing Ireland estate on Monday, a fantastic scheme of 60 plus houses that it developed - they are social housing - in Carrigaline. It was supported through the capital advance leasing facility, CALF, financial system.

The point is that we will have to work at all levels. The projects that are in the pipeline, ready to go and shovel ready should be facilitated by counties up and down the country. Supply is the issue.

I have no doubt that a great deal of money will be spent next year. The one thing we cannot do is waste it; the other thing we cannot do is to take a short-term approach. Long leasing for 25 years on 90% market rents with a four-year review is an expensive way of delivering when the State does not own the asset at the end, but I am increasingly seeing it. Developers are being encouraged to choose this option for Part V housing. When we reduced the Part V obligation from 20% to 10%, the assumption was that Part V housing would deliver permanent social housing, but that will not happen.

The mortgage will be paid over 25 years. That absolutely must be looked at as a matter of urgency in terms of value for money but also good outcomes. In addition, we need to look at where the logjams are. We can throw numbers around about housing lists coming down but it is about how they are coming down. That is important as well because this money is finite. My big ask is that the Taoiseach look at this long-leasing model.

In the first instance, direct build is the preferred model in the context of social housing. That is where the focus will be and where the overwhelming allocation of resources will go. In 2021, we will see the largest State-led social housing building programme in the country's history. We will build 9,500 homes next year, which is more than any single year before that.

I will get the data for the Deputy in terms of the long-term leasing. As I said, some leasing is advisable in the context of the homelessness issue and the desire to acquire properties that have become vacant, particularly in cities, because of the impact of Covid. We are particularly anxious to secure properties that would be suitable for single people who are at risk of homelessness or who are homeless. That explains the mix, but I will get the actual data in terms of the specific leasing scheme to which the Deputy referred. On the social housing front, the predominant model will be to build houses that will remain in stock, either through approved housing bodies or local authorities.

Last Wednesday, the Taoiseach and his Government insulted the student nurses and midwives of this country by voting down the Solidarity-People Before Profit motion, which was drawn up in conjunction with those student nurses and midwives, calling for them to be paid. The Taoiseach has since insulted them by suggesting that they are not doing real work and that he is protecting their education, when we have repeatedly given him dozens of testimonies from those student nurses and midwives about the extent of their work, about how they are being exploited in terms of working with Covid-19 patients, getting Covid-19 themselves, working with the sick, the dying and mothers giving birth and about the number of hours they work. The Taoiseach has also insulted them by suggesting that they are getting allowances when huge numbers of them are not getting allowances at all. Even if they do get them, those allowances would not cover their accommodation or travel costs.

The Taoiseach has added the final insult by refusing to pay the student nurses and midwives who protected us on the front line of the Covid-19 pandemic and signing off on an unbelievable restoration of pensions and of increases of up to €15,000 for former taoisigh and civil servants who are in already in receipt of payments in excess of €100,000. That is simply shocking beyond belief. In doing this, the has further insulted those to whom I refer by betraying the promise in the section of the programme for Government relating to healthcare workers in which it is stated that the Government would reward our healthcare workers for the work they have done on the front line of Covid-19 and for their dedication and professionalism. He has betrayed what he said directly to me in this House on 20 October to the effect that he would return them to the healthcare assistant, HCA, rate of pay which had been agreed during the period of Covid-19 earlier in the year. In fact, the first thing the Government did after penning the words in the programme for Government was to take that HCA rate off them. The Taoiseach should stop with the spin, stop believing the fantasy he is being told by the HSE and listen to the voices of the student nurses and midwives.

Will the Taoiseach reinstate the HCA rate that was given to the student nurses and midwives earlier in the year and that he took back from them as one of his first actions in office? Will he dispense with the nonsense that there is a choice between getting paid and getting a degree? Even in Britain, nurses pursuing degree courses get significant bursaries and do not have to pay excessive fees. Will the Taoiseach stop insulting the intelligence of student nurses and midwives, respect the work they do and pay them for their placements?

First of all, I do not insult people. I do not go about trying to insult people. The Deputy referred to the cases raised by him, Deputy Paul Murphy and others yesterday. I told him he should send details of those cases to the HSE in the form of complaints that require investigation. It was stated here yesterday that a student nurse had to console a mother at the bedside of her dead baby. If that happened, it demands an investigation because that is an abuse of a student nurse clinical placement. It should not have happened. That is not spin. I have spoken to nurse educators across the country. I have been making a fundamental point in this regard. I made it yesterday and I make it again today. I believe in what I am saying because I brought in the programme in the first instance. If we want to change the programme and go back to the apprenticeship model, well and good; let us say that. I am genuinely of the view, however, that this would be a retrograde step for nursing.

Of course, Deputy Boyd Barrett juxtaposes this matter, as only he can, with the final of the reversal of the financial emergency measures in the public interest, FEMPI. That reversal was something he wanted to happen in 2016. He put a motion to the Dáil at that time to the effect that the FEMPI Act be repealed in its entirety. Does the Deputy know the implications of that? It would have paid the higher earners and higher pensioners back in 2016. If he had his way, they would have had their pension cuts reversed back in 2016 and not 2021, which is now the case. The only reason the Minister of Public Expenditure and Reform brought that in was because he had no legal alternative but to do so on foot of the Act that was passed in 2017. The latter states that the longest this reversal could be put off was to December 2020 and then a date would have to be named for the final reversal of FEMPI.

Maybe a bit of honesty in the debate would not go amiss from Deputy Boyd Barrett's perspective. He loves playing the divisive card and pitting one group against another. He wanted FEMPI ended in its entirety back in 2016 and stated that it was one of the hallmarks of repressive regimes, even dictatorships. He wanted it all gone in 2016, irrespective of high earners or low learners within the public service. The fact is that the reversal for highest earners have been delayed the longest period possible. I have the quotes from the Deputy. I went through his quotes at the time in the Dáil and in The Irish times. That was his position.

Coming back to the student nurses, the same applies to medical students, who have far more clinical placement hours. The same applies to pharmacology students, radiography students, physiotherapy students and occupational students. This goes to the heart of the model of education we want for healthcare personnel and professionals at all levels and in different disciplines. It is not as simple as the Deputy was trying to make out.

In the first wave, the HCA rate was paid because student nurses were formally brought on to fill rosters and to work. We have been told by nursing directors and the HSE that did not occur in the second wave of the pandemic and that the nurse education aspects of the clinical placements must be protected.

I thank the Taoiseach.

Surely, the Deputy would agree that first, second or third year students should not have to do the kind of work mentioned by the Deputy.

Taoiseach, we are over time.

He keeps ignoring that point I made to him. They should be protected.

I thank the Taoiseach. I am going to move on to the Independent-----

I am sorry, I have to respond.

I beg your pardon, Deputy Boyd Barrett.

One student said: "My name is Conor. I am a first-year nursing student. In the last week I have had to wash, feed, lift and dress Covid-positive patients unsupervised." Another, Michelle, said:

I finished my final six weeks' unpaid placement of fourth year. I was doing between 70 to 80 hours per week for six weeks, sometimes finishing placement at 8.00 p.m. and going directly into a 12-hour night duty sleepover shift, most of the time not sleeping as I had to get up and assist people with their needs.

I could go on; I have dozens of these testimonies. The Taoiseach does not need to talk to the HSE. I have invited him - and I invite him again - any day this week or in the next week to meet with the hundreds of student nurses who will give him the accounts directly of how it is systematic. It is not an isolated instance; it is systematic.

We were in favour of FEMPI restoration for nurses, teachers and ordinary low- and middle-income front-line workers who were robbed as a result of austerity cuts. We always said that nobody - politicians, top civil servants - should be getting pensions or pay from the public purse of over €100,000.

The Taoiseach should not spin that nonsense to deflect from the shocking unwillingness to pay student nurses and midwives and should instead keep to the commitment to giving them the healthcare assistant rate that the Government took off them but that they were given earlier this year.

The bottom line is that if the Deputy had had his way in 2016, the higher earning pensioners and public servants would have had their full restoration at that time.

Nonsense. Absolute nonsense.

That is a fact. One cannot legally discriminate between the two and the Deputy knows that but it does not suit him to spin it that way or to tell the truth in respect of it. He read out the case of a first-year student who had to wash, dress and feed a Covid patient. Does the Deputy think that is okay? I do not. I think it is a scandal.

It is the Government's health service.

It is a scandal that is wrong and it should be investigated. I am amazed that the Deputy thinks it is okay.

We do not think it is okay.

He does think it is okay. He is saying they should be paid. My view is they should never have been asked in the first instance to do that and I want it investigated. I want the Deputy to give me the details of that case because we need to get to the bottom of this.

I have invited the Taoiseach to meet the people involved.

I have said to the Deputy that if any hospital employs a student nurse on a roster, he or she should be paid. It is completely undermining a degree programme if he is telling me that a first year student in a clinical-----

Does the Taoiseach want to meet them?

I am not disagreeing. I am saying the Deputy is missing the point. If that happened, it is a scandal. It should not happen because it is exploiting the student and it represents an abuse of the student.

Since the pandemic began, the need for good broadband throughout the country has become more apparent. As the national broadband plan is being rolled out, there are problems with regard to tree-cutting, the polers and even the guys putting up the wires, although hopefully those problems can be overcome. It is unusual to hear contractors say that as bad as Eir was when they were working for that company, this crowd does not seem to be organised at all. That is despite €7 million having been spent, according to an article in The Irish Times yesterday, on oversight to do this properly. Hopefully, over the coming months it will be got right.

In 2017, we were all invited to Ballinasloe, where Enet and SSE were rolling out broadband. Other counties were mentioned but we were interested mostly in our own. The word, and it is still on the Department's website, was that Ballinasloe would be getting the fastest broadband speeds anywhere in the world. That was still on the website this morning. That was great, and people from different backgrounds jumped up and down. I have seen so many quotations welcoming this great announcement by the spin doctoring of the previous Government.

Garbally College, a fine college in Ballinasloe, is located beside Scoil Uí Cheithearnaigh, an Irish-speaking school that has 204 youngsters. Ballinasloe hospital is located 50 yd to the front of it, a housing estate is 50 yd to the left of it and Ardscoil Mhuire is perhaps 200 yd or 300 yd away from it. Those other schools have broadband brought to them, but funnily enough, despite appeals from the board of management, the principal and the parents' association, this school on the Gaza Strip has been left without broadband. It gets 2 Mbps. The Department, in fairness to it, has sent the school laptops and all the gear that is required. It is like sending somebody the shell of a car without the engine; that is what has happened.

To put it simply, because I know a bit about this, broadband can be brought along a duct within 50 yd from three different sides. Funnily enough, all that the Department of Educations has ever said to the school is to go back to the service provider, but the service provider has not provided for this school and those children. Those 204 children in Ballinasloe matter as much as every child in other schools.

I agree with the Deputy. All schools should get the optimal connectivity possible. We have been working with the Department involved with a view to seeing whether we can do something additional to ensure that schools in particular are connected properly and that they have access to the highest level of connectivity. I do not have the specifics on the case the Deputy identified but what he outlined is not good and needs to be dealt with. He referred to an event in 2017, which was three years ago, when he was told that Ballinasloe would have the fasted broadband anywhere in the world. Clearly, that has not yet happened. The national broadband contract was signed in November 2019, two years after that event.

The intervention area covers 1.1 million people, 540,000 premises and 100,000 businesses and farms, along with 695 schools. I do not know whether National Broadband Ireland, NBI, is the other crowd he referred to, in respect of there being one service provider versus another. The design work, we are told, is complete or ongoing in target townlands in every county, with 137,000 premises surveyed as of 3 December. The first fibre-to-home connections are expected shortly in Carrigaline and will be subject to technical testing and validation prior to a wider release in the area. I am told that to ensure swift network roll-out, NBI is taking on more subcontractors and negotiating revised timelines where possible with all third parties involved in the build. Broadband connection points are a key element of the NBP, providing high-speed broadband.

As of 3 December, some 217 broadband connection points had been installed by NBI and 59 of these are now connected with high-speed broadband through a service provider contract with Vodafone, which is managed by the Department of Rural and Community Development. Each local authority is also playing a critical part in the selection and enablement of these broadband connection points, with a broadband officer appointed in each county to help communities. In addition, school broadband connection points are being provided with high-speed broadband for educational use only, through a service provider contract managed by the Department of Education. To date, 25 schools have been connected with high-speed broadband for educational access. The budget allocated €210 million to the roll-out of the national broadband plan.

As I said earlier, I am interested in accelerating the schools programme and perhaps carrying out a discrete school-based initiative to ensure that we can advance and accelerate the programme in respect of schools. If the Deputy can forward me the details of the specifics of the case he identified, I will follow that up.

I welcome the Taoiseach’s response. It is not me talking about the fastest broadband in the world; it is on the Department's website and it was announced by a Minister. We were all invited to this great hoo-ha about what was going on. Generally, when one talks about a town, one talks about 50 km zones. As I have said, there are other providers in the town. There are four different options to ensure that those 204 children are given the same opportunities. It is sad to think that during lockdown, the teachers in question had to go to different places to teach their classes.

I will give the Taoiseach the details he requested, but I do not want one organisation simply to pass the buck to another. The Department of Education has constantly told the school to go back to the service provider. If the service provider is not fit to provide the service, the Department of Education needs to get in somebody new. I will give the Taoiseach the details and I ask him to get the Ministers, Deputies Eamon Ryan and Foley, involved to get these children what they deserve, namely, proper broadband in their school like every school in this country should have.

I agree with the sentiments articulated by the Deputy. I will engage with the Minister for Education on this, and with the Minister for the Environment, Climate and Communications and his Department.

At a recent meeting we identified the potential of doing something with the schools. The costs would not be excessive by any means. I did it once previously. As Minister for Education in the late 1990s, we connected every school to the Internet in one year through Eircom at the time. Schools should always be a priority in terms of education and the learning environment. I will certainly engage with the relevant Departments in that respect.